Three questions with Dr. Sandeep Wadhwa: Shining a light on outpatient safety

I sat down with Dr. Sandeep Wadhwa, 3M Health Information Systems global chief medical officer, to talk about how outpatient safety measures could shake up the industry for the better. 

3M recently announced that U.S. News & World Report will incorporate 3M™ Ambulatory Potentially Preventable Complications (AM-PPCs) in the analysis of this year’s Best Hospitals Specialty rankings for orthopedics and urology.

There’s a lot to take in with that statement. Can you break down what’s significant about this and how it benefits the public?

Yes, and breaking news: U.S. News & World Report actually released its Best Hospitals rankings last week. For decades, U.S. News has evaluated hospitals’ quality outcomes to provide the public with information they can use when deciding where to pursue care. These hospital performance evaluations had previously focused largely on inpatient measurement of quality. This year, in collaboration with 3M, U.S. News has added outpatient outcome measures for two specialties: orthopedics and urology. It’s impactful to see how U.S. News is evolving its approach in line with the industry’s shift to more outpatient care.

This is where 3M AM-PPCs come in. Our solution uses classification logic to allow, quality organizations, regulators, providers and payers to identify and analyze complications in outpatient settings by specific procedures, service lines, providers and facilities. Using the 3M AM-PPC software, U.S. News is incorporating new outcome measures – called “prevention of outpatient procedural complications” – into its orthopedics and urology rankings for 2023-2024 so consumers are better informed about outpatient care outcomes.

Why orthopedics and urology? Not long ago, major orthopedic procedures were  essentially performed in inpatient settings, such as joint replacements. The market has really changed in five years, though, and people are now having nontrivial procedures like hip or knee replacements done largely in outpatient settings. Urology represents another high volume area of outpatient care. I give U.S. News a lot of credit for prioritizing elective procedures and informing the public about outpatient quality outcomes so people can make informed choices about where to seek care. We're thrilled to support these insights along with U.S. News – and I suspect these two specialties are just the beginning.

To provide some perspective, the U.S. health care system has built an amazing quality improvement infrastructure for inpatient care, but it currently lacks similar infrastructure on the outpatient side. So providing greater visibility into outpatient safety and quality is really important. 3M is helping providers, payers and oversight organizations fill this gap with a new way to evaluate outpatient elective procedures; 3M AM-PPCs help advance patient safety for elective procedures by allowing for specific procedure safety and complication measurement.

With outpatient safety measures in early stages, what do you see as the next phases of development – both for industry rankings like U.S. News Best Hospitals and for industry safety measures more broadly?

Looking ahead, there are opportunities to expand outpatient outcome measures for preventable complications in U.S. News Best Hospitals specialty rankings as well as procedure and condition ratings. Both of these evaluations are important – though I’m especially excited about the potential for procedure and condition ratings.

Why? Specialty rankings are of greatest use to people with complex cases who are able to shop around centers of excellence across the country for specialized care, or who benefit from proximity to top ranking hospitals.

On the other hand, procedure and condition ratings are used for more common procedures, so the impact for improving safety may be even broader. These ratings are more applicable to the general public and can be used to help consumers make more informed choices about where to seek care in their region. When you consider that the vast majority of care is delivered locally, it’s clear how meaningful it would be for patients to find out whether care providers in their area perform above or below average for the elective outpatient procedure they’re looking to schedule.

As it stands today, health systems’ outpatient procedures are booming in growth – they are convenient and less costly than inpatient care. However, many health care organizations lack awareness of how they’re performing regarding outpatient safety, and they don’t know where they stack up in relation to other providers in their area.

I think more light is coming to shine on outpatient safety. This area has traditionally been hard to measure because recovery happens at home under less supervision, but we’re now better able to track and link to post procedure events. I suspect health systems and ambulatory surgical centers will be eager to learn where they are performing better or worse than expected and to take steps to improve performance. They have an opportunity to be in charge of their own story, as opposed to someone else writing it for them – and now is the time to pick up the pen.

If a light is coming, then 3M AM-PPCs software is like a bulb, so to speak, because industry organizations and health care providers alike can leverage it to gauge performance and identify outpatient safety issues and opportunities. Since the software launched late last year, what questions and feedback have you been getting?

As I’ve been presenting about 3M AM-PPCs at industry events and webinars, there are two questions that come up time and again. The first is: Does the system work for kids? And the answer is yes – we designed the solution to span age groups and are eager to see its use for pediatric populations.

I’m also frequently asked which data sources the software uses. The system uses coded clinical data from a health system’s clinical data warehouse, or it can run from claims data. There’s a wealth of information and insights about inpatient and outpatient care outcomes found in the health systems’ data repositories; our software is one way to help sift through and gain valuable patient safety insight.

It's still early days for 3M AM-PPCs. We’re hearing that quality departments remain more focused on inpatient because there’s currently greater accountability around safety measures in that setting. I’m excited that we have a tool that can help organizations start looking at outpatient quality. Being part of this change means a lot to me because of how it can positively impact the lives and well-being of the growing number of patients who are turning to outpatient settings for elective procedures.

For more information about 3M AM-PPCs, watch the MGMA webinar “Advancing outpatient safety with reliable and actionable insights” or visit the 3M AM-PPCs webpage.

Dr. Sandeep Wadhwa is the global chief medical officer at 3M Health Information Systems.

Angela Haile-Selassie is a marketing communications specialist at 3M Health Information Systems.