For the past year, an AATS Task Force has addressed the question: “What would a quality assessment program look like if it were developed from the ground up in the 21st century?” In Saturday’s “Plenary Session – Quality and Outcomes,” Eugene H. Blackstone, MD, of the Cleveland Clinic Foundation, said: “This afternoon we answer the question by introducing you to the AATS Quality Assessment Program for the 21st century.” He presented the program on behalf of the Governance Committee of the new AATS Quality Program.
“This program was presented to the AATS Council in December and it was voted unanimously to pursue this initiative,” according to David Jones, MD, current AATS Secretary.
“By way of background, a group of AATS leaders from large academic centers began to conceive a new quality program using different platforms and technologies aimed at a new purpose. Our ambitions evolved toward building a completely novel capability that could generate innovative real-time quality analyses using advanced data science,” added David Adams, MD, AATS President. “Our main focus is on serving patients.”
In this spirit, Dr. Blackstone began his presentation quoting Geraldo O’Connor, MD, who for over 20 years was Research Director of one of the most effective quality improvement programs in cardiac surgery, the Northern New England Cardiovascular Disease Study Group. Dr. O’Connor noted that “data and reports are a means, not an end. The data are for action. They are for solving problems. These data can provide answers to some of the most important questions in cardiac surgery: The physician asks: ‘How am I doing?’;
The patient asks: ‘What are my chances?’; and the profession asks: ‘How can we improve?’”
“Given the enormous strides in communication, the internet, and computer technology on the one hand, and data science with machine learning and artificial intelligence on the other, what would a quality assessment program, squarely focused on those three questions, look like if it were developed from the ground up in the 21st century?”
It would be a single, cloud-hosted solution, said Dr. Blackstone, comprised of core quality datasets, which would be right-sized for adult cardiac, general thoracic, and pediatric and congenital heart disease.
“We are proposing a vision of resources and collaborative discussions focused on how we improve. ...We envision multiple sites connecting themselves as a peer group, with no geographical boundaries, to develop and execute quality initiatives to help us improve,” he added.
“For the patient asking ‘What are my chances?’ we will provide risk assessment across all procedures, providing individualized and site-specific prediction of risk for counseling and informed consent,” said Dr. Blackstone.
“Why should you support the new AATS Quality Assessment Program?” he asked. “It can give you the information that you and your patients need at low cost.”
The program will also be available 24/7/365 for self-service data analytics with the latest data science methods applied to provide personalized risk assessment. Importantly, it will also engender improved peer-to-peer collaboration without geographic boundaries.
Former AATS President Pedro del Nido commented, saying: “The ability of surgeons to collaborate and work in developing better solutions for their patients is a critical part of this program. That’s what we have not had the capability to do up until now. We are trying to develop a system where individual surgeons can share their results in a way that doesn’t make them worried that somehow they are going to be judged by individuals who don’t understand their practice. Because otherwise what you are going to do is inhibit innovation, and you are going to make surgeons risk averse. The willingness to innovate has been the hallmark of our profession,” he concluded.
After Dr. Blackstone’s presentation, Jeffrey B. Rich, MD, Past-President of the Society of Thoracic Surgeons, as part of a panel of experts assembled to answer questions stated: “This contemporary quality program is unique. It’s not a brick and mortar database with legacy data, it’s a live, dynamic, interactive technology data platform.” He added that the new platform would be able to codify the up to 60% of patients that fall outside of other databases.