Sepsis is the number one cause of death in American hospitals–higher than cancer or stroke. Your chance of dying from a sepsis infection can triple if you choose a hospital that doesn’t have a good sepsis response team.
Care outcomes always vary from site to site and from caregiver to caregiver. For instance, if you have cystic fibrosis, your life expectancy can be diminished by a decade if you choose one of the lower success care programs for that disease.
But people don’t know where to go for best care for almost any level or category of care. That is the missing link in our healthcare delivery infrastructure. The least successful cancer centers will not get better if neither they nor the world knows how relatively low their success levels are. The world needs a scorecard for care performance that is mathematically sound and scientifically valid. It should only measure and report outcomes where outcomes vary and matter.
Enough of those areas exist now, but others still need to be created. The survival rates for each stage of each major cancer should be in a publicly accessible database, and patients with cancer should be able to consult that database to see where to go for best care. The database should also show clearly what the survival rates are for each major type of treatment for each stage of cancer. For example, surgery survival rates, hospital infection rates and cancer treatment survival rates would be a nice starter set for improving patient choices about care.
Such a database is entirely feasible, but we need people with authority and purchasing power to demand it. Employers, care purchasers, governmental care buyers and the new health insurance exchanges created under the new American health care reform act should all be insisting on these data sets.
The new computerized claims payment and medical record data sets can be modified easily to add the data fields needed. The new data fields just need to include key outcome phrasing, like “Did the person die?” Knowing this simple data can be a matter of life and death for individual patients.
Historically, the infrastructure of care delivery has taken a strong stance of resistance to any level of outcome reporting for two main reasons: caregivers did not trust the reporting process, and there was no reason for caregivers to report outcomes when everyone believed all outcomes were, in fact, identical.
Results are not identical and choices matter. Creating a new health care marketplace based on best care outcomes and optimal care results is entirely possible. It can be done and will be done if the market wants it done and is willing to pay for it.
George Halvorson is chairman and chief executive officer of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, headquartered in Oakland, California. Kaiser Permanente is the nation’s largest nonprofit health plan and hospital system. This post first appeared on The Economist.com.