I’m often taking aback by the lack of automation and underutilization of information assets in the world of healthcare. Over the years, so much effort went into dealing with compliance and privacy issues that the core thrust of why the healthcare systems exist seems to be lost in the mix.|
No matter if you were for or against the new healthcare regulatory changes, the end result is that more people will be tossed into a system that is already at capacity. You can either ration the capacity you have, which is unacceptable, or, increase capacity quickly, which is unlikely. Or, you can get better at delivering healthcare services with the resources that exist.
The fact of the matter is that most healthcare providers are under-funded, which leads to being under-automated and under-innovative. Moreover, there seems to be a growing chasm between those who deliver healthcare to patients, and those how drive IT within healthcare provider organizations.
The statistics back up my statements. According to Gartner, anticipated growth opportunities put some industries at the top when it comes to global IT spending (see Figure below). However, Healthcare Providers were not in the top for growth opportunities, coming in at $15,311M. Even Utilities beat them out by a projected $18,756M. Think about the number of changes in the world of healthcare providers and this is surprising at best, or very scary at worst.
The solution to this problem of too much to do and not enough resources to do it, is one of leveraging the right new technologies, some careful planning, and moving from a reactive to proactive state in the world of healthcare IT. Here are just two opportunities that I see:
Manage patient data holistically, and in new, innovative ways. The rise of big data as a set of new technologies provides new options for both the storage and analysis of information. This leads to better patient care and cost reductions. The use of cloud computing provides the elastic capacity requirements at costs that almost all healthcare provider organizations can afford. When combined, you have something that is clearly a game changer.
This concept is nothing new. When I ran a healthcare IT organization in the 90s, there was then the vision of leveraging healthcare data for the greater good of the patient. However, there is only so much Oracle and Mumps that you can afford, as well as data center space to run them on.
The use of Hadoop and other cost effective open source and proprietary technologies allows healthcare providers to gather all of the information that they should be gathering. This includes massive amounts telemetry data (e.g., data gathered through sensors linking back to smartphones), such as ongoing blood pleasure readings, heart rate readings, O2 saturation readings, activity, etc.. Then that information fires back to large databases where it can be analyzed along with patient profiles, and treatment data, and then perhaps it links back with massive amounts of predictive modeling information, such as historical anonymous diagnosis, treatment, population, and outcome data. Again, this has always been the vision, but, until recently, well out of affordability and practicality range.
Now doctors can use this information to better form correct diagnostic opinions, or, perhaps more importantly, automatically determine negative health consequences from existing time series data gathered, and recommend preventative treatment. While there are obvious moral issues around making sure we provide patients with the best care possible along with data privacy, the business case is that we’ll ultimately put much less strain on the healthcare system by keeping people out of emergency rooms and hospital beds.
Stacey Higginbotham’s recent piece on the use of big data in healthcare at Aetna is a good point of validation that the use of big data is a clear economical path to providing better care. “Aetna, the insurance company that currently serves 18.2 million members, has a lot of data on its customers in the form of conditions treated (or billed for), prescriptions filled and the types of treatments doctors prescribe, and now it’s using that data to improve patient care.”
The objective here is to control costs, but they are able to do this by keeping their patients as healthy as possible for as long as possible. They can become proactive rather than reactive, now that they have true visibility into patient information over time.
Combine data into huge analytical data sets that exist on cloud computing providers, providing universal and open access. Building on the big data concept, the other opportunity is to combine diagnostic, treatment, and outcome data within a central site that becomes the historical context for new diagnostic and treatment data.
Again, this is an old vision. However, with the use of newer big data technology, the elastic capabilities of public clouds, and the ability to do this largely without new capital expenditures, this can now be the “perfect storm” of innovation and utility.
Thus, when we go to the doctor’s office for preventive care or treatment for a health issue, we don’t rely on the experience of just one doctor who forms opinions based upon only the data that he or her sees in that instance. Instead, we’re able to place our symptoms and biometrics in context with millions of other symptoms and biometrics to find patterns in treatment and outcomes that will better our own treatment and likelihood of a positive outcome. Or, perhaps we will find issues that may not be readily apparent to the clinicians, such as symptoms and biometrics that may point to more series issues such as cancer, as well as the patterns of treatment that are likely to succeed.
Of course, there is the whole big brother aspect of this type of technology, and the perception that privacy will be the tradeoff for better analytical metrics or quality of care. Those in healthcare IT are understandably concerned about violating patient privacy as well as violating the law. You need to be vigilant about these issues, understanding that we could actually provide better security and privacy with the emerging technology if attention is paid to the planning and design.
Again, there are not many new concepts here. However, there are some new, shiny tools in the shed, namely, big data and cloud computing, that have some amazing potential. As the size of healthcare providers IT budgets remain frugal, and the requirements on the healthcare systems continue to increase, those in healthcare IT either need to get innovative and creative, or count on the next ten years to be difficult for both providers and patients.