Solutions for the Health Industry
9Cs Comparative banner

The practice of benchmarking is said to date back to the middle ages, when cobblers used the surface of their benches to help them deliver a custom fit. A patron would prop his foot up on the bench for the cobbler to measure and mark its size; the shoes were then made to order. The cobbler developed a highly functional way to measure the process in order to ensure an optimal, marketable outcome.

The comparative practice of benchmarking is still relevant today in the world of healthcare – and there is much money to be saved by mining the potential for greater efficiency. There are 5,723 hospitals in the U.S. today1, along with 893,851 physicians split almost 50/50 between primary care and specialty.2 Among this statistically significant sample set, there are, of course, many variations in practice efficiency and the quality of patient care delivered.

It has been estimated that up to 30 percent of all healthcare spending is either unnecessary or duplicative.3 Understanding the differences in practices in order to identify high-quality, efficient practitioners can distinguish best practices and set benchmarks for excellence. So what is the secret to unlocking the power analytics necessary to compare such outcomes? For analytics to be actionable, it must be trusted, both in source and methodology. Of course, without a comparative context, the value of analytics is dramatically diminished. If your organization reported just five patient safety events last quarter to your competitors' ten, you may be reassured. However, what if you learned that your competitors had three incidences during that time, and the best performing organizations had none?

Is such benchmarking in healthcare relevant for physicians? The answer is not so straightforward. In the above example, each of the patient safety events may have been attributed to five different physicians. Yet is it fair to hold a physician accountable for institutional process barriers that likely contributed to the safety breach? Sometimes, the answer is yes, such in instances of true lapses in clinical judgment or practice. Often, though, the system has failed to support established processes designed specifically to mitigate such incidences.

When your organization tackles the topic of physician variability, make sure to include these easy steps:

  1. Prior to exploring physician variability, take a close look at organizational processes likely impacting workflow and patient care. As an example, it may not be constructive to discuss an increased length of stay if case management is contributing significantly to delays in discharge and placement.
  2. Review physician variability within the context of a high volume of strategically meaningful procedures or diagnoses. When variability is limited by low numbers, there is a higher concern of random variation and questionable statistical significance. To uncover true differences in care, you should use a high volume.
  3. Compare physician performance within a particular procedure or diagnosis using any benchmark of your choice. This process does not necessarily require comparison to a top performing benchmark, since the objective is recognition of best practice within the cohort. Sharing the best practices of your excelling clinicians with the group is the ideal way to help ensure widespread adoption.

The desire for "physician alignment and engagement" is commonly echoed by healthcare executives. Yet it is not such an elusive goal. What doctor does not wish to provide the best care for his or her patient? And what practitioner does not want to attain economic viability and prosperity? By leveraging analytics with an empathic sensitivity to the unique challenges of our physician community, we can help ensure the delivery of quality care and promote success for our physician practices.

Benchmarking in healthcare requires the use of sophisticated healthcare analytics. Learn how Healthcare Analytics can help your organization identify and exceed performance benchmarks.

1"Fast Facts on U.S. Hospitals." American Hospital Association. Health Forum LLC, 2 January 2014. Accessed December 16, 2014.
2"Total Professionally Active Physicians." The Henry J. Kaiser Family Foundation. Kaiser Family Foundation, 2014. Accessed December 16, 2014.
3"About the Campaign." Choosing Wisely. ABIM Foundation, 2014. Accessed December 16, 2014.

Michael Udwin

About the author

Michael R. Udwin, MD, FACOG is Executive Director of Physician Engagement Services and a member of the Web2pro Business Advisor Consultants team. With over twenty years experience as a results oriented physician leader, he leverages both health care analytics and IT resources to achieve enterprise-wide performance improvement goals. Specializing in physician alignment, Dr. Udwin recognizes the unique role providers play in the sustained consistent delivery of best practice on behalf of hospitals, health systems and communities. In addition, Dr. Udwin serves as assistant professor providing maternity care in a large academic center.