Do you have the information?

Fans of the American Movie Channel will recognize the great character actor Peter Lorre. His bug-eyed, deadpan visage and strangulated, French-accented whine conveyed a feeling of dangerousness, used to striking effect in such films as "Casablanca" and "The Maltese Falcon." A comedian in the 1950s could get a sure laugh by imitating Lorre's supposedly stock line, "Do you haff the infoomashun?" Today it seems that Mr. Lorre is re-embodied in the form of various managed care executives asking health care providers, over and over, "Do you have the information?" - or, more likely, "Do you have the data?"

Data, data, data - it's all you hear these days in discussions of health care (and if it isn't, it soon will be). Today's long-term care is a lot about accountability. OBRA is based on nursing homes being made accountable for their care, and accountability is the very reason for the existence of managed care. As long-term care (and other) providers have discovered, to their increasing pain, accountability means documentation - i.e., "show me" in a language that we can all understand (i.e., numbers, aka "data").

For those who went into health care for all the right reasons, such a strong emphasis on numbers can be highly offputting. Obviously facility managers are accustomed to financial numbers, and clinicians use numbers - in laboratory tests, physical examinations and prescribing - all the time. But the true bottom line is (or should be) the well-being of the resident or patient. To focus so much on data - well, it's small wonder that the "Star Trek" character named "Data" is so pasty-faced and green around the gills.

Oh, well, it's time to get over it. There's no escaping the demand for more data. Maybe, though, there's a way to make all this more professionally satisfying. What, for example, if these data could be put to use to actually improve the provision of health care? What if they could be made to create "pictures" showing you, the manager and/or provider, what is being done to whom in your facility, and how often? What if they could show you how your answers to these questions compare to the answers your peers might give? Would you feel better informed about what's really happening in your facility - what's good and should be re-emphasized, and what's not so good and should be stopped or improved?

That's the promise offered by a new generation of computer software just making its entrance into the long-term care field. It still does counting, because that's what software does best. But it counts not only how much you bill, how much you take in and how much you spend. Nor does it count only what you order, how many treatments of a specific type you are providing, or how many residents are coming and going through your facility. Rather, it ties all of this together so that you know who, or what, is costing you the most, where you seem to be getting the "biggest bang for the buck" and where, conversely, the costs are exceeding your income. It doesn't answer "Why?" No data can. But it can give you very strong direction in your efforts to find out.

It's called integrated software, and you'll be hearing a lot about it in coming months and years. Of course, "integration" is another favorite word of 1990s healthcarespeak - you'll be hearing more and more about "integrated" health care delivery systems, too. In fact, if you can use "integrated" and "data" in the same sentence in talking about your facility operations, chances are you have a leg up on the Millennium.

This issue of Nursing Homes is designed to help get you there. Hopefully you will find yourself in a better position to "get the information." If nothing else, it will help keep that scary Peter Lorre at bay.