Roji Intel Blog

Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentResearch
February 21, 2017

For Patients, “Trust Me” Is No Longer Good Enough for Medical Decision-Making

It’s time to rethink ideologies of medical care that no longer make sense. The following may sound revolutionary, but are nonetheless true: Patients are the future leaders in medical care. Patients must and can make their own medical decisions after being informed. Patients can and must learn to discern useless from useful information. Science must improve to match the increasing abilities of patients. At present, none of these concepts are fully embraced by the business of medicine and, in fact, may be a 180-degree reversal from the way things work now. So, why are these statements important? Because getting the…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentPerformance Improvement
February 14, 2017

Turning Patients into Health Care Consumers—For Economic Survival

If we want to help people take better charge of their health—both physically and financially—we should start by treating them as real consumers, instead of patients. While that may seem like a simple change in terminology, it is anything but. A Patient Is a Recipient of Services, Not the Actor Health care organizations often work hard to welcome patients and provide as many services as needed. They design facilities to be comfortable, and there are often superb training programs for staff to be courteous, communicative, and to make patients comfortable. But let’s be honest. Health care is a business concern,…
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Thomas Dent, M.D. 0
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Future of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
October 11, 2016

Physician Culture Must Transition from Defensiveness to Performance Improvement

Physicians undergo long and arduous training, with good reason. Lives are at stake. Learning to make the correct diagnosis, to expertly perform the appropriate procedure and to properly treat conditions is essential. Mistakes or flaws are scrutinized and not tolerated. Being wrong may cause greater harm to the patient—and lead to malpractice litigation. In short, physician culture places a premium on individual performance and responsibility. Steeped in those values, most physicians take great pride in the quality of care they deliver to patients, in the examination room or the surgical suite. Teams who provide specialized services, such as Emergency Departments,…
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Thomas Dent, M.D. 0
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Clinical Data RegistryMACRAMedical Decision-MakingMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingRegistry ScienceResearch
July 19, 2016

MACRA Match-up: How EHR Source Data Will Benefit Registry Research

At the core of MACRA and MIPS requirements, Electronic Health Record (EHR) source data will soon become a key component for Registry research. Specifically, Clinical Performance Improvement Activities (CPIAs) are a required component of MIPS. Performance improvement efforts will no longer be optional. Quality data will be essential. EHRs present an excellent data resource, but the data is not flawless. Registries are well suited for validating data and assessing performance using a continuous improvement model—testing an idea by changing a practice and measuring its impact. When done on a small scale, testing performance improvement activities and the feasibility of population-based…
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Robert McNutt, M.D. 0
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Clinical Data RegistryFuture of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
March 1, 2016

First, Ask Questions: How to Harness CDR Data for Better Patient Outcomes

As more and better clinical data becomes available and demand grows for better outcomes, the Clinical Data Registry is positioned to fulfill the role of data manager—a vital mechanism for improving care. The CDR is the engine driving a smoothly running system toward better outcomes. This involves much more than data collection. A high quality management function for CDR data requires making inferences from the data it collects. But drawing inferences from present data sources presents significant challenges, no matter how big the data source. As a medical journal editor, I have reviewed many papers from countries with massive data…
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Theresa Hush 0
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Clinical Data RegistryMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
February 9, 2016

Plenty of Data, Not Enough Answers: What We Need to Improve Health Care Performance

If you read the industry hype, you might believe that we’ve left the data wasteland for the data land of plenty. Some health care technology and analytics companies allege that, with all this enhanced data capability, you can now discover everything you need to know about your operations and patients that will lead you to higher profitability. But if that’s so, why are health care costs continuing to increase? Why are providers still not able to succeed under risk-based payment models? Why don’t we know more about what actually works to improve patient outcomes? It’s true that we have access…
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Theresa Hush 0
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Clinical Data RegistryFuture of Health CareMeaningful UseMedical Decision-MakingPerformance Improvement
November 24, 2015

Putting the “Meaning” in MU Public Health Reporting: 
How to Move Beyond “Check the Box”

Can Medicare influence health care delivery via the “public health” reporting requirements of the EHR Incentive Program? That question is central to the updated EHR Incentive Program (more commonly known as Meaningful Use, or “MU”). The answer boils down to a fundamental choice: whether providers view the external reporting Objective as just one more compliance effort, or an opportunity to improve. Apart from governmental reporting, Modified Stage 2 of MU requires eligible providers to submit data reporting to one of three types of “public health” registries: immunization, syndromic surveillance and Specialized Registries. This is reporting for the public good, and…
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Thomas Dent, M.D. 0
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Future of Health CareMedical Decision-MakingPopulation HealthResearch
February 17, 2015

Should Wearable Tech Be Tied to Patient Outcomes? Benefits and Risks of Sharing Personal Digital Data

How many steps did you take today? If you’re a Fitbit fan, you know precisely, and you’re not alone. Digital health devices were a $5 billion-plus growth industry last year, and the range of gadgets is expanding rapidly, from ear devices that measure blood pressure, respiration rate and oxygenation level, to iPhone cases that record your ECG. While wearable tech is a popular means to track your personal health and fitness, the data you collect is also a valuable commodity for ACOs, Health Systems and employers, who are looking for new ways to achieve meaningful savings under Value-Based Health Care.…
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Robert McNutt, M.D. 0
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Medical Decision-MakingPopulation HealthQualified Clinical Data Registry ReportingRegistry ScienceResearch
January 13, 2015

Are “Flat-Line” Outcomes the Kiss of Death? How to Use a Registry for Outcomes Improvement Research

Despite a huge investment in health care, we have yet to demonstrate real progress in improving outcomes. A major study of patient outcomes last year revealed disappointing “flat-line” results for patient-centered medical home services, which means no difference in outcomes over time, regardless of significant expenditures. And that’s just the beginning.  Assessments of cancer outcomes, preventive screenings and chronic disease indicators show similar, disappointing results. It’s hard to accept that we have failed to improve mortality or morbidity in a way that can be attributed to medical management and treatment, rather than to lifestyle and nutrition. In most cases, however, that’s where…
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