Improving Clinical Outcomes for Patients

Jason Wasfy, MD, is the medical director of the Massachusetts General Physicians Organization and the director of quality and analytics for the Mass General Heart Center.

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In this video, Dr. Wasfy discusses his passion for fundamentally understanding the effects of public policy changes on clinical outcomes for patients. It’s his desire to implement policies that are effective in improving those outcomes.

Transcript

We used a large database within the Massachusetts General Hospital Heart Center of echocardiograms to understand the question of how patients fare with aortic valve replacement when they have very low ejection fraction. The guidelines support us operating on these patients but in practice, many surgeons walk away with the concern that the patients may not be able to survive surgery. And we took advantage of a unique data resource at Mass General because we have access to all these echocardiograms. Through clinical registries of surgery, we can know how patients do with surgery, but we don't necessarily know how patients do with surgery relative to no surgery. And that's what matters. Because what we need to do for these patients is make an assessment of whether their life will improve with surgery.

What we found effectively is that’s patients who receive surgery in this clinical situation live far longer than patients who do not receive surgery. In any kind of observational analysis, we can’t totally adjust for all the characteristics that are different between these populations, but we believe that our results should build a lot of enthusiasm for operating on these very sick patients because they appear to do a lot better with surgery in these circumstances.

I’m really passionate about really fundamentally understanding with great detail the effects of public policy changes on clinical outcomes for patients. Very often health policies change without a lot of evidence for what policies help our patients the most and really rigorous statistical approaches to large data sets can often give us a lot of insight into how policies affect our patients. We want to implement policies that are effective in improving clinical outcomes and certainly don't have adverse effects. We’re very interested in looking at Medicare data and data from large national data sets to understand a lot of the effects of health reform on clinical outcomes for patients. There is a lot of controversy about health reform and health policy but we take the position that really rigorous evidence is critically important to inform policy development in the future

Refer a patient to the Mass General Heart Center