Problem: LEGAL/ETHICAL CHALLENGE

Hospitals Are Using Big Data to Evaluate Doctors at Work: Is It a Good Idea?

"Memorial Care is part of a movement by hospitals around the U.S. to change how doctors practice by monitoring their progress toward goals, such as giving recommended mammograms." Although many doctors do not like this approach, Barry Arbuckle, Memorial Care's CEO, believes that tracking doctors' performance is "absolutely key" to the hospital's future. "Cardiologist Venkat Warren said he worried that ‘some bean-counter will decide what performance is.' He wondered whether doctors would be pushed to avoid older and sicker patients who might drag down their numbers. ‘If it isn't cost-cutting, what is it?' Dr. Warren asked." CEO Arbuckle counters that he wants to create an "integrated health system that operates efficiently and hits quality goals." "Technology is making it easier to monitor doctors' work as patients' details are compiled electronically instead of on paper charts."

A host of software companies are starting to market programs that hospitals can use to track physicians' decisions and performance. Given the push to reduce the cost of health care in the United States, it is likely that more hospitals will consider using big data to make decisions. Memorial Care is using big data and it does not have plans to stop. It currently keeps data on a variety of performance measures and uses them to determine a doctor's level of pay. Some doctors don't like this approach because they feel it is hard to quantity good patient care and that big data can put too much pressure on doctors. One doctor commented that "physicians are going to feel that you're whipping them to do more, and they're going to burn out."94

Do You Like the Practice of Using Big Data to Evaluate Physician Performance?

1. Yes. Tracking physician performance and patient outcomes is good for everyone. Big data can be published so that patients can use it to select doctors, and hospitals can use it to reward doctors.

2. No. Trying to quantify something as complex as the quality of patient care is likely to demotivate the very physicians we need to improve the health care system.

3. I think it would be useful for certain specialties but not others. I agree with Dr. Warren that the use of such data might lead doctors to avoid "sicker" patients.

4. Identify another option.