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re: Why Physicians Don't Like Big Data
I don't think your average, non-academic, non-administrative physician could care less about data analytics at this point. While everyone has heard the term and has at least a general sense of what it's all about (cost cutting), the fact is that it has virtually no impact on almost any physician's practice, yet. Private institutions are beginning to publish articles extolling the findings of some analytical study, but these are very limited in scope and very tentative in their conclusions. The fact is - and the majority of physicians understand this, too - that almost no one, and certainly not the government, has as yet obtained enough _valid_ data to be of any use. Given that medicine's stock in trade for the last 50 years has been data analytics, albeit on a much smaller scale (what else do you call all those double-blind studies over the years), the low hanging fruit is long gone. To be useful data analytics on the scale envisioned by the IT community needs hundreds of thousands, if not millions, of data pieces, and the medical community does not yet have either the standardized dictionary or the data transmission standards necessary to obtain _valid_ data on that scale, except in a very few instances at large academic institutions, and a couple of private insurers.
re: Why Physicians Don't Like Big Data
Technology in general, big data in particular and recent federal health care initiatives all have little to do with what good doctors do best, provide high quality care. The former all have a lot to do with controlling what doctors get paid. We need an honest broker in the middle weighing what's best for the patient, In modern health care, there is no such broker.
re: Why Physicians Don't Like Big Data
Depending on how the stats are rolled, doctors could just as easily seek out sick patients if graded on a relative improvement factors. For instance, if someone is obese, has horrible cholesterol and high blood pressure, prescribing the right meds will likely rapidly improve 2 out of 3 symptoms.
Of course it's difficult to measure cost savings since achieving target blood cholesterol and pressure levels is the epitome of good preventive medicine, it'll take years to determine the savings.
Of course it's difficult to measure cost savings since achieving target blood cholesterol and pressure levels is the epitome of good preventive medicine, it'll take years to determine the savings.
re: Why Physicians Don't Like Big Data
If our goal is to seek to understand, not only what is the most appropriate care for any patient but also what is a good outcome based on that patient's individual comorbidities, behaviors and beliefs, then I can't think if a better way to start than with data...and the more data the better. The trick is to set achievable targets, based on case mix and other factors (that today's overly simplsitic models don't take into account) to ensure that great care is appropriately rewarded. The alternative sounds like speculation and personal opinion, which doesn't sound like a good way to advance healthcare delivery.
re: Why Physicians Don't Like Big Data
Lorna, education was my first thought to. As currently devised, the idea of a "value-added" metrics has its heart in the right place, but it's pretty misguided overall. Just because we can capture more data than ever before doesn't mean everything can be quantified in a useful way, and even when useful quantification is possible, we don't always pick the right variables and definitions. Paul does a great job explaining why physicians are scared of data maniacs who can't see beyond the numbers.
re: Why Physicians Don't Like Big Data
The problem with metrics is that they encourage people to focus on meeting the metrics requirements, even when those requirements are not fully aligned with optimal outcomes. In fields where the definition of success is open to interpretation, whether that's medicine or the arts, over-reliance on meeting numerical targets produces mediocre results.
re: Why Physicians Don't Like Big Data
Paul, I see many corollaries to teachers being rated on test scores - yes, they're largely out of their control, much like a diabetic taking his insulin, but properly weighted such stats are a starting point.
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8/26/2013 | 7:02:47 PM
Jay Simmons
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