In its upcoming Sunday magazine, The New York Times is turning the spotlight on Intermountain Healthcare — a network of hospitals and clinics in Utah and Idaho that doctors at some of the world’s most prestigious medical centers point to as a model for health reform. In the 8,000-word story, Dr. Brent James, a surgeon and Intermountain’s chief quality officer, explains the science and thinking behind their “evidence-based” care — a mix of rigorous treatment protocols, detailed measurement of actions and results, and electronic medical records that is at the heart of Intermountain’s approach. After talking to leading doctors who are championing medical reform, the Times writer observes: “When I have asked them whether they have any hope that medicine will change, they have tended to say yes. When I have asked them whether anybody has already begun to succeed, they have tended to mention the same name: Brent James.”
Intermountain is likely familiar to GE Reports readers, as GE has partnered with its clinics on a number of a projects, many of which center on the substantial impact that electronic medical records (EMRs) can have in delivering better care and in reducing costs. For example, as you can see in the links above, the GE partnership with Intermountain ranges from EMRs, to a new computerized system to give doctors faster access to current research, to working with Intermountain to evaluate new ultrasound technology now coming out of GE’s labs.
As the Times writes: “The explosion of medical research over the last century has produced a dizzying number of treatments for different ailments. For someone with heart disease, there is bypass surgery, stenting or simply drugs and behavior changes. For a man with early-stage prostate cancer, there is surgery, radiation, proton-beam therapy or so-called watchful waiting. To enter mainstream use, any such treatment typically needs to clear a high bar.” The result, the magazine says, is that “different doctors frequently end up coming up with different answers to the same question. Cardiologists in Davenport, Iowa, are quick to insert stents; cardiologists in Iowa City and Sioux City are not. They can’t both be right. Some people with heart disease are getting the best treatment, and some are not. The same is true of debilitating back pain, various cancers and even pregnancy.”
What Intermountain is doing is building a vast repertoire of treatment protocols — which are driven by committees of doctors — and then using EMRs to measure and track the results. The best treatment actions are then embedded into the constantly evolving computerized system to further improve outcomes.
As the story notes: “Intermountain has reduced the number of preterm deliveries, as well as the number of babies who must spend time in the neonatal-intensive-care unit. So-called adverse drug events, which include overdoses and allergic reactions, were cut in half in the mid-1990s. A protocol for dealing with one broad category of pneumonia cut its mortality rate by 40 percent over several years. The death rate for coronary-bypass surgery was cut to 1.5 percent, from the national average of about 3 percent. Medicare data on heart-failure and pneumonia patients show that Intermountain has significantly lower-than-average readmission rates. In all, James estimates that the changes have saved thousands of lives a year across Intermountain’s network. Outside experts consider that estimate to be fair.”
Dr. James says his belief in evidence-based care isn’t about defending protocols. Rather, it’s a defense of measurement. “It must be done right,” he says, “with hospitals monitoring outcomes at every step, quickly sharing that data with doctors and altering the guidelines as necessary.”
* Read the full story in The Times: “Dr. Brent James Will Make It Better”
* Read about GE’s digital partnership with Intermountain and other leading clinics
* Read “New GE program fast-tracks electronic medial records” on GE Reports
* Read “Code Blue: We need I.T. in E.R., stat” on GE Reports
