TDI embarks on health care study

by Sam Rauschenfels | 1/4/11 11:00pm

The Dartmouth Institute for Health Policy and Clinical Practice will participate in a new collaboration with Dartmouth-Hitchcock Medical Center and five other national health systems that aim to identify effective low-cost ways to deliver quality health care to patients across the country, TDI director James Weinstein said in an interview with The Dartmouth. Members of the collaboration will share data on various medical conditions in order to determine the most efficient practices.

TDI will function as the information nexus of the seven-hospital collaboration as it compiles and analyzes data from the other organizations, according to Rick Adams, DHMC media relations manager.

Cleveland Clinic, Denver Health, Geisinger Health System, Intermountain Healthcare and the Mayo Clinic will work with Dartmouth to share information on health care outcomes and cost on a variety of medical conditions and treatments. Together these health systems serve over 10 million patients, according to a December DHMC press release.

The collaboration will examine eight medical conditions knee replacement, heart failure, diabetes, weight loss surgery, asthma, spine surgery, depression, and labor and delivery, according to Adams. Since patients typically spend hundreds of billions of dollars each year on these procedures, the collaboration will review patient outcomes and costs in order to determine the most effective treatment protocols and make recommendations that can be implemented nationwide.

Researchers from the participating hospitals chose these common conditions due to their "high cost, high variation" nature, Weinstein said. For instance, surgeons perform over 300,000 knee replacements each year at an average cost of $16,000 to $24,000 per operation, the press release stated. Researchers from the seven hospitals hope to use the results to improve care and reduce cost. They also plan on disseminating their findings to hospitals across the nation so that various hospitals can adapt efficient care models according to regional needs, according to the press release.

"Through our collaboration with other leading health care organizations, we hope to advance the transfer of knowledge to health care providers across the country," Glenn Steele, president and Chief Executive Officer of Geisinger Health System, said in an e-mail to The Dartmouth. "By sharing best practices we can effectively initiate new models of health care delivery that result in better quality and lower costs for a greater number of patients."

The partnership comes at a critical time since the health care overhaul bill the Patient Protection and Affordable Care Act was signed into law by President Barack Obama on May 22, signifying a change in health care delivery, according to Weinstein.

Because the collaboration is still so new, exact procedures for implementing the results obtained have not been fully developed, Adams said.

The collaboration will look into knee-replacement surgeries first, while developing methods to analyze the other conditions and treatments, the release stated. Work on diabetes and heart failure is expected to commence in 2011.

Weinstein compared the implementation process to "learning how to climb rope, or how to sail," adding that everyone learns the most effective way to complete a task from those who are best at it.

Although the collaboration was announced on Dec. 18, the partner hospitals have been communicating about working together to develop a data-sharing arrangement for more than a decade, Adams said.

The seven health systems have been participating in weekly conference calls for over a year to determine how the collaboration will be structured and how it will function, according to Weinstein.