Healthcare 360: Measuring Change with the Center for Healthcare Delivery Sciences

January 31, 2024

Podcast: Healthcare Delivery Sciences & Policy

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with Dr. Bruce Landon, MBA, professor of medicine at Harvard and Beth Israel Deaconess Medical Center (BIDMC) and senior scientific advisor for BIDMC’s research group Center for Healthcare Delivery Sciences, and Dr. Jennifer Stevens, a BIDMC physician who runs the Center for Healthcare Delivery Sciences, to discuss healthcare policy.

The Center for Healthcare Delivery Sciences

Drs. Landon and Stevens have been working together at Center for Healthcare Delivery Sciences for several years. The idea for the Center goes back 20 years and started with a colleague’s desire to learn about how similar types of centers were being organized at other health systems and then eventually launch a center of their own. One of the remarkable projects they’ve worked on aimed to help other hospitals measure their COVID level of risk.

When asked about some of his favorite findings from the Center, Landon says, “I'd say there's been some really interesting equity and value-focused work that we did around the state’s measures of crisis, standards of care, working with the ethics group here, and David Sontag, who I believe was somebody else on your panel, to look at whether or not if we had implemented our crisis standards of care as written for the state, what that would have meant for racial, ethnic and sociodemographic equity.”

“We found some troubling things which actually led to changes at both the state level and locally.”

The Problem with Measuring Data

According to Stevens, one of the biggest disadvantages of measuring healthcare data is that everything hangs on risk adjustment.

“They're (risk adjustments) entirely based on billing data…things that are measured at the end of an admission, things that are measured at different time, points, things that don't actually ascribe to any sort of good data stewardship or strategy or perspective research approach that you would ever want them to do,” she says.

Landon agrees, bringing up an adage: Once you pay for something that you're measuring, it becomes a useless measure. “And that's because of all that gaming that happens around it,” he says. “That’s a big challenge we have with all of the measurement systems that we have in place, is that, you know, people basically play to the test.”

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Drs. Landon and Stevens here, and check in regularly for new episodes of Healthcare 360.

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