Healthcare // Clinical Information Systems
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11/1/2012
11:40 AM
Paul Cerrato
Paul Cerrato
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Big Data Analytics: Where's The ROI?

Not everyone is impressed with the latest health IT megatrend. At least one prominent critic says payment reform should take precedence.

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11 Healthcare-Focused Business Intelligence Tools
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If you're old enough to remember the Reagan administration, you remember the politically charged expression "trickle-down economics," which referred to the theory that if you provide benefits and incentives to businesses and the wealthy, those benefits would trickle down to wage earners at lower socioeconomic levels.

In some ways, big data analytics is like trickle-down economics. Only the biggest healthcare providers with the deepest pockets can afford the kind of analytics platforms required to get useful intelligence from tens of thousands of patient records. But in theory, those benefits will trickle down to smaller providers that either don't have the financial support or the large patient populations to do this type of data crunching on their own.

How exactly is this supposed to work? Consider this example: A recent study conducted by Kaiser Permanente looked at the incidence of blood clots among women from two integrated health care programs and two state Medicaid programs, who were taking various oral contraceptive (OC) formulas. Their analysis revealed that one formula in particular, containing drospirenone, increased the threat of blood clots by 77% when compared to the risk in women taking several other OC formulas.

How might such big data analytics benefit the checkout girl at my local supermarket, or my car mechanic and his wife, who live in a small town and may be part of a group practice that can't do this kind of research?

Proponents of big data would say that's what peer-reviewed journals are for. The big guys publish the work in a creditable venue and clinicians in smaller community practices learn from their findings.

[ Is it time to re-engineer your clinical decision support system? See 10 Innovative Clinical Decision Support Programs. ]

The only flaw in that reasoning is the huge lag time between published research and widespread adoption of that research in the trenches -- 5 to 10 years, by some estimates. In some cases, the research never gets put into practice.

And that disconnect between big data analysis and the rest of the healthcare system is only one of many. A panel discussion at last week's Connected Health Symposium in Boston raised several others. Even the session's title suggested controversy: "Big Data Healthcare Analytics: Frontier or Fiction?"

Charlie Baker, president of General Catalyst Partners, a venture capital firm, and former Secretary of Health and Human Services for the Commonwealth of Massachusetts, suggested that the industry put less emphasis on big data and more on fundamental payment reform. To fix what's broken in the healthcare system, Baker says, "I'd start with a reimbursement system that awards technology, procedures, fragmentation... and punishes primary care... There's nothing about big data in the short term that's going to solve that problem."

Baker went on to emphasize what many other stakeholders are shouting about: Finding a way to move from a pay-for-services system to a pay-for-value system has to be our top priority, not big data analysis.

That's not to suggest that such analysis shouldn't play a role in healthcare reform. But all the big data in the world isn't going to give us a substantial ROI if hospitals and individual practitioners continue to be rewarded for the quantity rather than quality of care they provide.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)

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jaysimmons
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jaysimmons,
User Rank: Apprentice
11/6/2012 | 5:26:10 AM
re: Big Data Analytics: Where's The ROI?
As more large companies start investing in Big Data, those benefits will trickle down, even if not in direct forms such as publications or results. The technology created to support such analysis will most likely be available to smaller companies in some form, if not immediately, eventually in some sort of licensing. I think what youG«÷ll end up seeing is a consortium of smaller offices polling data together to make some sort of meaningful use out of it. That or the government will step in and try to pool data. When the technology becomes readily available, the speed at which the findings become published, peer reviewed and verified will increase as well. The 5-10 year figure will most definitely drop.

Jay Simmons
Information Week Contributor
justink
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justink,
User Rank: Apprentice
11/2/2012 | 2:09:16 PM
re: Big Data Analytics: Where's The ROI?
I would say that big data has even moved beyond frontier. Big Data is a necessity for most larger business, and even for the little guys. The mom and pop Dr. or smaller practice might not be using big data analytics, but are those practices still around? Let's say that they exist, they still need to stay updated on the changes in their field, just like we all do. Maybe the group practice is not publishing the study, but they are benefiting from by reading it in a journal or the internet (We are assuming these practices have access to the internet). They are also benefiting from the big data analytics that the pharma companies are using. Big data not only makes information available, but it does it fast so that it can be spread out faster, there is no longer the 2 month trickle down time frame. http://www.actian.com/solution...
jamesvgingerich
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jamesvgingerich,
User Rank: Apprentice
11/1/2012 | 5:48:18 PM
re: Big Data Analytics: Where's The ROI?
Paul,

That's just it. Wouldn't you agree that being able to analyze things first, would assist in optimizing one's list of priorities?

I guess we're stuck in a which should come first, chicken or egg type discussion here. Good article. It makes you think.
pcerrato10
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pcerrato10,
User Rank: Apprentice
11/1/2012 | 5:35:22 PM
re: Big Data Analytics: Where's The ROI?
James, thanks for your comments. My point was not that big data analytics is fiction. I too believe it's a frontier. As I say in the column:

"That's not to suggest that such analysis shouldn't play a role in healthcare reform. But all the big data in the world isn't going to give us a substantial ROI if hospitals and individual practitioners continue to be rewarded for the quantity rather than quality of care they provide."

My point is the healthcare system should put other priorities ahead of such analysis.

Paul Cerrato
Editor
InformationWeek Healthcare
jamesvgingerich
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jamesvgingerich,
User Rank: Apprentice
11/1/2012 | 5:21:00 PM
re: Big Data Analytics: Where's The ROI?
Respectfully I would have to disagree with the premise of this piece. Big Data is frontier not fiction. Your article does nothing to address the fundamental benefit of Big Data or Analytics to the healthcare industry, namely, "Outlier Detection." Keeping track of healthcare statistics in real time within a given region, disease or section of the population, allows you to monitor in real time, norms and data points outside the norms. If survival rates for a particular cancer are trending up in one area, over the norm for all areas; the best practice of that area can be adopted by the rest and the survival rate of all increases. On the operational side of things, hospitals' financials could be monitored in real time. Outliers from the norm, on the good and bad side, can be readily identified and either fixed or learned from, to the benefit of all.

Your view of Big Data tends to equate it with a car's spare tire, implying that one may never need to use it and that it should just stay locked up in the trunk. Big Data on the other hand is more like a car's headlights. They allow you to drive at night, with speed and with safety. Headlights blow away the darkness in front of you enabling you to make more informed decisions about the direction of your vehicle. Without big data, one's ability to correct or improve the healthcare industry would be like trying to drive 60 miles an hour down a side road, at night, with no headlights.

As for that check out girl at the supermarket? Big data improves the productivity of all companies who adopt it by 5% - 6% per year. This should eventually lead to lower costs of providing healthcare and lower costs to her for health insurance. That's the benefit.

As for the car mechanic and his wife? They might be a little less well off, for there would be fewer drivers zipping around without headlights, fewer accidents and hence fewer car repairs requiring his services. This might cost him some immediate repair income. However, his ride home should be a little bit safer.

James Gingerich
Sr Partner Account Manager
Sybase, an SAP Company
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