AdvaMed: Dashboard compares docs' outcomes performance, revenue generation
BOSTON—Broward Health, a Florida system with more than 30 facilities, has created and instituted a digital dashboard that compiles and reports detailed data on the economic and clinical utilization of physician performance.

Brian Bravo, director of corporate resource and materials management at Broward, described this model during an Oct. 3 presentation at the 2012 AdvaMed conference in Boston. “Data can unlock the clinical understanding of supply utilization, not just costs,” explained Bravo.

Specifically, the tool displays information about each of the system’s physicians: in-liner volume (or how many patients the individual treats), length of stay of those patients, complication rate percentage with those patients, mortality rate of those patients, age of the patient and contribution margin. The dashboard can also display these statistics with national quality comparators, as well as compare how the physician matches up with his or her peers at Broward.

While it may seem initially foreign to physicians to have their financial contribution to the hospital assessed, Bravo said it is important for them to have a better understanding of the revenue that they bring into the facility. “If the hospitals don’t stay afloat financially, you won’t have a shop to work in,” he added.

“With the click of a mouse, we could accurately and objectively benchmark our physicians,” Bravo said. The dashboard has been live for a year, and initially C-suite level executives with access to the tool didn’t do anything. But after some prompting from Bravo, they started reporting to physicians about their performance, with colleagues' names blacked out, so they understood how they matched up nationally and within the organization.

Equipped with this knowledge about who is “a core performer,” Broward administrators now discuss these performance measures with their physicians.

Also, the dashboard does not only collect data on physician performance, but it also informs the facility about its overall performance and expenses. Specifically, the dashboard collects outcomes data (complication rates, readmission rates, mortality rates, comorbid conditions and patient safety), ancillary services, length of stay and supply costs.

“All these data are available within hospital systems, but the traditional problem is the disparity between the IT systems that don’t allow the executives to pull from all of them,” Bravo said. “My department set out a few years ago to merge all these systems to create this dashboard.”

When assessing the value of purchasing new medical technology for Broward, Bravo asked: What services and value do medical device companies bring to Broward hospitals? Is the new technology worth the cost increase? In his opinion, patient outcomes are the determining factor, because ultimately reimbursement may be judged on outcomes. The dashboard allows for a comparison of technology cost vs. benefits.

“With reimbursement changes coming down the line, it’s no longer about purchasing the highest level of technology where it’s not needed, but it’s all about the patient outcomes,” said Bravo, who noted that this is what he often tells industry folks.

Specifically, he said that hospitals need to prepare for Medicare’s value-based purchasing, which will reward hospitals for high-quality care (pay for performance) by withholding money from poor performing hospitals. Scoring is based on whether a hospital meets or exceeds the performance standards.

However, Bravo sees the direction of reimbursement changes as a positive because it allows providers to look at medical technology purchases not just for the cost, but also for the outcomes they can produce. If hospitals appropriately plan for the reimbursement changes of 2015 and 2017, then they can situate themselves now for success.

“This presents a unique opportunity for providers who are empowered with the appropriate data,” he concluded.