“Open Source” Healthcare

The current New Yorker has a must-read Atul Gawande piece about the effect of data transparency on hospitals and healthcare. As the article’s subhead puts it, “What happens when patients find out how good their doctors really are?” The answer: A lot.

In medicine, we are used to confronting failure; all doctors have unforeseen deaths and complications. What were not used to is comparing our records of success and failure with those of our peers. I am a surgeon in a department that is, our members like to believe, one of the best in the country. But the truth is that we have had no reliable evidence about whether were as good as we think we are. Baseball teams have win-loss records. Businesses have quarterly earnings reports. What about doctors?

To fix medicine, Berwick maintained, we need to do two things: measure ourselves and be more open about what we are doing. This meant routinely comparing the performance of doctors and hospitals, looking at everything from complication rates to how often a drug ordered for a patient is delivered correctly and on time. And, he insisted, hospitals should give patients total access to the information. No secrets is the new rule in my escape fire, he said. He argued that openness would drive improvement, if simply through embarrassment. It would make it clear that the well-being and convenience of patients, not doctors, were paramount. It would also serve a fundamental moral good, because people should be able to learn about anything that affects their lives.