P557 Data communication practices for reporting health care outcomes to improve quality of care: A scoping review

Abstract

Abstract Background Value-based health care (VBHC) aims to improve care quality while minimizing costs. An important mechanism of VBHC involves monitoring and reporting health care outcomes to health care providers (HCPs) through data communication (DC) or data feedback. For complex diseases like Inflammatory Bowel Disease (IBD), unwarranted variation in care practices is ubiquitous. Health care data can be used to improve care by showing insights about achieved outcomes and practice variation to HCPs. While some tentative best practices for DC exist, a comprehensive overview is needed to gain a better understanding of how to effectively report health care outcomes to HCPs. This scoping review addresses this gap by examining the use and effectiveness of DC practices not only within the specific realm of IBD but also drawing insights from other clinical fields. Methods Studies that implemented and evaluated DC to engage HCPs with data and improve outcomes with qualitative or quantitative designs were sought. Medline, CINAHL, Scopus, Web of Science, Embase, the Cochrane Register of Controlled Trials and PsycINFO were searched for publications in English between 2010 - April 2023. Two researchers reviewed titles, abstracts and extracted data from eligible full texts. Results We screened 5,857 studies and included 239: 51 randomized controlled trials, 28 quasi-experimental, 121 pre-post intervention, and 39 qualitative studies. In 35% of those, feedback was implemented in acute care, 30% in primary care, 25% in tertiary care and 10% in other settings. Most interventions (76%) combined DC with co-interventions targeting HCPs’ intrinsic (providing education, post-feedback discussions) and/or extrinsic motivation (incentives, social influence). Additionally, 80 (33%) studies included nudges as part of co-interventions: action toolbox (n=38), reminders (n=28), posters to visualize compliance (n=12) and commitment messages (n=2). Best practices used in DC design included ‘benchmarking with peers’ (n=131), ‘timely feedback’ (n=141), and ‘active delivery of feedback’ (n=147). Most pre-post studies showed positive outcomes (96%), while only 63% of the studies with controlled designs showed positive improvements in outcomes. Conclusion The findings of our study highlight the use of DC (co-)interventions in various clinical fields. Additionally, we identified only few studies with controlled designs. In the future, studies with controlled designs testing the effectiveness of DC strategies and additive effects of different co-interventions are warranted to facilitate targeted improvements, particularly in the care of IBD patients, where care practices vary widely.