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Ann Thorac Surg 2001;72:1-2
© 2001 The Society of Thoracic Surgeons

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President’s page

STS database activities and you: "what’s in it for me?"

Address reprint requests to Dr Orringer, General Thoracic Surgery, University of Michigan Medical Center, 1500 E Medical Center Dr, 2120 Taubman Center, Box 0344, Ann Arbor, MI 48109
e-mail: morrin@umich.edu

In roughly 15 years, the STS effort to establish a credible, risk-adjusted national cardiac surgery database has evolved into a series of parallel activities with far-reaching implications for every practicing cardiothoracic surgeon in our membership. The Cardiac Database had its origin in 1984–1985, when a small group of cardiac surgeons began to discuss the feasibility of comparing their respective clinical data so that they could determine how they were doing relative to one another. Dr Richard Clark was the "point person" for this rudimentary database effort, and his contact with Ed Sweeney of Summit Medical, Inc, of Minneapolis, MN, led to the collaborative development of software to standardize adult cardiac surgery data collection.

Selling the concept of a National Cardiac Surgery Database to STS members in these "early years" was viewed by the majority as akin to selling the proverbial coals in Newcastle. Cardiothoracic surgeons, perhaps the most compulsive of all medical practitioners, were accustomed to collecting data about their personal series and saw little reason to adopt a new system with its added administrative burden and costs. And then the extraordinary impact of the HMOs and governmental regulation of Medicine began, and the database began to take on a different meaning. As HMOs attempted to limit the number of specialty practitioners within their spheres, it was suggested that aggregate data in the National Database might be used to provide comparative information on the clinical outcomes of cardiac surgeons. And then Blue Cross/Blue Shield made a decision to use STS Database participation as a criterion of inclusion of cardiac surgeons on its lists of preferred providers. The economic incentive to be part of the National Database was born. The ability of cardiac surgeons to demonstrate that their operative results meet the norms established by the database has become an increasingly . . . [Full Text of this Article]

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