From 3M Health Information Systems
Ambulatory complications: Why this patient cares
I dealt with a hospital acquired infection when I had my third son and ended up back in the hospital a few days after going home with our little boy. I remember feeling really awful: I had to pump at the hospital in the bathroom because I was sharing a room with a guy who was screaming nonstop (the hospital apologized over and over for that) and my husband was at home with three kids under three. Let’s just say it was an experience none of us wants to repeat.
Fast forward to today. After telling my physician that my father just had surgery to deal with his colorectal cancer, I’m told that I should have colonoscopies every 5 years as a preventative step. Can’t say that is exciting news, but I do intend to follow professional medical advice.
My first thoughts: Who is the best at doing this procedure? How do I figure that out? A Google search takes me to a National Library of Medicine site that talks about complications in the Center for Disease Control and Prevention’s (CDC) Colorectal Cancer Screening Demonstration. Out of more than 3,300 colonoscopies, the serious complications were found to be “low,” but there were bowel perforations that required surgery, hospitalizations for post-polypectomy bleeding, cardiopulmonary events and an emergency department (ED) visit for excessive abdominal pain that led to surgery for an identified colorectal mass.
Another study again reported that “serious complications within 30 days of screening and surveillance colonoscopy are uncommon,” so I’m feeling better about the overall rates of complications being generally low, but there is always risk in anything we do – or don’t do. I want to do more research, but is there a searchable source that tells me what I want to know about performance by provider in my area?
There may be something out there, but I couldn’t find one after around an hour of digging on the internet. I do think that this information is just as important as cost because I will pay a bit more for better quality (I will pay more for quality peanut butter, so I sure as heck will for colonoscopies). One complication will cost more than saving a few bucks here and there every year.
And I hope that my providers care about having this information. The only way we know if we are doing well is if we have a benchmark to measure against. As a facility – whether a hospital, and ambulatory surgery center, or a doctor’s office for a procedure – it is helpful to know if the rates are notably above or below an expected range of performance. Risk adjusting for similar patients, is one provider doing something well that others can learn from to improve care for all of us?
And lastly, I hope my health insurer cares enough to track performance as well. I do think tracking quality and value is part of what I pay for – and my employer pays for – in an insurer. I went to my insurer’s website, logged in and did a search for colonoscopies. I got a list of providers and information about his or her years of service, credentials and affiliations. There are spaces for awards and recognitions for me to review the provider (most indicated I would be the first to provide a review). But, I could not find anything about performance.
I know 3M is leader in the effort to identify and study health care performance and patient outcomes. I’m proud to work for a company that is on the cutting edge of using data to improve our health care system – and I am excited that U.S. News and World Report is evaluating 3M™ Ambulatory Potentially Preventable Complications grouping software for potential use in its “Best Hospitals” rankings. My hope is that a year or two from now there will be a searchable site to go to and learn more about providers in my area for a colonoscopy – seems like I will have a number of them in my future.
Megan Carr, head of the regulatory and payer solutions team at 3M Health Information Systems.