One of the more positive outcomes of the COVID crisis has been a greater appreciation of our health and physical well-being and the recognition that neither can be taken for granted. But while there are certainly steps that can be taken to reduce the possibility of illness or the potential for injury, there is no way to become hermetically protected against the ravages of nature. We therefore rely on health professionals and facilities to guide us through those periods of vulnerability and weakness, and on the Health Ministry to establish the protocols and standards on which our health depends.
The public, however, is entitle to more than generic policy statements and boiler-plated descriptions of long-term visions and goals, neither of which provide much help in determining the direction in which lies the soundest health care. Consequently, public health officials and administrators throughout the world have been steadily providing their respective citizenry with pertinent information related to health management and practice. Israel lagged a bit behind, but has recently caught up. To some extent, anyway.
With surprisingly little fanfare, the Health Ministry recently added to its website a compilation of graphical representations of statistics related to the quality of public health care in Israel. Called Data World, the principal objective of this newly-embraced transparency is to provide relevant information required for budgetary and facility planning by public health and finance officials as well as to enable the general public to make sounder decisions regarding the selection of health funds and procurement of health services and facilities. In addition to being visually impressive, the dashboard provides an array of data related to the level of treatment in hospitals and specialized facilities and institutions, a summary of the complaints that were filed against the major health funds over a period of time, and surveys of patient satisfaction of service received in the various departments and treatment areas of hospitals throughout Israel.
Little effort is needed to understand the advantages of this long overdue transparency. Such dashboards, introduced internationally throughout the last several decades, have been validated by varied and independent management and health services consultants to provide significant benefits to both health care professionals and consumers of health services. Providing, that is, the dashboards are relevant for the population for which they are intended and reflect the specific considerations required when deciding among various alternatives and options.
More importantly, the collection and representation of such data has no purpose unless it is actually used. In most western countries, health transparency generally covers the quality and expanse of available services as well as the comparative costs for procuring them. The data needs to, in the first place, be reasonably extensive and focused, but more importantly it must be designed to be user friendly and understandable even to those not particularly comfortable in the world of digitalization. Too often, the navigation of web sites and their various pages can be very confusing and finding the desired information seems like a scavenger hunt. It would be more than counter-productive if this were to describe a health-related dashboard.
What has thus far been learned from the documented experiences of those regularly using these dashboards is that transparency is not a “one-size-fits-all” characteristic. Data that is made available must, first and foremost, reflect the structure of the health system from which it is being collected and compiled. Pertinent information of health facilities in Canada, for example, may have little value in Germany. So while the statistical abstracts and presentations provided in the Health Ministry’s Data World should, in theory, provide support when health-related decisions need to be made, the charts and graphs are useless unless they are based on an accurate representation of which health services are available and how they are administered in Israel.
Israel’s healthcare system is relatively uncomplicated, which, ironically, reduces the potential benefits that transparency provides. There are, after all, only four health funds (HMOs) from which to choose, so deciding which is the most suitable is not a particularly overbearing endeavor. Factoring into the equation that not all four funds have facilities in every city, town or settlement in Israel makes the decision that much easier. The Kupat Cholim Leumit health fund, for example, may provide better home-based services and treatments than the others, but such an advantage may be outweighed by the need to travel thirty or forty minutes for something routine such as a blood test or regularly scheduled infant care. Data World does not provide what researchers refer to as non-quantifiable but nonetheless significantly important factors in the decision-making process.
What is provided, though, is the level of satisfaction measured for each of the funds. But without knowing the questions that were asked during the collection of the data, the metric is not overly helpful. There is no apparent indication of supplemental costs that are levied by the funds for unique pharmaceuticals or specialized services such as support for private nursing services or caregivers. Granted, statistical overviews are not intended to provide a comprehensive drill down of individual facilities or treatment centers, but a cleverly designed depiction of satisfaction levels can be somewhat misleading. It would be a mistake for consumers to be guided or impressed by trendlines but must, rather, check out what each fund offers and the associated costs. Only then can an intelligent decision be made as to which health fund is most suitable.
Similarly, Data World is of little use when the need for emergency treatment is called for. When an elbow is broken in a fall or an appendix unexpectedly bursts, proximity to an emergency room is the principal consideration. Even if the dashboard included comparisons between the level of service provided by the different emergency rooms in Israel – number of doctors on call, the average waiting time, available treatments and services – it would make little difference; the closest hospital with an emergency room is where panic-driven parents or spouses will run to in the event of an unexpected calamity.
What the Health Ministry has thus far provided is a good start. It recognizes that we are living in an information-driven world and that obfuscation is no longer a viable option. More importantly, there is little that concerns the general public as much as personal and family health. The more feedback the ministry receives on this new initiative – positive and negative – the more improved and relevant Data World will become. And the better off we’ll all be.