Medicine: the big data challenge

In 2005, when I founded Practice Fusion – the first free, web-based electronic medical record (EMR) system in the US – I envisioned a birth-to-death personal health record (PHR) for patients everywhere.

Now that we are the largest patient-physician community in the US, with over 50 million patients on our platform, that vision is becoming a reality.

America badly needs a medical record system. Healthcare in the US continues to lag behind other developed countries like Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom. Compared to many of these, we pay more than double per capita without improved outcomes. Yet we excel in technology and innovation, two things that can be used to bring much needed efficiency to the sector.

A recent McKinsey report estimated that $300 billion in annual healthcare savings – 8% of current US total expenditure – could be found by using “big data” better. That is a saving equal to the annual gross domestic product of South Africa.

Big data requires large numbers of brilliant data scientists. The most powerful data analysis tools are ineffective unless they can be unlocked for patients, physicians, pharmaceutical companies and budget holders alike.

The first obstacle is access — you need data before you can use it. And access depends on incentive. Pharmaceutical companies have incentives to capture data on research and development and medication effectiveness, but small, busy providers do not.

If you get reimbursed for a service delivered, the clinical outcome data is largely irrelevant to your bottom line. Larger clinics and hospitals, whose pricing schemes are unpredictable and often extravagant, actually stand to lose money as a result of greater transparency.

But how portable is this data? Practice Fusion aggregates clinical information from small practices all over the US. This is a start, but still a long way from having integrated data between hospitals and primary care (to ensure continuity of patient care), or between providers and pharmaceutical companies (to increase insight into medication effectiveness).

Without this incentive, what future does data in healthcare have? While no one has strong reason to gather and integrate their own data, everyone stands to gain from what everyone else shares. Budget holders want to know the cost-effectiveness of providers’ treatments. Providers want to know whether their patients are complying with medication regimens. Pharmaceutical companies want to detect Vioxx-style medication recall meltdowns before they happen, as do patients.

As companies and innovators in this space, it is our job not only to meet the demands of all the stakeholders, but also to create a demand for more data by showing them it can produce better care and cheaper costs.

We have to demonstrate the power of the health data ecosystem. Luckily, we, at least, already have a great incentive to do so.

 

About the author: Ryan Howard is chief executive officer of Practice Fusion, a provider of free, web-based electronic medical records. Practice Fusion were selected as a World Economic Forum Technology Pioneer 2013.

Photo: Reuters/Nir Elias