"We tried to address a big-deal problem in a way that is very comprehensive, because we feel much of what has been said to this point has been in bits and fragments," says Gary Kaplan, MD, a member of the authoring committee as well as Chairman and CEO of Virginia Mason Health System in Seattle. Providers, payers, patients, funders, the government—everyone—has to see quality, outcomes, technology, fraud and waste in a holistic fashion.
Kaplan adds that the committee hopes "that the first thing to come from this is awareness. Too many providers are saying to themselves, 'We're alive and well; we know change is coming, but we're banking that change will be glacial, so we don't have to do much right now. We're profitable.' "
A case in point is the transition to electronic health records and the attainment of meaningful use attestation. While some providers may see these moves largely as big expenditures, for which they may recoup some federal incentive payments, they may overlook the enormous potential of using EHRs to gather real-time data on inappropriate, unnecessary or incorrect use of expensive hospital resources.
"We can know for the last 100 patients who had X procedure, we have this percent of complication. We know that in real time, not through 18-month-old data. This is not an abstraction, and can provide us with early warning signs and places where we may intervene."