massachusetts health quality partners


Better Doctor-Shopping Is On The Way — But Will You Use It?

The federal government has just announced that it will let more light shine on a great trove of Medicare data — medical claims records from its 47 million patients. And in particular, it will let employers, consumer groups and insurance companies mine those mountains of claims to help them rate the performance of individual doctors.

So does this mean that something on the scale of — or Rotten Tomatoes! — is coming to American medicine? Not any time soon.

What does it mean? I asked Dr. Tara Lagu, a research scientist at Baystate Medical Center and an assistant professor at Tufts University School of Medicine, who studies the effects of making health quality data public.

Dr. Tara Lagu

Her bottom line: Probably within a couple of years, patients will be able to determine a given doctor’s volume — how many cases like theirs the doctor treats every year — and possibly quite a bit about how well those cases have gone. But quality ratings themselves are likely to remain contentious, and the big question is whether patients will be able to take advantage of the newly available data.

Our conversation, lightly edited: 

My main take on this new Medicare announcement has to do with how patients will digest the data. The great potential of this could be lost if it’s not presented to patients in the right way. We really could be missing an opportunity to help patients participate in the quality improvement process.

What exactly is the data that will be released?

Every time a Medicare patient receives health care, the place where they got that service files a claim with Medicare, and Medicare puts it into a big database. So it’s a set of billing records. It doesn’t have things like lab results; it doesn’t have a lot of clinical data. So the first thing patients should know is that their clinical data is not going to be available. All this is, is documentation of interaction with the health care system. Medicare aggregates it on a very big scale: How many patients in Boston saw Dr. X or went to hospital Y?

‘Only 6% of patients are aware that the data exist.’

Medicare also collects quality data, mostly through chart review. For example, how many patients who had a heart attack got a beta blocker? Most of that information is available at the hospital level and presented on the Hospital Compare Website. So part of the data is actually not a new thing — that’s been available for some time. But only 6% of patients are aware that it exists, and probably even fewer are able to see the information and comprehend it. Continue reading