Studies show it takes an average of 17 years for research evidence to reach clinical practice. That’s too long, especially in this digital age. Seventeen years ago, Bill Clinton was running for re-election, Newt Gingrich was Speaker of the House and E.R. was the top-rated TV show. Do we want E.R. doctors treating strokes and heart attacks today with knowledge and technology from 1996? Of course not.
For this reason, the Cardinal Health Foundation has for the past several years been providing financial support to the innovative concept of health care “networks.”
In the language of business, a network continuously collects and analyzes data at the system level (upstream), so it can create procedures and protocols that let doctors, nurses and pharmacists easily make good decisions at the clinical level (downstream). In essence, networks try to hardwire the system so best practices become automatic and mistakes rare. They’re a cost-effective way to help evidence-based practices flow quickly from research to clinical practice.
High Reliability Organizations (HRO) in the airline and nuclear industries have taken a similar approach to implementing best practices for decades. Health care networks are an effort to import HRO strategies from other industries into health care. A simple example: airline pilots use checklists before taking off because the practice is known to reduce human error. Pilots accept and appreciate the checklist as an example of “hardwiring” the system to prevent human error. Everyone knows it’s not OK to crash a plane - even once.
Thinking like an HRO changes the way health care providers think about how to measure, share and respond to patient data - especially when it comes to errors. Airlines share safety data with competitors -- to the benefit of all. Networks let health care providers do the same: Share data across many institutions – to the benefit of all.
Networks are crucial because scale matters. Sharing information (a) improves data quantity and quality, (b) increases the number of experts analyzing information and (c) speeds the widespread implementation of best practices.
The results of the networks we’ve funded have been exciting. We’ve seen health care networks accelerate change, improve patient outcomes and save money. The federal government is now helping expand our first network investment - reducing preventable complications at eight Ohio children’s hospitals - into a nationwide children’s hospital network.
The current health care reimbursement system doesn’t naturally support multi-institution networking. To fill this gap, the Cardinal Health Foundation has donated nearly $4 million to fostering health care networks and is committed to further support.
We provide financial help, but it’s our institutional partners who do the heavy lifting - building networks, gathering data and treating patients. Three successful examples:
The Cardinal Health Foundation is in the fifth year of its multi-million dollar effort to promote knowledge-sharing networks. Why are we so excited? Our partners are generating hard data that confirms the enormous potential of networks.
For example, the eight Ohio children’s hospitals referenced above reduced adverse drug reactions by 40% by sharing data, creating protocols and rigorously adhering to best practices. Surgical infections fell more than 60% in cardiac, neurosurgery and orthopedic surgeries.
Pause for a moment. Imagine the healthier children. Real kids on the playground, not just statistics in medical journals.
This is cost-effective medicine at its best. In two years, 7,700 children avoided harm and $11.8 million was saved by preventing these complications before they occurred.
In recognition of this success, the Centers for Medicare and Medicaid Services awarded the Ohio hospitals noted above an innovation grant to take the program nationwide. Today, 79 children’s hospitals across the country have joined the network.
Let me share some things that the foundation and its partners have found to be valuable when building a successful health care network:
Remember, “networks” are real things - like water pipes or power lines. Once built, they open a pipeline between patients, doctors, researchers, administrators and others. Networks are infrastructure that can create lasting change.