!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> Streamline Training & Documentation: Evidence-Based Medicine

Sunday, October 08, 2006

Evidence-Based Medicine

In an earlier post, I mentioned increasing attention to evidence-based medicine as an example of how astute decision-makers make careful use of data; they don't act on the basis of conventional wisdom or on pure instinct.

An example of how evidence-based medicine is developing in the real world is described in a recent article about Prometheus Payment, Inc.,1 a non-profit organization whose mission is to drive improvements in quality of care, coordination of care, and medical innovation by reforming the US healthcare payment system.

The article (actually, a press release from Prometheus) explains:
The Prometheus model breaks from existing health care payments systems in basing payments on evidence-based guidelines and whether patients receive the right amount and type of care. Designed to distribute clinical and insurance risk fairly, Prometheus uses Evidence-Based Case Rates (ECRs) to determine the total resources required to deliver clinically appropriate care. An ECR is a payment rate that establishes the total amount to be paid to all providers to care for a patient through an entire episode of care according to what the evidence says is the best protocol in clinical practice guidelines.

... The result is providers offering effective and efficient care, wihout burdening them with administrative hassles or insurance risks they can't conrol. Because the Prometheus reimbursement model also includes performance incentives, some providers can earn more than 100 percent of the ECR, depending on how well they deliver care.
The Prometheus model is currently in the testing stage, and I will be watching with great interest to see how it fares in its staged rollout. I anticipate useful lessons not only for the healthcare sector, but also for business enterprises generally.

1 PROMETHEUS stands for Provider payment Reform for Outcomes Margins Evidence Transparency Hassle-reduction Excellence Understandability and Sustainability.