By Dr. Cole Stanley
I’m sitting here at 36000 feet somewhere over the Pacific, on a long-haul flight with no WIFI, and I can finally sustain some focus. My team has given me no easy task this month: write an “engaging” article about the role of our Clinical Data Stewardship Committee (CDSC). Hmmm, maybe we could start by calling it something less yawn-worthy? Perhaps I’m feeling a little snarky due to travel-related lack of sleep. But wait, maybe I can make use of that attitude? My mind drifts to a truly engaging, once-in-a-lifetime experience I had in Whistler a couple years back, amid social distancing requirements and “no dancing!”. The guests were mandatorily seated in the large high-ceilinged conference centre hall, where some of the more cerebral elements of the show had room to go way over my head. But still, the performer dazzled the audience. She proceeded through a loose interpretation of Dante’s Inferno, replete with a musically-numbered 9 circles of hell, and given it was a drag show, snarkiness was set to max.[1]
Here’s my attempt to, in true QI fashion, shamelessly steal that format, and repurpose it to convince you of this:
The perils and pitfalls of healthcare data are many, and we need teams who function like the CDSC to save us from these circles of data hell.
A short disclaimer before we start our ghoulish tour – I am coming at this from the perspective of a family physician who believes that we need to embed quality improvement (QI) within our daily work, and that measurement and healthcare data should be used as a tool for these efforts. I’m lucky to work in a team-based primary care clinic where we are putting this into practice. I’m also a Physician Quality Improvement (PQI) coach, have experience with team-based and Collaborative QI initiatives, and have spent a fair amount of time thinking about the intricacies of measurement using healthcare data (specifically at HDC and with the Measurement System for Physician Quality Improvement). These are where I have come across the pitfalls, sometimes through firsthand experience.
What I do NOT want you to take away is that I think other system players’ perspectives (eg. researchers’, data scientists’, policymakers’) aren’t important, and that their purposes for measurement are somehow less valid. Instead, we need to work together and be mindful of these pitfalls, so that we can measure safely and not let one group’s good intentions pave the road to, well you know.
Now let’s start our descent to the 12 Circles of Healthcare Data Hell.
Circle 5: Submit to the Central Data Committee
Circle 7: Unappreciative Inquiry
Circle 8: Stepford Wives Dinner Party
1. Sincere apologies to my friends and co-workers who are Drag Race superfans, as it took some online digging for me to figure out it was BenDeLaCreme’s Inferno A-Go-Go Show.