In this blog, we spend a lot of time talking about how EMRs should be used by clinicians. Today, though, I offer you a twist: how hospitals can use EMRs to examine how providers perform. In a nice analysis, Melissa Outlaw of SEERHealth lays out some ways in which hospitals can zoom in on physician productivity and quality by tracking key EMR stats.
One metric she suggests hospitals track is privilege to procedures performed. If your hospital’s privileging system is linked up to ICD and CPT codes, it can make sure that providers are only performing procedures for which they have permission.
Another useful exercise hospitals can perform with their EMR is to determine, using benchmark data, how well they’re performing the procedures they are privileged to perform. She suggests comparing physicians to their peers, other hospital providers and others in your health system (if relevant), using the following data points:
- Number of Cases
- Case Mix Index
- Morality Rate
- Number of Readmissions
- Readmission Rates
- Average Length of Stay
She also suggests using patient statistics by provider to see what impact providers are having on your organization as a whole, specifically by tracking the following:
Counts by Physician Role (Admitting, Attending, Consultant, Secondary Surgeon, and Surgeon
Top DRGs as Attending
Top Diagnosis Codes as Attending
Top Inpatient Discharge Statuses as Attending
Top Procedure Codes as Surgeon/Proceduralist
ICD-9 Complication Codes
Counts by Physician Role
Top CPT/HCPCS Procedure Codes as Surgeon/Proceduralist
Top Outpatient Discharge Statuses as Attending
This makes tremendous sense from managerial perspective. My concern would be, however, that if they’re not used diplomatically, collecting such stats could give physicians one more reason to resent the presence of their EMR. My feeling is that this is a tremendously valuable way to use EMR data, but one that could blow up politically, so use with care.