I remember it well: it was a brisk fall morning in 2007 and we had just learned of yet another problem related to CMS Core Measures that had caught us completely by surprise. A patient at our specialty eye hospital had, unbeknownst to those of us in Quality, had a heart attack during his stay and this meant information on the quality of the care he received was supposed to be submitted to CMS. Unfortunately, that didn’t happen.
We were a couple of years into focusing on our Core Measures performance, and a big part of that was tightening up the whole process around data submission. We put monitoring tools into place to alert us to issues, we added more people to the process of ensuring data quality and completeness, and we put pressure on our vendor to ensure they had their house in order. And yet, issues kept popping up.
Our eye hospital, where it was rare to even have a midnight census of one, had cared for a heart attack patient who received appropriate care but was unknown to the Quality department—we weren’t watching for Core Measures cases to occur at that hospital. This was no minor issue. A portion of the hospital’s Medicare reimbursement was at stake for failing to report the quality of this patient’s heart attack care.
Well-intentioned, competent people were putting hard work into improving the Core Measures process, and yet those efforts only did so much. Out of frustration, I dusted off high school algebra concepts and demonstrated my assessment of the situation on the whiteboard: hard work had definitely reduced the (forgive my language) suckiness of Core Measures, but there was an asymptote at “still too sucky” that seemed impossible to cross.
What’s an asymptote, you ask? Here’s a refresher: an asymptote is an imaginary line, or limit, that an equation approaches but never touches (much less crosses). Take the equation y = 1/x. As x gets larger and larger, y gets smaller and smaller but never reaches zero (1/1 = 1, 1/10 = .1, 1/1000 = .001, 1/1000000 is still ever-so-slightly above zero), hence the equation y = 1/x has an asymptote at 0. Core Measures, you’ll remember, had an asymptote at “still too sucky.”
This concept of an asymptote seemed to resonate with people, especially nerdy people like data analysts and doctors. So we decided to create a campaign, complete with buttons. But everybody knows an effective campaign needs a catchy slogan. We tossed around ideas like “Remove the Asymptote,” “Eradicate the Asymptote,” and “Mitigate the Asymptote through a Concerted Effort of Like-Minded Peers,” but none of those seemed worthy of the cause. Then a particularly astute member of the team—we’ll call her Sallie Boronis—said, “we need to defy the asymptote, like you would defy gravity.” She was right. An asymptote, like a law of nature, can either be accepted…or defied!
I could tell you that we had some grand purpose behind the Defy the Asymptote campaign, but that would be a lie like the one I told you about remembering the weather on the day we found out about the heart attack/eye patient. No, it was more about a fun respite from difficult work and sticking it to the enemy (asymptote) in our own way. But the response we got from the campaign was so positive that when it came time to name our fledgling healthcare consulting company years later, we had to incorporate defying the asymptote somehow.
So that’s the story behind the “DTA” in “DTA Healthcare Solutions”. At DTA we use defying the asymptote as a tongue-in-cheek way to describe how we can help with problems that seem like they can’t be improved. Maybe your asymptote is patient satisfaction scores that have plateaued, or physicians that aren’t “engaged” in improvement, or a situation where you’re making all these deposits into the EMR and can’t get any useful data back out, or quality improvement projects that are just plain stuck. Whatever your asymptote, if it falls into the category of healthcare strategy, quality and experience improvement, or the data necessary to accomplish those things, we can help!
