Kristine Martin Anderson, a Booz Allen Hamilton senior vice president, says that a key enabler to healthcare reform is creating a system with tight feedback loops and strong communications about expectations for treatments. Anderson discussed how Booz Allen is helping clients convert healthcare data into meaningful information that can be used to improve the effectiveness, quality, and safety of healthcare interventions—and ultimately save lives.
Kristine Martin Anderson: It’s all about having access to evidence-based information, so patients and providers can make sound decisions about preventing, diagnosing, and treating a medical condition. If Intervention B provides me with similar quality of care as Intervention A but with fewer side effects, I may choose Intervention B. When a best practice is identified through CER and the results are communicated widely and integrated into decision processes, it can standardize health practices, reduce medical errors, and lower costs.
Anderson: A 2007 article in the New England Journal of Medicine cited a CER study that showed how widely held assumptions about the merits of treatments can be false. The study compared the effects of angioplasty with a metal stent combined with a drug regimen versus the drug regimen alone. Over a five-year period, it found no difference between the two groups in survival rates or heart attack occurrence. Yet stents remain a common practice and patients demand them. This also shows that it’s not enough to synthesize studies—dissemination of knowledge is critical.
Anderson: One core strength of Booz Allen is our thorough understanding of complex policy issues combined with our very deep functional expertise. We’re adept at standing up new government programs. With services in technology health analytics, communication and dissemination, and program design and management, Booz Allen supports numerous federal agencies that are laying the foundations for aspects of health reform.
Anderson: We design and implement analytic methodologies to help clients extract better insights from large amounts of data. Our comprehensive approach to analytics can improve decisions involving strategic analytics, which improve long term and wide scope decision making; performance analytics, which improve service, operational, or project performance; risk analytics, which identify, quantify, and mitigate program risks, and more. Through analytics, CER may bring rigor to decision making often influenced by tradition and marketing, and eventually bend the health cost curve.
Anderson: The U.S. has more work to do to see the impacts of CER. The most important question is how CER will be disseminated to clinicians and patients in a way that informs decisions, improves health, and enhances healthcare system performance. Evidence creation will not be impactful without changes in the way information is accessed. A single CER study, such as the stent study, can be extremely impactful if the results are communicated widely via multiple modes and patients understand how to engage differently in treatment decisions. In addition, the best methods of delivering this information at the point of care must be determined to integrate the information into the normal workflow and decision processes of clinicians and patients.
Anderson: Early efforts in the U.S. to stand up a CER capability are focused on infrastructure to catalog evidence and translating evidence into language appropriate for decision making by stakeholders. Large-scale impacts of CER on the full system will happen over the next several years. President Obama’s health reform legislation includes $500 million of annual funding for CER, which should accelerate CER generation, communication, and translation.
With its rich history of standing up major government programs and decades of health industry experience, including partnering with the National Institutes of Health caBIG™ bioinformatics research grid project to facilitate data sharing, Booz Allen encourages innovative thinking at all levels. Associate Brian Balicki’s idea, “A Prototypical Approach to CER in Primary Healthcare,” won accolades at the 2010 Booz Allen Ideas Festival and shows how a prototype may support systemic changes in the cost-efficacy of primary care and ease roll-out to other levels of care.
story posted June 3, 2010
