Good quality information has been slow in coming in health care, mainly because not all the big players on the provider side of the equation are all that enthusiastic about having hard readings out there about mortality rates, infections, readmissions and outcomes.
Data and information is emerging, often from Medicare databases, but the pace has been anything but breath taking. Yet the growing army of consumers – estimated at more than 30 million people with personal health accounts and high deductibles – needs quality ratings on providers just as much as they need hard price information.
It can be done. It’s done in manufacturing all day, every day. Auditor teams from customers, led by black belts, descend on vendors to assess their capabilities. Either you pass the audit, or you don’t get the new business. It’s that simple.
Further, the audit teams really are there to help. They find non-conformances from best practices and they report them. Then they help with solutions to help the vendor get better.
A few years back, The Wall Street Journal sent out a top radiologist and a reporter to rate shops that did scans, such as MRIs. Astounding! They found no correlation at ten dispersed shops between quality and price. None.
Of late, the Wisconsin Collaborative on Health Care Quality has put out price and quality data on heart procedures and pneumonia treatments. Voila! Now, there’s an inverse correlation. A group of high quality hospitals charge less than low quality providers. Egad! Cheaper is better.
Remember when Toyota took over the car world with that formula: cheaper, better?
Using Toyota methods, some hospitals are going after defects, such as infections, with a vengence. They are reporting almost no infections in their operating rooms.
Would you want to know that before you have an elective surgery? Ask Jermichael Finley, the Green Bay Packer all-pro tight end. He lost a season to staph infection incurred during a relatively minor knee procedure.
Such progress or lack of progress could be dug out in short order with quality audits. (My company goes through one about every two weeks from different customers. They’re painful at first, but you get better with each one.)
Big self-insured companies could order up those audits tomorrow. They already have black belts aboard. Then they could make the results available to their employees. They don’t need to wait for government help.
Johnson Wax in Racine has been doing such audits for major procedures for years, and they steer their people to the best providers. It can be done.
Reforms always work better and faster when they come from the ground up, from the private sector. Real reform is about management science, not political science.
Quality audits for hospitals, clinics and doctors and a prerequisite for landing or retaining business would get the relationship between payers and providers straightened out in a hurry.
Note to providers: the customer is the guy who writes the check.