Efforts to improve transparency still don’t include clinical pathology lab data
Veterans, their family members and their healthcare providers can now go online to compare the performance of their local Department of Veterans Affairs (VA) hospital against other VA hospitals. This new service launched just last year.
That is when the VA opened its Hospital Compare website to the public. This important step is consistent with the VA’s declared intent to achieve total transparency in veteran’s healthcare. Pathologists and clinical laboratory managers will want to check out this website to see how the quality performance of different VA hospitals is presented to patients and the public.
Goal is to Create an Atmosphere of Trust
In a Modern Healthcare article, Robert A. Petzel , M.D., the VA’s Under Secretary for Health, said that his goal was to “create an atmosphere of trust,” with Congress, with veterans, and with anyone whose interests lay with the VA’s healthcare.
“Being transparent about your performance data,” said Petzel, “is one of the ways you build trust with those various groups.”
Pathologists and clinical laboratory managers are well aware that transparency in healthcare is becoming a driving force in their industry. In the past year, several states have gone online with their own hospital comparison websites. Dark Daily recently covered the opening of Washington State’s Quality Indicators Search Page in an article titled “Hospital Outcomes Transparency Gets New Tools in Washington State.”
The VA’s opening of a similar hospital comparison website continues to fulfill the pledge made by Secretary of Veteran’s Affairs General Eric K. Shinseki, U.S. Army (Ret.), in 2009, that the VA would be “open and accountable.”
VA Leads U.S. Healthcare with Its Constant Progress toward Transparency
The VA has come a long way since releasing its first Hospital Quality Report Card in 2008. That report delivered raw data in PDF format. Although this information was thorough and informative, it required extreme diligence to analyze. Patients needed to study it carefully to arrive at any meaningful conclusion.
The new VA Hospital Compare website presents two data sets or “dashboards.” They include:
1. “LinKS (Linking Information Knowledge and Systems). This data set summarizes outcomes in areas such as acute care, safety, intensive care, and other health measures; and,
2. “ASPIRE, which documents quality and safety goals for all VA hospitals, plus how well the hospitals are meeting those goals.”
The VA enthusiastically describes the new Hospital Compare website, writing: “Just like an auto dashboard shows how your car is driving, the public website is the VA’s ‘quality dashboard’ with goals and how well VA meets them.”
The VA’s Hospital Compare tool is divided into two areas:
1. Outcomes and Process Measures
2. Surgical Care Improvement Project (SCIP)
Outcomes and Process Measures
Similar to other hospital comparison sites, the VA compiles data on three types of medical conditions that the VA claims “give a good snapshot of the quality of care that hospitals give.” Pathologists and clinical laboratory managers will recognize that some of these medical conditions require extensive use of medical laboratory tests to properly treat the patient and deliver an improved outcome. The VA’s website includes data on these medical conditions:
1. Congestive Heart Failure
2. Heart Attack
The data is then broken out by three additional parameters:
1. Process of Care Measures2. Readmission Rates
3. Mortality Rates
The user simply selects the state and medical condition to be researched and the Hospital Compare website displays the data for all VA hospitals in that state. Process Measures data is displayed as a percentage of patients who received specific treatments, and Readmission and Mortality rates are shown as check marks under three categories:
1. Lower than National VA Rate
2. Within National VA Rate
3. Higher than National VA Rate
The VA “risk adjusts” the readmission and mortality rates to account for some hospitals treating sicker patients than others. It does this using so-called “complex math” to create a fair comparison between hospitals.
Surgical Care Improvement Project (SCIP)
Focus is on reducing preventable surgical complications due to:
• Blood clots
• Respiratory problems
Data is categorized as percentages of patients who received specific treatments.
All of the data on the VA’s Hospital Compare is calculated using the records of patients discharged from 2008 to 2009.
In its survey of this website, Dark Daily believes it could use some tweaking to make it more user friendly. However, as promised by the VA leaders, all the data is there. This data enables veterans and their families to make more informed healthcare decisions. That is the end goal of transparency.
None of the government health programs have yet to create some type of informational database on clinical laboratories. But that day grows ever nearer. Alert pathologists will note that, once the VA put up its first hospital performance data in 2008, it took less than 24 months for the VA to create a more accessible website for patients.
This could be considered an important sign that there is a commitment among the leaders of different federal health programs to be better and faster at making useful provider outcomes data available to patients via a website that is easy for consumers to navigate.