Seven Reasons Why "Data" Is Not Enough To Change Physician Behavior

Thie Disease Management Care Blog offers this new insight from a physician leader who was in the "ground floor" of the formation of a very large clinic in California.  Think that "information" is all that is needed to enable physicians to improve quality, reduce costs and make the patient experience of care better?

Think again....

As a physician leader who has been instrumental in founding a large group in California, I can assure DMCB readers that “information” is necessary but far from sufficient to change physician behavior. 

The reasons are as follows:

1. Doctors are uncomfortable with data that are cloaked as supporting “appropriate care” when they are really intended to reduce costs.  While the intent may be to limit or improve underutilization, correct overutilization, prevent fraud, or reduce variation, this has little meaning to docs in the course of day-to-day care with patients who need care and need it now.

2.  Thanks to ingrained physician culture, it can takes decades to align docs’ thought process on the kind of “group think” necessary to benefit patients and the health system.

3. Information must be paired with strong committed physician leadership.  In my experience, that is typically lacking and, as an aside, it remains to be seen if ACOs will recognize its critical importance.

4.   Powerful, robust, usable, stable information technology must transform to data in ways that enable coordinated care and some decision support at the point of care.  Data doesn't equal insight.  We just ain't there yet.

5. Good information management is starved for capital.  Most physicians don't have access to it and, even if they did, are not willing to risk any losses for first 3-5 years of any implementation.

6.  The data support for robust care coordination infrastructure doesn't develop overnight.  It took ten years for me to develop thanks to countless small but accumulating delays.  Some health care systems haven't even started yet.

7.  In my estimation, disease and care management information systems are not mature enough to capture a long term return on investment.  It can take years before unit costs and trends can reach a point where savings can truly be measured.