A few weeks ago I spent some time in Chicago for a couple of days. I have this uncanny ability to get lost in many of my traveling adventures. Whether I have a compass, the navigator app on my phone or even someone verbally telling me 12 step directions, I tend to easily become lost. I have zero sense of direction whether in a city or on a trail in the woods.
As I was trying to figure out how to get to the Navy Pier, I took a little excursion to see a whole lot of sailboats. The colors and the lines snagged my attention to such a degree I had to snap a photo. The whites and the blues... the perpendicular lines... with a backdrop of really tall buildings just seemed to appear really neat.
When I see the above image, an important question pops into my head.
What's real? I know that seems like an odd question. I'm very serious about this question though. We live in a world that we can no longer say that everything we see is true. Even I just had to take liberties to change the real photograph to make it how I really wanted to see it.
I didn't like the black and yellow at the bottom of the image. The construction going on with the blue and gold building ruined the perpendicular lines. Why not just get rid of the bothersome parts? I can get rid of them... so poof... gone!
I have a few patients I've treated this last quarter that are going to affect my outcomes data. I'm sure every clinician has patients that don't improve. Why not wave a magic wand and have those patients be eliminated from analysis? If I were analyzing my own data within my own database, it would be tempting to delete data. It really doesn't take much time or energy to delete a record of data - just a click of a button.
We live in an altered world... raw is gone and altered is in. We don't know what's real. The non-real is affecting our perceptions of what is real.
What do you need clinically that is real and unaltered to measure your clinical performance?
You need your real patient data. You need a system with millions of episodes of care that is able to risk adjust based on your real, raw patient data to provide a predicted outcome.
You need to know what percentage of treated patients are included in the analyzed data.
You need to know the percentage of complete data sets that were analyzed when measuring your clinical performance. What I mean by this: for every patient with a predicted outcome there has to be another set of data telling the rest of the story - what happened after receiving services?
You need a scorecard. The data has to be consistently analyzed to inform you of your clinical performance.
Because we live in an altered world, it probably isn't realistic to depend on an in-house solution. It's too easy to alter data in your own database.
I have mixed feelings about the image I altered. The altered image appears better to my eyes. Deep inside me though, I know the altered image is fake. If I can easily change an image to be to my liking, where is the line in the sand that I won't cross between true and lie? Granted, I know for the moment it's just an image. At the same time, I also know that small decisions lead to habits which build or change one's character.