This Wednesday, July 1, it finally starts. A year and four months after it was unveiled, and nearly a decade in the making, the Oryx project gets under way.
On that date the Joint Commission on Accreditation of Healthcare Organizations expects every accredited hospital and nursing home to begin collecting data on patient outcomes. Those data are to be entered into a proprietary performance measurement system of the hospital's choosing, formatted and sent to the Joint Commission.
The idea behind Oryx is to create a more continuous, data-driven and comprehensive accreditation process that not only evaluates an organization's methods of doing the right things (standards compliance) but also the outcomes of those methods.
Data for the third quarter of 1998 must be submitted to the Joint Commission by the end of March 1999.
Hospitals and nursing homes have to start with at least two clinical indicators and may submit as many as five, to cover up to 20% of their patient populations.
The JCAHO keeps an updated list of which performance measurement systems have been approved. The table on the next four pages, prepared by the commission as of May 30, lays out how many clients have registered for each one.
June 30 is the deadline for hospitals to notify the Joint Commission of any change in vendor. After that, changes in measurement system will be allowed only as exceptions to policy.
A number of the more popular measurement systems can be traced to associations, alliances or hospital corporations with a built-in customer base. Among them:
Columbia Health Outcomes Information System, of Columbia/HCA Healthcare Corp., with 281 sites. Also, Tenet HealthSystem's Outcomes Management System, 67 sites.
The Indicator Project managed by Daughters of Charity National Health System, 142 sites.
Veterans Performance Measurement System of the Department of Veterans Affairs, 149 sites.
Collaborative Approach to Resource Effectiveness, Georgia Hospital Association, 115 sites. Also popular: systems of the Illinois (78), Indiana (93) and Michigan (66) hospital associations.
HBSI Explore (90) and Fathom (82), hospital measurement systems of HBS International, marketed and part-owned by hospital alliance VHA.
Clinical Data Base Fast Track of University HealthSystem Consortium Services Corp., 65 sites.
Perspective comparative database of hospital alliance Premier, 45 sites.
An emerging breed of variation-analysis software, which can comb through reams of clinical data and lift troubling patterns of care (May 5, 1997, p. 66), appears to be catching on slowly. Examples are CaduCIS, marketed by Care Management Science Corp., with 18; Open Management Foundation Outcomes Scorecard, Cerner Corp., 22; and QSM System, HCm, 18.