Clinical & Research News Profiles
David Bates, MD, Chief Quality Officer,
Bird-watcher and Extreme Skier
This feature is intended to build a sense of community among physicians and researchers by providing profiles of staff that focus on their work at BWH and their passions outside of hospital walls. Send suggestions for future profiles to bwhclinicalandresearchnews@partners.org
David Bates on a bird-watching trip in South Africa. |
This fall, BWH Chief Quality Officer David Bates, MD, spotted something he’s been waiting his entire life to see: an African green broadbill. This rare, tiny bird was among the highlights of Bates’ vacation in Rwanda and Uganda, where he visited the Albertine Rift, a mountainous and deep forest area along the borders.
“The African green broadbill is a very strange bird, not closely related to anything else,” said Bates, an avid bird-watcher who has seen approximately 6,000 of the world’s 10,000 birds. “We were fortunate to get a good look at it.”
Bates dedicates himself to his hobbies –birding and extreme skiing—with the same intensity as he invests in his work in quality, safety and health information technology (HIT). Named the hospital’s chief of quality this summer, Bates has spent two decades studying how to harness the power of HIT to improve the quality, safety and efficiency of care.
Quality, Safety and HIT
Bates is known around the world for his research into HIT, but informatics wasn’t something he formally studied. In 1988, when he began a fellowship in general internal medicine at BWH, his main interest was in physician decision-making. “I found that physicians in many instances were not making the best decisions,” he said.
As his fellowship concluded, BWH was beginning to implement computerized physician order-entry. “It was clear to me that CPOE was going to be a game-changer in helping physicians to make decisions differently,” said Bates, a graduate of Stanford University and the Johns Hopkins School of Medicine.
CPOE and its potential to impact decision-making sparked Bates’ interest in HIT, and his pursuit of that interest has shaped his career, impacting countless patients and care providers around the world.
“I never had formal training in informatics, but I am really happy I pursued this direction,” said Bates, a primary care physician who was eventually named board chair for the American Medical Informatics Association and now teaches a course on the topic at Harvard School of Public Health.
Studying the Impact of HIT
Bates has led pivotal studies examining the effectiveness of CPOE; his findings show that adverse drug events dropped by 55 percent when doctors used CPOE. He then helped BWH implement and evaluate the use of bar code technology in hospital pharmacies. His initial research found that medication dispensing errors were reduced by 31 percent, and administration errors were reduced by 40 percent. Further research found that the BWH customized electronic bar code system reduced dispensing errors by 85 percent and potential adverse drug events by more than 60 percent.
Bates continues to study CPOE, now focusing on its impact in community hospitals. “Most studies done on CPOE look at its benefits in academic medical centers, which use systems that are different than community hospitals,” said Bates, who directs the Center for Patient Safety Research and Practice at BWH. “This is the first big study to see if the medication safety benefits of CPOE are the same in community hospitals and academic medical centers.”
That study is one of several Bates plans to publish in the next few months.
This month, his study on patient satisfaction will be published in the Journal of Quality and Safety in Health Care. “We looked at patient expectations in different countries and tried to assess whether care providers knew what their expectations were,” he said. “If we do a better job around assessing expectations, we’ll do a better job of meeting them and that will result in more satisfied patients.”
Other studies he expects to conclude involve using telephony, a computerized approach to calling patients, to identify patients having problems with potentially high-risk medications, as well as a study on encouraging patients to adopt the personal health record. “We believe that will improve their care,” said Bates.
Looking Ahead to Care Redesign and the Role of HIT
As care redesign initiatives unfold, Bates expects that the hospital will focus even more on measurement going forward. “We’re focused on improving the quality of care across an array of measures. We want to do better with making measurement electronic so as to minimize the burden of collecting data for all these measures,” he said.
The next year will likely see a focus on preventing deep vein thrombosis. “This is an important cause of harm,” he said. “We’ve done a lot of work around preventing it, but our performance could be better.
Nationwide, health information technology is going to be a major focus. “I think it’s going to be absolutely foundational for all care redesign efforts we undertake to improve efficiency, safety and quality,” he said. “It’s a very powerful tool that we can use in an array of ways to improve care.”
Recent advances in HIT, like personal health records and widespread clinical data exchange, have the potential to make a major impact on health care delivery and management of care. “We can already do widespread clinical data exchange from a technical standpoint, but making it work operationally and figuring out business models that pay for it are going to be challenging,” he said.
At the Brigham, the focus will continue to be on making care even better. “We want to be international leaders in delivering the highest quality, safest care,” Bates said. “We are already delivering outstanding care, but we are constantly striving to make it even better.”
Work Hard, Play Hard
As busy as Bates is with patient care, research and administrative responsibilities, he strives to dedicate time to his passions outside of work, which take him around the world, often with his family.
Birding has been a hobby since he was 5 and his father started taking him out. His father has seen about 8,000 of the world’s birds, making him ninth in the world for bird watching. What’s so fascinating about birds?
“Birds live in all ecological niches, and they are a very strong indicator of how our planet is doing,” said Bates. “It’s fun watching them come back from migration each year. I especially like spring migration – all the warblers come back from South America in high plumage and singing.”
Bates’ family chose to live in Watertown because it’s close to the Mount Auburn Cemetery, one of the best places in the Northeast to see migration happen. You can often find him there on May mornings before coming to work.
This winter, he and his family will trade binoculars for skis, as they coast from Mont Blanc in France to Matterhorn in Switzerland through the glacial passes and mountain peaks of the Haute Route.
Bates, who also enjoys snow and rock mountain climbing, said, “I work hard and play hard, and I place a big emphasis on doing things outside work.”