Strata Rx 2013: Data driven physician selection

BOSTON--“There is no best physician," Vinay Mohta, chief technology officer at health data management firm Kyruus, told an audience at Strata Rx 2013.

He began his talk by sharing the experience of the Shah of Iran, Mohammad Shah Pahlavi, who in 1978 asked the United States to send its best physician to remove a lymphoma next to his pancreas. Unfortunately, the U.S. government sent its “best” physician—a cardiology expert—who botched the operation due to his relative inexperience performing splenectomies.

This lesson can be applied today, when patients often choose physicians with little real knowledge whether they are the best fit, Mohta said.  “We know more about our cars than our doctors, and doctors don’t know that much about other doctors, except for data gleaned from personal interactions.”

But, he said, “Data can help. Even a small dose can make a difference.”

For example, if a patient at risk of a stroke faces a situation where there is a 4 percent chance a procedure will not work and result in death, and a 10 percent chance of death within six months if no procedure is done, data can help. It is proven that physicians who have performed 16 or more cacrotid endarterectomy (CEA) procedures a year produce better outcomes, thus hospitals can develop a model to move patients around so more physicians reach that threshold, he said.

That, including the availability, location and languages of a physician, can drive a better choice of physician for a procedure, he said.

This model starts with a look at a single physician’s panel of cases, and if he or she is one short of reaching the 16 CEO procedure benchmark, it can then analyze whether there is an opportunity to shift one procedure from a physician already at the volume necessary to improve outcomes.

At one hospital, Mohta said research found they could move 16 percent of cases. “We’ve built more complex models, collaborating with a couple of academics,” he said.

Piecing together patient scheduling by analyzing physician clinical experience, availability and demographic data, Mohta said hospitals not only can save tens of millions of dollars but reduce wait times.

“There is a business case for this,” he said.

On the issue of how new physicians can build the level of volume needed to improve outcomes, he recommended more exploration of mentorship/apprenticeship models.