Cost vs. Outcomes: The Balancing Act of Healthcare



All would hopefully agree that transparency in healthcare is much needed.  A recent article entitled Endless Forms Most Beautiful: Evolving Toward Higher-Value Care delves into a very relevant topic regarding transparency, and one that we see impacting healthcare tremendously.

Dr. Ari Robiscek and Dr. Caleb Stowell brilliantly make the case for greater transparency and patient-based costing to be the foundation of quality improvement efforts at Providence Health. Their fascinating data indicates that more often than not, good doctors versus bad doctors is a false dichotomy. Especially when it comes to cost, best and worst practices can exist within the same physician.

This new approach is certainly relevant as healthcare is facing greater challenges to reduce costs and improve quality of care than ever before. Robiscek and Stowell’s work analyzes the variance between various providers and looks for indicators of the best outcomes paired with cost-effective measures. This method for simultaneously measuring cost and outcomes and “drilling down” into the specific practices that drive variation is what they refer to as a Value-Oriented Architecture (VOA).

Coupled with transparency around cost and outcomes, and with alignment between clinicians and hospitals, we believe the “selective pressure” of a data-driven Value-Oriented Architecture can drive adoption of higher-value clinical practices that have often lain dormant among a handful of providers.
— Dr. Ari Robiscek & Dr. Caleb Stowell


At SwipeSense, we believe we can go even deeper. A Value-Oriented Architecture (VOA) can take into account machine generated data from all staff members and devices used during the patient’s journey. By pairing this with the electronic medical record (EMR) data, health systems can take their quality initiatives to newer heights.

One reason why machine generated data is a necessary part of the equation is that legacy EMR systems alone often fall short. Future blog posts will examine this further, but the ultimate shortcoming is the level of accuracy in clinical workflow data. The past decade saw an explosion in EMR adoption and nearly every hospital has a custom software built just for them. It is a remarkable story of growth and transformation for the entire business of operating a hospital. However, most of the data inside the system is still generated by humans. This is prone to error, and it makes it notoriously difficult to build scalable analytics solutions. Here is what Leah Binder, President & CEO of The Leapfrog Group, says about this challenge:


Our mission at SwipeSense revolves around these two challenges: Lowering prices and improving the quality of outcomes. We are very excited to share more of our perspective and add Elisabeth Rosenthal’s book to our next book club.

Contact us to learn more about how our intelligent systems can support your quality improvement initiatives!

Mert Iseri