Big Data in Healthcare

August 1, 2014 - Healthcare has gone digital—as has most of our nation. There are always good and bad aspects of change and one of the good points for the digitalization of healthcare is the knowledge that can be gleaned from what was previously an amorphous handwritten record.

Imagine receiving an email from your physician’s office suggesting that you are due for a preventative test such as measuring your cholesterol, blood sugar, blood pressure, or for a flu shot. Similarly, picture being monitored at home by a relatively seamless device that watches your weight, eating habits, and exercise routine. These simple and affordable devices already exist and are sold commercially online or in computer or fitness stores.

I was recently at a local computer store with prominently displayed devices showing your steps per day, total movement, hours and quality of sleep and other measures. Being connected has never been easier and having a constant reminder in the background should change behavior for the better. Yes, it does sound like “big brother” could be watching and there is a loss of privacy, but as Andy Grove, engineer and former CEO of Intel, said years ago, “You have lost your privacy, get over it.”

If you use a credit card, many of your habits have already been collated and turned over to marketers. These folks now have a new advantage since they know what you prefer and can continue to tempt you with similar “bargains.” Other programs used by financial institutions can accurately predict who will be a good risk to repay a loan, or what other financial products would be best for you. The point is that healthcare is now catching up with other industries as we use big data to change our behavior—presumably for the better.

Physicians can now be reminded, as they are seeing a patient, about the patient’s current needs and prognosis. Newer programs remind a care-giver at the right moment, of potential diagnoses, appropriate treatments, and then share an accurate prognosis.

First, “do no harm,” is a basic premise of medicine. No one can keep the thousands of medications and their interactions straight. As a patient’s medical record is updated with a new prescription a smart electronic medical record will spot incompatibilities, duplications, omissions, unusual dosage patterns, etc., and then notify the physician, nurse practitioner, physician’s assistant, pharmacist, or patient about a potential conflict.

Medical knowledge is constantly growing and changing; some long-held beliefs are being disproven and contribute to the need for a digital backbone capable of rapid change and high capacity. Having a database which is rich with current literature and is searchable, interactive, and proactive would be of great assistance, as again, no mortal can read all that is printed on a daily basis.

These analytics also lend themselves to research. Patient-centered outcome research can be easily accelerated by using data collected from many different offices, shared with the cautions for privacy and confidentiality, but then studied to see who had the best outcomes and why this was so. Currently, getting a double blind controlled study done is exorbitantly expensive. Just having a large enough population base can quickly get to an end point, or at least help to organize a pilot study. We have so much data which is not aggregated and would be so easy to morph into evidence-based medicine—another way for doing research to define best practices.

The above attributes and capabilities do exist and like the future—which is here now but not evenly distributed—needs to be placed into offices, hospitals, and any area which would benefit from digital technology. We have to be able to use these tools appropriately, without forgetting that personal touch, compassion, a kind word spoken sincerely, will never be replaced by any type of technology. However, just being kind and compassionate, won’t cure you. The hard science and accurate knowledge, combined with the healing touch is what is best for one’s health.


 
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Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.