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Vital Signs:
DHMC goes public with detailed data on a new Web site

"Courageous" is a word more often applied to patients facing a serious illness than to the doctors and hospitals who care for them. But that was just the word used by a past president of the Mayo Clinic, Dr. Robert Waller, to describe a new DHMC project. "This is a courageous, pioneering initiative which is absolutely extraordinary and the right thing to do," said Waller.

"This" is the reporting of detailed outcomes indicators in areas ranging from pain management to nursing care-on the Web, accessible to anyone, anywhere. Waller was one of several experts asked to review the DHMC Web site during its development. His assessment was that its "format is user-friendly, and the content is clear."

Dartmouth is a national leader in reporting comprehensive outcomes information on the Web.

Beyond basic: Individual hospitals have resisted reporting hard numbers about care, arguing that there are too many factors-such as the severity of the case mix- that can affect data. But DHMC, along with a handful of other institutions, decided to go beyond the basic required reporting of outcomes and provide the public with comprehensive performance results. "We are committed to being an organization that helps our patients and the public understand and assess how DHMC is doing," explains Dr. Thomas Colacchio, president of the Dartmouth-Hitchcock Clinic. "If we want patients and families to be active partners in health-care decision-making, we must give them the tools."

Those tools are available at www.dhmc.org/qualitymeasures/. Launched in January 2004, the site gives comparative data on patient safety, satisfaction, and quality of care. The satisfaction data is based on national surveys, conducted by Press Ganey Associates, of inpatients at over 800 hospitals; more than 3,000 DHMC patients a year participate in this survey. The site reports patients' assessment of factors such as their involvement in decision-making and their doctors' thoroughness. It also has statistics on length of hospital stays and outcomes for specific conditions, from pneumonia to heart attack. Each data item has a link to a graph comparing DHMC's results to the national average and to the top 10% of institutions nationally, when that information is available.

The Web reporting project is part of a larger DHMC initiative to measure and report outcomes. The move was driven in part by nationally recognized outcomes research conducted at Dartmouth and in part by a 2002 Institute of Medicine report urging health-care organizations to inform patients about the quality of their services so patients can make informed choices.

"Let's say one of my friends was recently diagnosed with prostate disease," says Dr. Eugene Nelson, DHMC's director of quality education, measurement, and research. "We're making it possible where he can go on our Web site and quite rapidly have access to information from, literally, around the world."

Incidence: The Bone Marrow Transplant (BMT) Program has been a leader within DHMC in reporting outcomes. The site includes details ranging from the incidence of mouth tissue irritations to the length of post-engraftment hospital stays. It also lists 100-day, one-year, and twoyear survival rates for patients with lymphoma, multiple myeloma, and leukemia.

"Bone marrow transplant patients are unique in a sense because they are shoppers," says Ken Meehan, director of the BMT Program. "Of the patients I see, two-thirds or more have already been to our Web site."

DHMC is planning to expand on what it reports. This summer, data will be added about breast cancer, pediatric issues, and pregnancy care.

Matthew C. Wiencke

If you would like to offer any feedback about this article, we would welcome getting your comments at DartMed@Dartmouth.edu.

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