Using data to influence decisions, behaviors, and outcomes is as essential to improving healthcare delivery at Intermountain as it will be to transforming healthcare globally.

Intermountain’s Surgical Services ProComp initiative employs resources to provide surgeons transparent access to meaningful costs and outcomes data related to procedure comparisons, provider comparisons, patient-reported outcomes comparisons, and supply comparisons. It also provides a forum to discuss those results.

The Surgical Services Clinical Program has been working with physicians, using ProComp, to improve the value of healthcare in three specific clinical areas related to surgery: appendectomies, blood utilization, and tonsillectomies. Using ProComp cohorts and targeted data, physician-led collaborations have found practical solutions to reduce variation in care and ultimately make high-quality care more affordable.


Pediatric general surgeons at Primary Children’s Hospital discovered significant variation in supply costs for a laparoscopic appendectomy, with the average supply cost per case landing around $840 per surgery. Within one year of reviewing data and collaborating on best practice, our experts agreed on a standardized approach to the surgery and brought the supply costs down to $275 per case with no negative impact to quality outcomes for patients. This 67 percent decrease in supply costs has supported a 35 percent decrease in direct costs, an 18 percent decrease in total costs, a 16 percent decrease in total charges, a 23 percent decrease in insurance payments, and a 17.9 percent decrease in other payments. Following successful standardization at Primary Children’s Hospital, the physicians shared the practice changes in forums where surgeons across the system learned about opportunities to improve care in other areas.

Blood Utilization

The Surgical Services Clinical Program analyzed data that showed patients who received blood at Intermountain received two units 50 percent of the time, whether they needed two units or not. Although ordering two units of blood for every transfusion has historically been a practice taught in medical schools, it’s not an evidence-based practice.

The Surgical Services Clinical Program implemented evidence-based transfusion protocols, and physicians across the system championed protocol education to other clinicians. Since 2012, the project has decreased the number of transfusions by more than 12,000, eliminating $3 million in costs. Blood utilization continues to be a measure that the Surgical Services Clinical Program keeps in front of physicians. A customized report is sent to all providers whose patients have received blood during their care. By reviewing the reports, our physicians can track their orders for one or two units of blood and make more informed decisions going forward.


A physician-led case study reviewed the variation of costs and outcomes associated with the different devices used during a tonsillectomy.

The average supply costs for various tools to perform this same procedure had a wide range:

  • $46 for electrocautery
  • $254 for coblation
  • $202 for a microdebrider
  • $346 for a Harmonic scalpel
  • $40 for a basic steel knife blade

Basic outcomes data—consisting of surgery time, PACU time, complications, and hemorrhage statistics—indicated there was no difference in the complication rate based on the device used.

To prepare meaningful data that would be compelling enough to change the practice of providers, the Surgical Services Clinical Program began work on collecting patient-reported outcomes as well: 672 parent responses were voluntarily offered from the 1,444 patients included in the tonsillectomy study. Parents reported outcomes for the child’s pain score on day 2, 3, 7, and 14; the number of days until the child returned to normal activity; the number of days until the child resumed a normal diet; the number of days the child no longer needed any pain medication; and the number of days until the child stopped taking narcotics. These outcomes again indicated no statistical difference between the devices used during the procedure.

Educating physicians about this data through a customized report has led to more physicians reconsidering the devices they use during a tonsillectomy, and ultimately, will lead to consistent high-quality care at more affordable costs for patients.