You’ll recognize this scenario.
- Medical device or equipment maker claims its next generation product is superior to what came before. A little more expensive, yes. But it will yield better outcomes and ultimately, more savings. (See the white paper!)
- But wait! It doesn’t. A case of false marketing?
- Hold on! Was our data clean? Did we analyze it properly? Have we truly established this technology does not lead to better outcomes?
- And even if we do have confidence in our data, is it possible that we failed to use the technology properly, hence the poor outcomes?
It’s a tangled web that binds medical technologies with outcomes. Mercy, working with a few collaborators, is working to untangle it.
In October 2017, Mercy signed a deal with Medtronic in which Mercy would capture de-identified data from approximately 80,000 patients with heart failure to explore real-world factors that determine a patient’s response to cardiac resynchronization therapy (CRT).
Then, in July 2018, Mercy signed a data-sharing agreement with Johnson & Johnson Medical Devices Companies to establish a data platform that uses real-world clinical data to evaluate medical device performance.
Most recently, in January 2019, Mercy Technology Services – Mercy’s IT backbone – announced a research collaboration with BD that will enable BD to use Mercy’s clinical data platform to help evaluate and improve the effectiveness of medical devices and procedures, beginning with integrated vascular therapy and vascular access management.
“I believe that traditionally, marketing has beaten science,” says Vance Moore, president of business integration for Mercy. “Now we’re trying to make science beat marketing.”
And the only way to do that is with data, or real-world evidence.
A natural relationship
Headquartered in the St. Louis metropolitan area, Mercy has more than 40 acute care, managed and specialty hospitals, and more than 900 physician practices and outpatient facilities. Approximately 12 years ago, the health system extended the Epic electronic medical record system throughout its ministry. Consequently, Mercy has long, contiguous patient records. “We have taken that information, standardized it and used it productively inside Mercy,” says Moore, who helped found ROi, Mercy’s supply chain operation, in 2002.
Vendors (or “collaborators,” the term that Moore prefers) recognize the value as well.
“They have said to us, ‘We’re trying to make the very best products, but we can’t make our case without data,’” says Moore. “So it’s a natural relationship. The more data manufacturers get, the better they can make their case, and that is in best interest of all consumers of healthcare.”
Of course, sometimes the truth can hurt. In other words, the data might show that the collaborator’s technology doesn’t yield the outcomes as marketed.
“But they do want to know that, because over time, the truth does reveal itself,” he says. “If something doesn’t play out, it will ultimately surface.
“The companies we’re working with want to get ahead of that. They’d much rather find out themselves if something isn’t working than find it in the news headlines.
“It’s true that some marketing teams don’t want to learn that their product isn’t working as it had promised customers it would. But Mercy – and most collaborators – believe this is the right thing to do. The future of healthcare will be defined by the effective use of information and technology, and by great caregivers who can use that information effectively.”
It’s about the data
When asked about the challenges involved in gathering real-world evidence, Moore responds, “It’s about the data. It always is.” The three big issues are data definition, data cleanliness and data completeness.
- Data definition. Over the years, the meaning of data points can drift or “morph,” making it very difficult to gather and analyze information. For example, when the Mercy team reviewed generations of its medical record system, they found eight different definitions of “OR start time.”
- Data cleanliness. Medical information isn’t always recorded uniformly in the medical record, Moore points out. Instead of a field in the electronic database, important information might show up on a piece of paper. All those scraps of information have to be gathered and organized.
- Data completeness. One facility in a health system might be diligent about filling out every field in the electronic medical record, while another might say, “I’m not so sure it’s essential,” says Moore. “So you get partial data.”
“We have spent a lot of time building our system, curating the data, and extracting it,” he says. Perhaps Mercy’s biggest advantage – and what makes it a desirable partner for collaborators – are its data scientists, that is, the people in IT, many of whom have had experience in healthcare. Because of that experience, they understand the context of the manufacturer’s request for information, and can supply it readily.
Ultimately, the entire industry – collaborators, providers and patients – will benefit as more data is shared among all parties, says Moore. Even Mercy – as large as it is – can benefit by gaining a broader perspective on product usage. “That’s democratization of data in a consistent fashion,” he says. “That is crucial to being able to get the broadest picture possible.
“Our hope is that products will improve, and that we will gain an understanding of what works better, when, where and how. With that information, we can build better care paths. That will differentiate us in our marketplace. We will compete with others on the basis of who provides great care.
“None of us has all the answers. That’s why it’s important we share information in such a way that it leads to improved health outcomes.”