How to Change Physician Behavior

If you want to modify physician performance, it’s simple: just show them their metrics. And oh, by the way, open up the data of their peers as well. George Reynolds, M.D., who serves as both CIO and CMIO at Children’s Hospital Omaha, offered a rapid-fire presentation of quality dashboards and other scorecards at the Physician I.T. Symposium at the HIMSS13 Conference in New Orleans on Sunday, March 3.

With an overarching data transparency policy, the 143-bed facility runs Allscripts on the inpatient side, while ambulatory care is documented in Epic. Both systems support dashboards and scorecards. The hospital has nearly 40 customized, home-grown dashboards, each of which requires several weeks to build.

In a 10-minute talk, Reynolds described efforts to curb the number of unnecessary alerts firing during physician order entry. Reynolds walked the audience through a sea of data available on the order entry screens in the hospital setting. After seeing which orders generated the most alerts, Reynolds asked the medical staff which areas needed improvement. On the ambulatory side, Children’s boosted its quality scores on asthma treatment and autism screening, Reynolds said, suggesting that the best approach is to show physicians their data, and then get out of their way. He presents the data at monthly staff meetings of the physicians, flashing the results on a large screen in the auditorium.

Much of the valuable data in the EHR exceeds the reach of the discrete-data driven dashboards, Reynolds said. “There is a lot of unstructured narrative,” he said.