title: Gathering and learning from relevant clinical data: a new framework.
abstract: Given the rising costs of health care in today's economic environment, the need for effective, value-driven care has never been more pressing. While the U.S. health care system strives continually to improve patient outcomes, it struggles with the inadequacies due to variation in care and the inefficiencies of unnecessary resource utilization. The tools traditionally used to study care, from retrospective studies to randomized controlled trials, may be inadequate to address the complicated, interdependent questions related to defining effective care. To overcome the deficiencies of these traditional tools and better optimize our health care system, a new kind of methodology is required--one that integrates the functionality of previously existing tools in a novel way. Standardized Clinical Assessment and Management Plans (SCAMPs) were designed to accomplish this goal. A SCAMP is a care pathway, designed by clinicians, to guide medical decision making around a particular disorder. SCAMPs are unique in that they invite knowledge-based diversions from their recommendations and are accompanied by data collection and continuous improvement processes. Through these mechanisms, SCAMPs successfully reduce practice variation, optimize resource use, and create an integrated medical learning system which overcomes many of the inadequacies of traditional research tools. As such, the SCAMP paradigm may represent an important breakthrough in the effort to define and implement effective health care.
authors.affiliation: Dr. Farias is a fellow in pediatric cardiology, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Dr. Friedman is a staff cardiologist, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Dr. Lock is cardiologist-in-chief and professor of pediatrics, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Dr. Rathod is a staff cardiologist, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Farias
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Friedman
authors.forename: James E
authors.initials: JE
authors.lastname: Lock
authors.forename: Rahul H
authors.initials: RH
authors.lastname: Rathod
mesh_terms: D000465:Algorithms; D035843:Biomedical Research / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D010043:Outcome and Process Assessment, Health Care