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Ep. 19 Public reporting: necessary evil or harmful fake news?

Dr. Robert Yeh

Public reporting of outcomes aims at improving quality but has also harmed patients and doctors alike.  Can any good come out of it?  Our guest on this episode is Dr. Robert W. Yeh, Associate Professor of Medicine at Harvard Medical School and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston.  He is an expert on the outcomes of outcome reporting.

GUEST:

Robert W. Yeh, MD: Twitter

Papers by Dr. Yeh and colleagues on public reporting:

http://www.onlinejacc.org/content/65/11/1119– paper suggesting an association between public reporting of PCI mortality and lower rates of PCI especially for high risk patients, and higher mortality for MI patients overall.

https://jamanetwork.com/journals/jamacardiology/fullarticle/2537379 – paper showing that after New York removed cardiogenic shock patients from public reporting of PCI, PCI rates went up and shock-related mortality went down.

https://www.ncbi.nlm.nih.gov/m/pubmed/28249879/ – study showing that hospitals identified as PCI mortality outliers tend to be the large hospitals with CT surgical programs where complex patients are referred. In addition, after being identified as outliers, hospital appeared to improve mortality without worsening risk avoidance.

https://jamanetwork.com/journals/jamacardiology/article-abstract/2680626 – a survey of interventional cardiologists in public reporting states on the extent to which reporting programs have changed their and their colleagues practice.

RELATED LINKS:

Anish Koka. The High Cost of Public Reporting (published in “The HealthCare Blog”)

RELATED EPISODES:

The dangerous business of public reporting.

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