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Tech Fixes for Healthcare

One of many alarming statistics in American healthcare is the number of patients who die due to medical mistakes. According to the Wall Street Journal, medical error is the sixth leading cause of death in America, ahead of Alzheimers, even. As Mark Makary argues, many of the problems stem from a lack of accountability in hospitals.

Fortunately, some relatively simple technological solutions can change this. One promising idea is the use of online “dashboards” to allow customers to better decide which hospitals to patronize:

Nothing makes hospitals shape up more quickly than this kind of public reporting. In 1989, the first year that New York’s hospitals were required to report heart-surgery death rates, the death rate by hospital ranged from 1% to 18%—a huge gap. Consumers were finally armed with useful data. They could ask: “Why have a coronary artery bypass graft operation at a place where you have a 1-in-6 chance of dying compared with a hospital with a 1-in-100 chance of dying?”

Instantly, New York heart hospitals with high mortality rates scrambled to improve; death rates declined by 83% in six years. Management at these hospitals finally asked staff what they had to do to make care safer. At some hospitals, the surgeons said they needed anesthesiologists who specialized in heart surgery; at others, nurse practitioners were brought in. At one hospital, the staff reported that a particular surgeon simply wasn’t fit to be operating. His mortality rate was so high that it was skewing the hospital’s average. Administrators ordered him to stop doing heart surgery. Goodbye, Dr. Hodad.

Another promising development has doctors filming procedures to evaluate the performance of those under them and provide helpful feedback:

Doug Rex of Indiana University—one of the most respected gastroenterologists in the world—decided to use video recording to check the thoroughness of colonoscopies being performed by doctors in his practice. A thorough colonoscopy requires meticulous scrutiny of every nook and cranny of the colon. Doctors tend to rush through them; as a result, many cancers and precancerous polyps are missed and manifest years later—at later stages.

Without telling his partners, Dr. Rex began reviewing videotapes of their procedures, measuring the time and assigning a quality score. After assessing 100 procedures, he announced to his partners that he would be timing and scoring the videos of their future procedures (even though he had already been doing this). Overnight, things changed radically. The average length of the procedures increased by 50%, and the quality scores by 30%. The doctors performed better when they knew someone was checking their work.

America’s healthcare problems are as large as ever, perhaps larger than they were before the passage of Obamacare two years ago. Fortunately, we live in an age of unprecedented, rapid technological developments, and even as our healthcare problems get worse, creative thinking abounds.

Read the whole thing.

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