"Notes from the Field" is a special newsroom feature highlighting industry professionals working to transform healthcare. In this edition, we spoke with Dr. Angela Chien, Obstetrician/Gynecologist and the Medical Director for the Obstetrical Care Outcomes Assessment Program (OB COAP) at the Foundation for Health Care Quality (FHCQ).
1. Tell us about your role.
I serve as the medical director of the Obstetrical Care Outcomes Assessment Program (OB COAP) at the Foundation for Health Care Quality (FHCQ), a nonprofit organization based in Seattle, Washington.
FHCQ is home to several programs focused on quality improvement and patient safety – one of which is OB COAP. OB COAP is a perinatal collaborative, collecting and housing provider-specific, chart-abstracted obstetrical data, including labor, delivery, and postpartum, from voluntary participant hospitals. This standardized database allows hospitals to compare their performance with others in the collaborative, providing more insights into robust clinical outcomes than what can be obtained from electronic medical records or administrative data used for billing purposes alone.
This database also enables us to track performance measures over time and gain insights into perinatal care that are not readily available through other means. In addition to my administrative role, I am a practicing obstetrician and continue delivering babies across two hospital systems.
2. What inspired you to pursue a career in healthcare?
My grandfather was a rural family doctor in Taiwan, where my family is from. He had an exceptional rapport with his patients, who held him in high regard. From a young age, I assisted in his clinic, performing various duties like those of a nursing assistant or pharmacy technician today. This was at a time when plastic syringes were not yet available, so we had to sterilize glass syringes by hand by boiling them.
I vividly recall the experience of doing this from the age of ten until I was about 14 years old. Observing my grandfather's work from an early age left a lasting impression on me. When I turned 19, as I pursued a degree in biochemistry and contemplated my future career path, it seemed only natural to pursue medical school.
3. What do you think is the biggest challenge in healthcare?
One of the most significant challenges in healthcare is the presence of racial and social inequities. It's crucial to gather data on clinical outcomes for different racial and economic groups to address these disparities effectively. Existing healthcare data has not adequately addressed these inequities, but the Foundation's extensive database (as an example) can provide the necessary insights. We must analyze this data to drive meaningful change and understand what works and what doesn't in healthcare delivery processes.
4. What do you think is the most significant opportunity to improve healthcare?
I am convinced that enhancing healthcare hinges on the availability of comprehensive and robust data. At the end of the day, most physicians, midwives, and nurses are scientists, and data helps us from a clinical standpoint to ensure best practices. We have an opportunity to analyze the data and address disparities in healthcare, such as care variations across hospital locations and even among providers. Acquiring the data is undeniably challenging and labor-intensive. However, we are exploring the potential of utilizing AI to streamline data extraction from electronic medical records, making this process less burdensome.
5. What have you learned in the past year?
Over the past year, I've learned the importance of having patience. Early in my career, I was eager to see immediate progress, particularly in healthcare, but I've come to realize that meaningful change takes time. Although it can be discouraging when results are not immediately apparent, I've learned to persevere and remain committed to the process. With advancements in AI and machine learning, I am optimistic about our ability to analyze and predict outcomes more efficiently.
6. Who is your mentor, and why?
There are many trailblazers in the field of women's healthcare. Yet, I find inspiration from influential women across various industries and consider them all my mentors. They motivate me to persevere and keep pushing forward. What I truly admire about these women is their refusal to accept no for an answer. Their unwavering persistence and belief in their work are truly commendable.
In my role at the Foundation, obtaining hospital data can be challenging. Still, we press on because we believe this data is crucial for instigating real change within the healthcare system, especially as it relates to maternal deaths where women of color are overrepresented.
7. What refuels your passion for the work that you do?
My involvement in the maternal mortality review panel for the state of Washington constantly reminds me of the critical importance of collecting meaningful data to understand why we are still experiencing maternal deaths. When considering the progress made by the industry in reducing these deaths, it appears to be a slow process.
I firmly believe that analyzing data is crucial in this regard. Furthermore, when discussing maternal mortality at both state and national levels, it becomes evident that racial inequity plays a significant role. Women of color are disproportionately affected, highlighting the need to examine differences in care within hospitals and address any biases.
