Abstract
This study describes the impact of the exchange of daily, weekly, and quarterly information among a full range of health care administrators and practitioners on the accessibility and efficiency of care. These efforts produced increased accessibility of hospital emergency departments and greater efficiency of acute and long-term care.
Historically, individual researchers and organizations have exchanged health care data. This process has frequently involved public health departments, providers, and insurance plans in different communities.1-3 Professional organizations representing specific areas of care have also been active in this area.4 This exchange of information has often become the basis of efforts to improve health care outcomes and efficiency.
In recent years, increased attention has focused on collaborative efforts within communities to improve health care. Some of these efforts have resulted in the generation of system-wide data for the improvement of care. Usually, such information has been collected during specific interventions and used to evaluate the results of these programs.5-8
The development of competition among health care providers at the community level has, to a certain extent, generated obstacles to the sharing of health care data at the community level. At the same time, competition offers opportunities for providers to benchmark one another's experiences and improve performance.9 Widespread sharing of information within a group of competing providers has the potential for improving outcomes and efficiency for an entire community.
This study describes a series of efforts by all of the hospitals in a single metropolitan area in the United States to improve health care outcomes and efficiency through widespread sharing of health care data. It studies the impact of the exchange of daily, weekly, and quarterly information among a full range of health care administrators and practitioners on the accessibility and efficiency of care. The widespread distribution of outcomes and utilization data in the community was also intended to generate positive health care outcomes through the exchange of information among providers in the community. By reviewing the use of emergency departments, physician lengths of stay (LOS), nursing home admissions, and psychiatric unit admissions by all providers in the system, health care administrators and managers were encouraged to learn from each other's experiences and thus improve the outcomes and efficiency of services.