Catherine H. MacLean, M.D., Ph.D., Hospital for Special Surgery

Catherine H. MacLean

Value in Healthcare

Editors’ Note

Catherine MacLean, M.D., Ph.D., was appointed to her current post in August of 2015. Dr. MacLean, a rheumatologist, earned a Bachelor of Science in pharmacology from University of California; a Medical Degree from Washington University School of Medicine; and a Doctorate in Health Services from UCLA School of Public Health. Prior to joining HSS, she served as the Staff Vice President at WellPoint’s Center for Quality Measures and Improvement.

How do you define your role within HSS?

Value in healthcare is about the quality of healthcare in relation to the price we pay for it.

There is a lot in that definition and, as a starting point, we recognize that we all must be responsible stewards of our healthcare dollars, meaning that we need to avoid care that is unsafe, avoid duplicative care, and avoid inappropriate care. This has been the focus of most value initiatives across the country.

These three things feed into quality but, additionally, we need to be thinking about improving the health of the patients we’re treating. Patients don’t come to a hospital to avoid a complication; they come to a hospital to get better. We absolutely need to avoid complications, but that isn’t good enough.

A big focus of the work I’m doing is thinking carefully about that entire value proposition, how we can provide the highest quality care for our patients both in terms of improving health outcomes and avoiding complications, while also maintaining the extraordinarily high patient satisfaction that we have built over the years.

Part of my work is in incorporating the routine assessment of quality components and reporting those back into routine care delivery.

Every hospital has a quality department and a revenue cycle department. Often, these are looked at in silos, but we need to look at things in real time and build this information into our electronic health record and other systems we use to assess quality.

Is it important for you to engage HSS’ doctors in this work?

We’ve had a number of research registries for years where our clinical staff and our research staff have been looking at patient-reported outcomes and the impact of all manner of clinical activities on those outcomes.

We kicked off an initiative at the end of last year where, for every patient who has a procedure done at HSS as an inpatient or outpatient, we’re collecting a PROMIS global health assessment. Our goal is that, by the beginning of next year, we will be collecting a PROMIS global on everyone.

We’ve worked closely with our clinical staff to determine which measures are the best for each of the diseases, and we’re in the process of building up the operation to do that measurement for everyone.