|
We tried a couple of different approaches: tableau reports, emailing static data to providers, sending spreadsheets of patient-level data, and building a Facebook or Twitter style feed. And then had different variations on each, and would run trials comparing different approaches. We pretty quickly found that sending data ("push") was way more effective at engagement than just having a tableau report they could go to ("pull"), even when that dashboard was linked directly within the EHR, didn't require a login, and was contextualized for the provider (basically as low friction as you could get-- they would actually venture into it 1-2 times per year). We ran a trial where we changed how we presented data: either in terms of number of patients ("screen 20 people for depression this week") or in terms of quality rates ("your depression screening rate is 40% and going up"). Keeping the data in terms of patients led to ~20% improved screening, and in the surveys led to providers expressing more trust in the data (although, they also were more likely to say they "didn't have enough data to do [their] job", despite actually doing their job better than the other group). So then we took that idea for depression screening and extended it from depression screening to chronic disease management (where the specific task for the provider is much more variable). So we had one arm where we gave them access to data marts and trained them on how to "slice and dice" the data, and then compared that against a newsfeed that had the data pre-"sliced and diced". The engagement was higher in the newsfeed group. Interestingly, the only thing the "slice and dice" group seemed to do was look for patients without a primary care doc designed in the EHR and just assign them-- in evaluating the outcomes for this, that was the single least effective intervention they could do to improve chronic disease care (and this was validated in a follow-up study looking explicitly at the impact of PCP-assignment on patient care). So, our "newsfeed" arm ended up with, on average, around 60% better outcomes than the "slice and dice" arm. What's funny is that through all of this, some of the leaders would also say "we need more data!!" But when we'd build a tableau report for them, they'd use it once or twice and then never again. Or, in one case, the leader would actually use it for ineffective purposes ("we have to assign them all PCPs!!") or for things that are easily automated ("we're going to email each of our uncontrolled hypertensive patients"). I firmly believe that for doctors and data, you need to have clearly defined objectives: the goal should never be "give them access to data", but rather should be something like "make providers feel like they have the data necessary to do their job" and "improve quality rates through targeted provider intervention." Start from those first principles, and validate your assumptions at each step. I'm confident your solution won't end up with tableau. |
My takeaways:
- Start with first principles, such as "improve quality rates through targeted provider intervention"
- Push and simple stats works better vs. pull with fancy dashboards
- Slice and dice can help identify process exception but not great for process improvement, whereas simple stats on a regular basis improve outcomes