Standardization taking root in healthcare

One of the biggest debates in healthcare today involves the issue of standardization.

For those who dwell in a mythical past when all-knowing physicians like Dr. Marcus Welby imparted their medical wisdom developed over decades of experience to individual patients, the idea that data-driven experts can develop algorithms for care that are based on the collective outcomes of thousands or millions of patients is anathema.

Such standardization is the very opposite of individualized medicine or patient-centered care, they assert. Every patient is unique, so every care plan must be unique, too.

This ignores the experience of every other complex enterprise, whether it's manufacturing computer chips, flying airliners or delivering a complex and variegated menu to exacting standards in a chain restaurant, as Dr. Atul Gawande wrote in the New Yorker a few years ago after visiting a Cheesecake Factory.

“In medicine, too, we are trying to deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality,” he wrote. “Unlike the Cheesecake Factory, we haven't figured out how. Our costs are soaring, the service is typically mediocre, and the quality is unreliable. Every clinician has his or her own way of doing things, and the rates of failure and complication (not to mention the costs) for a given service routinely vary by a factor of two or three, even within the same hospital.”

But that is less and less true at healthcare systems across the U.S. And the organizations recognized this year on the 100 Top Hospitals list by Truven Health Analytics showed that standardization leads not just to better care, but to substantial cost savings for patients and payers.

As Modern Healthcare reporter Maria Castellucci reports, this year's top hospitals spent $1,733 less per case in 2014 compared with their peers in a cross-section of key service lines by focusing in part on standardization and the use of data to lower costs. Read on to discover how the drive for greater efficiency can lead to higher quality as well as lower costs.


Merrill Goozner

Merrill Goozner served as Editor of Modern Healthcare from December 2012 to April 2017. As Editor Emeritus, he continues to write a weekly column, participate in Modern Healthcare education, events and awards programs and provide guidance on coverage related to healthcare transformation issues. Over the course of his four decades in journalism, he served as a foreign, national and chief economics correspondent for the Chicago Tribune and professor of journalism at New York University. He is the author of The $800 Million Pill: The Truth Behind the Cost of New Drugs (University of California Press, 2004), and has contributed articles to numerous publications. Goozner earned a master's degree in journalism from Columbia University and a bachelor's in history from the University of Cincinnati, where he received the Distinguished Alumni Award in 2008.

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