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The Cohort-driven Method to Reduce Unwarranted Clinical Variation in Surgery

In today’s dynamic value-oriented healthcare environment, utilizing the right data and engaging in the right conversations plays a vital role in driving better quality and outcomes, controlling costs, and improving the experience of care for patients. An estimated $750 billion a year in healthcare spending is wasted in the form of unnecessary or inefficient services in the United States.1 Evidence shows that reducing unwarranted clinical variation and promoting recognized best practices improves patient care and clinical outcomes and helps control unnecessary spending for hospitals and ultimately for patients.2

Healthcare administrators and providers must first focus on variation reduction programs in the surgical suite to drive the greatest value. The goal is to identify and clarify standards of care based on evidence-based best practices, identify the low and high-value practice differences, and ultimately drive adoption of high-value care.

Traditional methods for identifying and communicating clinical variation opportunities utilize comparison groups of patients or surgical cases originated from billing codes such as Diagnosis-Related Groups (DRGs) or Current Procedural Terminology (CPT) codes. However, this taxonomy was largely developed for billing and reimbursement and does not provide meaningful clinical comparisons. Therefore, these methods may attain marginal improvement but fall short of capturing total value and engaging providers in dialogue with data they trust.

Surgeons, nurses and other clinicians, along with healthcare leaders and executives, can have the greatest impact on patient outcomes and better financial margins through a data-driven surgical cohort program. This is the best way to reduce costly, low-value clinical variation, engage physicians, and improve health outcomes.

1Kaiser Health News. IOM Report: Estimated $750B Wasted Annually In Health Care System. https://khn.org/morning-breakout/iom-report/. Published September 7, 2012. Accessed July 28, 2019.
2Goitein L, James B. Standardized Best Practices and Individual Craft-Based Medicine: A Conversation About Quality. JAMA Intern Med. 2016;176(6):835-838.

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