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Fall 2010


More Than Ever, It's About Data

Tony Mira
President & CEO

By the end of 2010, the Anesthesia Quality Institute will have records for more than one million anesthetics in its database, the National Anesthesia Clinical Outcomes Registry. This is an impressive feat, considering that NACOR only began accepting data on January 1. We are proud of the fact that some of our clients were among the first practices to sign participation agreements and that our information system, F1RSTAnesthesia, was quickly adapted so that we could easily transmit client data to NACOR.

The overall number of practices contributing data can be expected to grow exponentially now that the AQI has truly established its identity. The AQI booth at the ASA Resource Center in San Diego will certainly draw a great deal of interest. So will the various presentations and lectures on improving patient outcomes using case registries.

To paraphrase Richard P. Dutton, MD, MBA, Executive Director of the AQI and author of the lead article in this issue of the Communique?, the volume of quality management data is just the beginning. The real value lies in the use of the data, and Dr. Dutton makes an excellent argument for the proposition that “the bottom line is that QM data equals business data.” Table 1 on page 4 lists some of the ways in which the use of AQI data can add value to an anesthesia practice, including reducing costly complications, meeting regulatory requirements, understanding the basic metrics of the practice, and “fueling resource allocation and contract discussions with facilities.”

The AQI was the future; it is now the present. Also very much in the present is the need for anesthesia practice owners—the anesthesiologists themselves—to understand the basics of running their business and to continue studying the market. “Breaking Down the Business of Anesthesia” was written by two practicing anesthesiologists and one professional practice administrator. Attorneys Abby Pendleton’s and Jessica Gustafson’s article “Focus on Compliance” also contains here-and-now recommendations.

Still in the future are various vehicles for sharing the savings from improvements in health care delivery such as Accountable Care Organizations. Re-reading Kathryn Hickner-Cruz’s and Carey F. Kalmowitz’s article on ACOs, I am struck by how heavily the Patient Protection and Affordable Care Act stacked the ACO decks in favor of maximizing patients’ choices. Even so, the ACO provisions offer so much opportunity to run afoul of the anti-kickback and Stark laws and federal antitrust principles that as we go to press, the FTC and CMS are holding a major joint public meeting to resolve apparent conflicts. The nascent ACO rules could, all by themselves, turn out to be the “Full Employment for Lawyers” legislation that we feared the Affordable Care Act might become.

We expect to learn about additional developments and trends in anesthesia practice management at the ASA Annual Meeting that begins on October 15. Please come by our booth and talk with our staff and business partners. See you in San Diego!

With best wishes,

Tony Mira
President and CEO