Panel Seeks to Standardize Health Care : Medicine: White House task force considers developing guidelines for doctors in order to make treatment consistent.

In addition to cutting costs and providing insurance coverage for all, the Clinton Administration wants to improve the quality of American medicine by developing new standards of treatment for physicians and other providers to follow, White House officials and sources said Friday.

Staff members working for the presidential Task Force on National Health Care Reform are exploring ways to gather and disseminate data on the effectiveness of medical procedures and therapies.

Such information would be used to develop “practice guidelines” that, once refined and promulgated, would have to be followed by doctors and other provider groups--at the risk of financial penalties for failing to do so, sources said.

The ongoing White House discussions have been spurred by the work of pioneers in a field of study called “outcomes research,” which is generating data showing that doctors use strikingly different treatments for the same conditions, often based on little more than intuition or guesswork.

Such variations can be illustrated, for instance, by a tonsillectomy rate among children in Vermont, ranging from 8% to 70%, depending on where the youngsters live. Similarly, for no apparent reason, residents of New Haven, Conn., are twice as likely as those in Boston to have heart bypass surgery.

Such discrepancies can be found in the treatment of virtually every medical condition.

Thus, Administration officials believe, newly acquired information on medical efficacy will greatly enlighten the medical profession as well as the public, leading to more-or-less-uniform “practice patterns” around the country.

If endorsed by President Clinton and First Lady Hillary Rodham Clinton, who chairs the task force, the move toward practice guidelines is likely to meet with mixed reactions from physicians.

On the one hand, such guidelines could deter frivolous malpractice lawsuits--or at least provide a credible defense in court.

But on the other hand, many doctors disdain such guidelines as “cookbook medicine.”

White House officials also conceded Friday that establishing practice guidelines may create additional resistance from patients who would regard an unprecedented nationwide effort to collect detailed information about their medical histories as an invasion of privacy.

At the same time, some physicians also are apt to regard such a reporting system as unwarranted government meddling in a privileged relationship between doctors and patients.

Despite such concerns, a working group within the White House task force is moving forward expeditiously in search of a way to balance such concerns.

Sources said Friday that “outcomes research” was a topic about which Hillary Clinton knew relatively little until she was briefed on it during a meeting two weeks ago.

She almost instantly became a booster of the idea and, within days, promoted it during her meetings with members of Congress, sources said.

Analysts said Friday that using guidelines to encourage more standardized--and effective--treatment appears especially doable under a new system of organizing health care delivery that the President strongly favors.

Under the system known as “managed competition,” the federal government would establish rules leading to the creation of large consumer pools staffed by professionals who would shop among doctors, hospitals, insurance companies and other providers for the best quality and price.

In turn, such “health insurance purchasing cooperatives,” as well as participating providers, can be held accountable to certain standards of care in accordance with the guidelines, whether they involve immunization rates or lengths of hospitalization after a hip replacement, said Dr. Paul Ellwood, a Wyoming-based physician and founder of an influential group of health care thinkers known as the Jackson Hole Group, which developed the managed competition concept.

“Making organizations accountable for results is something they intend to do,” Ellwood said.