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Kyruus Blog

Constant Medical Practice For Better Patient Access

Thanks to their star player, Johns Hopkins’ pancreatic surgical team has a batting average of .980. This is no small feat.

Pancreatic cancer is infamous for its poor prognosis, even when detected early. Even its treatment, a complex surgical procedure called a Whipple procedure, carries a mortality rate as high as 25 percent – not exactly the most favorable odds for a patient who is already battling a frightening outlook [1].

However, at Johns Hopkins Hospital, this high mortality rate has become a relic of the past. A large part of that story can be attributed to Dr. John L. Cameron. Dr. Cameron is an avid practitioner of the Whipple procedure – in fact, he exclusively performs the procedure. As a result, he has completed more Whipples than anyone in the world. The results of this level of specialization speak for themselves: at Johns Hopkins the Whipple procedure has a mortality rate of only two percent[2].

At Kyruus, we endeavor to transform the delivery of healthcare by embracing the concept of Moneyball – the now widespread statistical strategy espoused by Oakland Athletics GM Billy Beane. Instead of relying solely on the marketability of appearance or a player’s name recognition among scouts, Beane used statistical data to build a team based upon an individual’s unique skill set. As the story goes, his tactics transformed the A’s from a perennial loser to a playoff contender that out-competed teams with more than 3 times the cash to pay their players.

If we were to translate Cameron’s surgical success rate into a batting average – Cameron would get a base hit 98 percent of the time. That type of statistic would make any recruiter or general manager happy to include him in their lineup. However – and this is the key – Cameron’s performance relies on placing him in the right situations to maximize his success. If he were playing baseball, he would be considered a player with a keen specialty: someone who may hit .980 - but only against left-handed pitchers that threw a knuckleball. His “batting average” would most likely drop significantly if he were not matched up in a situation where his special strength would come into play, such as heart surgery.

This highlights a distinct advantage of medicine over baseball. In baseball, neither the player nor the manager can control the type of pitch their opponent throws. But in medicine, a physician and /or her administrators should have the final say over what types of patients that physician sees. This should be a tremendous advantage for the practice of medicine – so why do physicians ever bat less than 0.980?

While the concept of broad medical specialties is well established in medicine, physicians often find themselves up to bat in the wrong situation – the result of mis-directed referrals or the simple lack of detailed profile information about their given expertise. Our research over the last couple of years suggests that over 97 percent of physicians have reported receiving inappropriate patient referrals and that more than a quarter of all referrals may be sent to the wrong specialist[3] every year! The net result is that millions of patients receive suboptimal care.

Our mission at Kyruus is to provide patients with a better match – to make sure that their physician is the right specialist for their condition. Using our platform, healthcare organizations (the Billy Beane’s of medicine) are able to match patients to providers that can tackle not only their medical needs, but ones that also fulfill other patient priorities, such as location, insurance, and earliest availability. Just like the Oakland experiment, this means thinking about medical practice in a new way – a way that utilizes data to inform the best probability for a good outcome. Whether a patient needs the best care for their pancreas, their heart, or their joints, we are striving to place someone like Dr. Cameron at the top of their lineup.

References:

[1], [2] 10 Changes in Surgery in 25 Years: Improved medical procedures have changed the way patients heal, available at: http://health.usnews.com/health-news/hospital-of-tomorrow/slideshows/10-changes-in-surgery-in-25-years/3

[3] Kyruus study on physician referral accuracy and sentiment, available at: http://kyruus.com/wp-content/uploads/2014/05/Kyruus-Whitepaper_Physician-Referral-Sentiment_FINAL_May_2014.pdf

Topics: Referral Management Analytics Patient Access Provider Networks