Becker's Hospital Review

48 CMO / CARE DELIVERY 3 ways health systems can better communicate data to physicians By Megan Knowles T o ensure physicians support quality and cost goals, health sys- tems should consistently share cost data and clinical evidence with physicians, regardless of whether they're affiliated with or directly employed by a hospital, three physicians said in an article for Harvard Business Review. e piece was written by Scott Falk, MD, John Cherf, MD, and Julie Schulz, MD. e three authors are physician advisors to Lumere, an organization that offers healthcare solutions and aims to help health systems eliminate unneeded costs and clinical variation. Lumere recently conducted a survey of its 276 physicians to better understand their perceptions of clinical variation and the factors that affect how they choose drugs and devices. ey found health systems can help physicians support the organization›s quality and cost goals by frequently sharing cost data and clinical evidence with them. Here are three recommendations health systems can use to better communicate hospital data to physicians: 1. Evaluate how data is shared with physicians. For most health systems, data sharing occurs irregularly and inconsistently, the authors said. In the Lumere survey, 91 percent of physicians said increasing physician access to cost data would positively affect care quality, but only 40 percent said their health systems are working to increase access to this data. e authors give several explanations for why health system leaders have been slow to increase physician data access, such as a difficulty obtaining accurate, clinically meaningful data and a lack of knowl- edge among leaders about communicating this data. 2. Find the right amount and type of data to share. "Using evidence and data can foster respectful debate, provide honest ed- ucation, and ultimately align teams," the authors wrote. Physicians should have access to published evidence to help choose cost-effec- tive drug and device alternatives without harming outcomes, and health system leaders should give clinicians access to cost data as well as data on clinical matters such as length of stay and post-operative recovery profile, the authors said. e authors recommend health systems should have a central- ized data/analytics department that includes quality-improvement team members and technology/informatics staff to analyze and disseminate data. 3. Compare data based on evidence-based guide- lines. When presenting data to physicians, health system lead- ers should ensure the data is organized in a way that emphasizes high-quality patient care. "Beginning the dialogue with physicians by asking them to reduce costs does not always inspire collaboration. To get physicians more involved, analyze cost drivers within the clinical context," the authors wrote. Health systems should also keep data and communication simple by developing and following key performance indicators, which should reflect the voices of patients, care providers and payers. n FDA approves opioid 10 times stronger than fentanyl By Harrison Cook T he FDA announced its approval of a new prescrip- tion opioid called Dsuvia Nov. 2, despite public criticism for the drug's approval in the midst of the opioid epidemic, according to STAT. Here are four things to know: 1. Dsuvia is a tablet version of an intravenous opioid and dissolves under the tongue. Dsuvia was a priority for the Pentagon because its unique properties make it suited for military use, which was a factor in the FDA's approval. 2. The FDA advisory committee recommended Dsuvia's approval in October, but was urged by critics not to endorse the drug because it's 10 times more powerful than fentanyl and could be diverted by medical person- nel. Along with leaders in the medical community, Sens. Edward Markey, D-Mass., Claire McCaskill, D-Mo., Joe Manchin III, D-W.Va., and Richard Blumenthal, D-Conn., wrote a letter to the FDA opposing its decision. 3. FDA Commissioner Scott Gottlieb, MD, said Dsu- via's different formulation and battlefield applica- tions allow the FDA to classify the drug as an "overall drug armamentarium." "The FDA has made it a high priority to make sure our soldiers have access to treatments that meet the unique needs of the battlefield, including when intravenous ad- ministration is not possible for the treatment of acute pain related to battlefield wounds. The military applica- tion for this new medicine was carefully considered in this case," Dr. Gottlieb said in a statement. 4. Dr. Gottlieb also mentioned the FDA will reformat how it evaluates opioid medication by developing a "formal benefit and risk framework." This will help the FDA eval- uate future opioid medication's safety and efficacy. Dr. Gottlieb indicated the FDA will re-evaluate its consider- ation of the individual and public health impacts of new- ly approved opioids entering the market. "I recognize that the debate goes beyond the character- istics of this particular product or the actions that we're taking to mitigate this drug's risks and preserve its differ- entiated benefits. We won't sidestep what I believe is the real underlying source of discontent among the critics of this approval — the question of whether or not America needs another powerful opioid while in the throes of a massive crisis of addiction," Dr. Gottlieb said. n

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