Healthcare Big Data in 3 Easy Steps

Big Data will change the way we practice, fund, and regulate medicine. Patients and clinicians need to know how this will impact them.

This post asks “What is Big Data?“, “How Will It Help Healthcare?“, and “What Should We Watch out for?“

What is Big Data?

We hear about it when giant companies collect every mouse click, or every second you spend on each website you visit. Data sets balloon in size and complexity beyond what common computing can handle.

Now imagine collecting every bit of information to do with healthcare: labs, x-rays, clinic visits, public health data, billing data, payer databases, electronic medical records, pharmaceutical databases…everything.

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Just collecting it would be a nightmare; trying to make sense of it all at once seems impossible.

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Big Data tackles both.

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You could imagine it’s a giant vacuum and catalogue system for structured and unstructured data; anything an organization or industry might want. To learn more check out: Big Data Revolution, McKinsey website, Wikipedia.

How Will It Impact Healthcare?

transparency improves
detailed information become available
accuracy sharpens
storage capacity expands
analytics improve quality, accountability, and decision-making for individuals and groups

What Should We Watch Out For?

privacy presents the biggest challenge
control by non-experts: insurance companies, government
relevance – should be relevant to healthcare not general interest
improvement – not punitive
abuse: people/governments/companies using data for personal gain; creating value only for themselves
confusing correlation with causation – data will show associations that might have no relation to causality
limits – Should we collect everything? Personal details?
overuse – Big Data is a sledgehammer that might be used for everything when simpler approaches would be more cost-effective (big data problems)

Big Data is here. How are we going to benefit patients with it?

Doctor Bashing in #TheGlobeandMail Re: Unemployed MDs

Mr. Picard makes it sound like presumptuous, young docs refuse to compromise their dreams and would rather be unemployed than work in rural towns: How poor HR planning leads to unemployed doctors – The Globe and Mail.

He’s wrong.

No doubt, some physicians would sooner be unemployed than work as the only specialist in a rural setting where they are on call 24-7. But, most unemployed docs are surgeons who can’t get operating room time.

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If the system can’t pay for surgical suites, then surgeons can’t work, and patients will continue to suffer on waiting lists.

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Let’s work together to find system solutions to patient waits and unemployed physicians instead of distracting with gratuitous slams on doctors.

Built to Fail: Canadian Healthcare + US Legal System

Canadians take pride in having non-American healthcare.

US healthcare makes millions by driving activity: patient visits, tests, and procedures. American lawyers take money back with lawsuits. Canadians have a very similar legal system, also based on English common law.

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If healthcare is a commodity that can be bought and sold, patients should be able to sue for bad product.

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But, if healthcare is a public offering paid for with tax dollars, patients should have rigid limits on lawsuits, or not be able to sue at all.

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Here’s why:

Threat of suit changes behaviour, but not for patient benefit. Providers change behaviour to protect providers, not patients. Physicians order tests far beyond what’s needed, just in case.

Defensive medicine is expensive. Providers know that ordering more tests protects them in court. More testing also fits commercial interests: sell more. So, commercialized medicine and medio-legal activity benefit each other: more tests and more law suits!

Extra tests put patients at risk. Every test carries some inherent risk: radiation, discomfort, etc. Tests also carry the risk of false positive results that can lead to useless surgeries (with risks) and more useless tests.

Publicly funded healthcare was designed for necessities, not to generate more business. It never existed to create work for itself. Doing more in a system designed to cover only the necessities eventually leaves too little to cover the basics.

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We need legislated legal reform. Our publicly funded system will go bankrupt if it exists with our current, American-style legal system.

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Benefits of reform:

Improved quality of care. While you’d think that keeping all healthcare providers in perpetual fear of punishment and lawsuits would improve care, it doesn’t. Instead, it creates a culture of covering up, or denying errors at all costs. Medicine, like life, is full of errors. Errors present an opportunity to improve quality, not something to hide or run-away from. Quality improves very slowly in a system that crushes speaking up.
Patient experience. Patients do not want to go through useless tests. Most want what’s necessary medically, not what’s necessary to protect providers in court.
Efficiency. If providers didn’t have to practice defensive medicine, we would see a drastic change in ordering behaviour. Huge numbers of imaging tests and lab investigations would be dropped in favour of clinical judgement.
Capacity. If providers only performed tasks that directly added value for patients, we could care for more patients; wait lists would disappear.

What do you think? Does it make sense to have a US-style legal approach to a publicly funded healthcare system?