Sharing expertise to serve patients

For the last year and a half, Mayo Clinic physicians have been building a database of their best and most up-to-date medical knowledge as a way to spread best practices throughout the organization.

Today, all Mayo providers can access the information and, if they want, call or message the foremost Mayo expert on a condition with questions.

Sometime in the future, Mayo plans to roll out the service outside its system. For a fee, providers around the country could tap into the same database and consult Mayo physicians.

Mayo officials also hope the so-called AskMayoExpert program will result in more patients being referred to its flagship center in Rochester.

Dr. Rick Nishimura, a Mayo cardiologist leading the project, talked to the Star Tribune recently.

QHow did AskMayoExpert get started?

AWhen I came here 35 years ago, it was very easy to know who the experts were. Often the Mayo experts were also the world's leading experts in their field. What's happened is that Mayo is so big now that a lot of people don't know who to call anymore. We saw that we needed to develop a mechanism where we as physicians could get the best, Mayo-vetted expertise.

Secondly, there's been such a knowledge explosion, physicians can't be expected to know everything anymore. This is basically a knowledge repository that all Mayo staff contribute to.

QHow well used is it within Mayo right now?

AWe just started building it a year and a half ago and are completing the first stage at the end of 2010. Out of the 2,500 physicians we have at Mayo Rochester, about 1,200 have started to use it. Many people use it 10 to 12 times a day. About two thirds of them find an answer immediately and about a third will go on to contact the experts in the area.

QAre there any other groups around the country that have built a database like this?

AOther institutions have talked about it. No other institution has taken on the task of building this, mainly because they don't have the culture needed to have physicians put their valuable time to put the information into the system. Others are amazed Mayo can do it.

QDo you mean the group practice culture where doctors are salaried?

AMore than that. There's this Mayo culture where you go out of your way [for the patient.] If a physician doesn't have it, they don't stay here. When the idea first came up, Denis Cortese was CEO. He said: "We should build it for Mayo, sell it to other institutions in the U.S., then give it away to the third world."

QTell me how you will sell it to other providers?

AThere's going to be an affiliated physician network where physicians who have Mayo standards join Mayo in one way or another.

QWhen will you roll it outside Mayo?

AIt's all in discussions. My job was to build it. One of Mayo's goals is the concept of practice convergence, where a patient coming into Mayo Scottsdale or Mayo Jacksonville gets the same care as a patient coming into Rochester.

QI think the public assumes that's what happens right now.

APeople assume that. We want to be absolutely sure that it's done. Physicians up until recently have shown a lot of individuality in practice.

QWould you say AskMayoExpert is to providers what Mayoclinic.com is to consumers?

AAs a consumer, as a patient, you go to Mayoclinic.com and you want to read a lot of information. With MayoExpert, you're a physician with a patient in front of you. You usually want a specific question answered. That's why it's so different.

Chen May Yee • 612-673-7434