Healthcare systems launch pioneering data-exchange collaborative

Six healthcare systems have announced a first-of-its-kind partnership that will see them joining the Dartmouth Institute for Health Policy and Clinical Practice to share data on outcomes, quality and costs across a range of common and expensive conditions and treatments.

The group, which includes Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare and Mayo Clinic, will determine best practices for delivering care for these conditions and will rapidly disseminate actionable recommendations to providers and health systems nationwide. In addition to achieving better quality and outcomes, the collaborative intends to improve the efficiency of standard clinical care delivery to reduce the per capita cost in these conditions and to keep costs in pace with the consumer price index.

The collaborative will initially focus on eight conditions and treatments for which costs have been increasing rapidly in recent years and for which there are wide variations in quality and outcomes across the country: knee replacement, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery, and depression, which together amount to hundreds of billions of dollars in direct medical costs each year.

"The intractable problems of quality and cost cannot be solved without getting to the fundamental issue of how we deliver healthcare in this country," said Brent James, MD, chief quality officer at Intermountain Healthcare and executive director of the Intermountain Institute for Health Care Delivery Research. "By collaborating to gather data and identify the most effective care models, we can address variation in treatment, cost, and outcomes to give patients the quality care they need and bend the cost curve down in a meaningful way."

The six healthcare systems, with a combined patient population of more than 10 million, will share data on outcomes and clinical protocols for the selected conditions and treatments, to arrive at optimal care models. The collaborative aims to see these best practices replicated across the country.

The Dartmouth Institute will coordinate data sharing and analysis, and report results back to the collaborative to inform development of best practices. The Dartmouth Institute has twenty years of experience analyzing Medicare claims data and disseminating the findings. This same expertise will be applied to the work of the collaborative.

The collaborative will first analyze total knee replacement, a procedure that is performed more than 300,000 times a year in the U.S., with a cost that ranges on average from $16,000 to $24,000 per surgery. Simultaneously, collaborative partners will build the metrics to study the care of the other selected conditions at their centers and arrive at best practices. Work to define best practices in diabetes and heart failure care will begin early in 2011.

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