Better health care through better information

Marketplace Staff May 4, 2007

Better health care through better information

Marketplace Staff May 4, 2007

KAI RYSSDAL: The World Health Organization said today it’s going to provide online one-stop shopping for information on clinical drug trials. Doctors, researchers and curious patients now have access to the results of 50,000 clinical trials in the U.S., Britain and Australia. It’s a big deal because, as it stands now, a lot of drug research never finds its way to publication.

The W.H.O. says it’s a “significant proportion” that doesn’t get published.

Commentator Michael Millenson says today’s news is a good start at addressing the broad issue of health care quality. But just a start.

MICHAEL MILLENSON: I was sitting in the doctor’s lounge of a hospital one day waiting to give one more talk on the broken health care system, when a thick report caught my eye.

Opening it was like finding a secret message accidentally left out in plain sight.

Inside, the report listed every cancer patient the hospital treated, without their names, how serious their cancer was, and the initial outcome of treatment.

This type of cancer registry, I soon learned, is available in every single state. Maybe I could make it public.

Although cancer doctors work long hours, they still fail, frequently, to provide therapies the medical evidence says the patient needs.

Sometimes the problem is occupational blinders. For instance, radiation oncologists think prostate cancer should be treated with radiation, while urological surgeons favor surgery.

Sometimes, it’s communication. The doctor thought a treatment had been considered, but it hadn’t.

Sometimes, it’s human limitations. The doctor thought he was doing what’s best, but his memory of the medical literature was flawed.

What’s scary is that getting treatment for any disease based on the medical evidence happens on average about 55 percent of the time — essentially, you’re flipping a coin.

We waste 30 cents of every health-care dollar providing treatments we don’t need, not providing treatments we do, and fixing preventable medical mistakes.

That adds up to a $700 billion problem.

But perhaps the worst thing is this: The public can’t see that cancer registry. By law, it’s confidential.

To really improve health care, we need reform that promotes real-time use of clinical evidence, like that registry.

And we need reform that holds up a mirror to busy professionals and reminds them that how good you are doesn’t say how good you can be.

RYSSDAL: Michael Millenson is a health care quality expert and visiting scholar at Northwestern University’s Kellogg School of Management.

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