Big Data Assimilation

In early October, I wrote a post entitled, Big Data and Brand Management.  In observing the Pub’s recent visit tracking activity that post has been getting some attention – particularly from the Netherlands.  I wish I had the time to investigate further to possibly understand why.

I do know that the subject of Big Data and Healthcare is quickly becoming one of the most intriguing – if not controversial, and to many, threatening – side shows of the big show that is Healthcare Reform and the impending implementation of the Affordable Care Act.

In the IT world this growing attention is seen as an anticipated awareness among the less informed masses to a level of consciousness they achieved over a decade ago.  But for all that foresight, there has been precious little headway made in addressing some very critical issues of access and security.  And that is because those issues are not clearly defined, have dramatic implications regarding personal privacy and must be framed within a context of assumptions about the future that are widely debatable and lacking entirely for empirical support.

There is a lot at stake here:  a huge potential for solving some very challenging social problems – yet just as great potential for infringing upon personal liberty.  While I share the justifiable concern over protecting the privacy of individual patient data and information, I believe that concern is clouding an even greater story here; and that is the alluring diagnostic trajectory that Big Data has launched us upon.

In combining Big Data (large static storage requirements) with highly complex  analytical algorithms (large dynamic memory capacity) requiring tremendous computing capacity (processing speed) what we are essentially doing is seeking to replicate and accelerate the thinking ability of the human brain.  The historically great equalizer of human intelligence has been a life’s experience.  To be sure, there are ways to broaden exposure to circumstances and events that contribute to such experience, but there is no way to accelerate the natural course of observable events, which ultimately comprise the sum total of that experience – nor the wisdom of maturity to make good use of it.

In the book, Blink, by Malcolm Gladwell, he explains the concept of rapid cognition: a fascinating treatise on how our minds instantaneously sort through and combine billions of observational data elements from our life’s experience, analyze the meaning of that data and then form a reasoned judgment about what we have just observed through our senses in a matter of a few seconds.  This is often also referred to as intuition, or a gut feel.  It’s something that has saved many lives owing to physicians’ diagnostic capabilities.

What many clinicians fear in a world of Big Data is an unproven overreliance on information technology to supplant or replace that diagnostic capability (or intuition, if you will).  While, in the aggregate, some of that concern may understandably be driven by a fear of professional obsolescence, I think the much more prevalent concern is challenging whether and when a machine will (ever) be able to truly replace the intuitive capability of the human mind.

And that really is at the heart of the longer-term Big Data dilemma, even if the focus right now is on privacy and protection.  I don’t mean to diminish such concerns, but I do believe we will ultimately be able to address those relevant concerns satisfactorily.

A much more difficult challenge, however, is assessing and understanding whether machines will eventually be able to capture the collective human knowledge and experience that clinicians currently rely upon and be able to analyze and apply that information in a way that achieves better overall patient outcomes than application of human assessment, analysis and reasoning.  And, if so, will patients be able to have access to that computing capability without needing human interface?

Then, what is the role of doctors in the future? Will there be a need for them? Will those who would have otherwise employed their talents in becoming physicians be the future engineers and programmers that work to develop, upgrade and enhance the computing capability of the new electronic caregivers?

A lot to think about.  Big Data offers a lot bigger challenges than just worrying about who owns the data.  The real concern is who is going to control the owner of the data – and how? Star Trek fans, think Borg.  Is that where we’re headed?

What do you think?

Cheers,
  Sparky

Chronic Care and Technology

Chronic Care and Technology

Whenever I think about Healthcare and Technology I am reminded of a wonderfully poignant joke that Rita Rudner (think, Rodney Dangerfield’s Young Comedians Special back in the 1980s) used to share:

"They’re trying to put warning labels on liquor now. ‘Caution: Alcohol can be dangerous to pregnant women.’ Did you read that? I think that’s ironic – if it wasn’t for alcohol, most women wouldn’t even be that way."

If it wasn’t for advancements in Medical Technology – and the attendant increase in life expectancy – one has to wonder whether the much maligned Cost Curve would hold sway over our social and political anxiety as it does today.  Undoubtedly, Medical Technology has improved delivery system effectiveness from the standpoint of decreased mortality and longevity.  But it comes at a substantial cost that ultimately impacts the cost of healthcare delivery.

The cost that society bears for increased longevity gained through technology is substantial, and we know that much of this cost is centered in the world of senior housing, aging services and post-acute/long-term care.  Evidence of the costs associated with chronic disease were explored on Tuesday at the second event of a three-part series being presented by the Alliance for Health Reform in Washington, DC.  Speakers at the event, Health Care Costs: The Role of Technology and Chronic Conditions, shared with participants some very interesting data and analysis (I encourage you to view the slide presentations).

I wish I could have participated because the presentation materials, though very informative, on balance seemed to focus more on general trends in how chronic disease drives healthcare costs rather than focusing on the specific role that Medical Technology has played.  But it nonetheless affords the opportunity to offer some thoughts on technology and the costs of managing and treating chronic disease. 

As the demographic Age Wave continues to move ashore – and taking with it an increasing amount of available resources – the theoretical discussion of tradeoffs between investments in technology and direct caregiving is likely to be become more intense.  Applying the concept of value to that discussion should not be viewed as a subjective assessment of the worth of an extra year, an extra month – an extra day of longevity by virtue of technology.  Rather, it should be viewed as a means of evaluating alternative investments of available resources.  This would seem to be a prudent basis for developing future policy surrounding public investments in technology.

Policy aside, however, senior housing and care providers face a daunting reality with respect to technology: the investment requirements can be substantial – and the consequences of making poor investments difficult from which to operationally and financially recover.  Yet to play in a world of integrated care delivery where both Information and Medical Technology provide distinct competitive advantages, ignoring required investments is just as sure a path to quiet obsolescence.

And while providers wrestle with that two-headed dragon, legislators have not yet appropriately recognized the need for parity investment in PA/LTC technology infrastructure, so many organizations are having to do what they can with available resources to position their technology investments in what they believe (hope) will be in alignment with acute care providers.  The irony here is of course thick if not beyond frustrating because the train that is integrated care delivery has left the station without the cars behind that represent the ability to achieve interoperability with PA/LTC providers.

There is also, I believe, a need of both providers – and policymakers – to understand that technology will only be able to help us so much.  It is not the silver bullet that will save us from the need to become more efficient, streamline care continuums, dramatically improve provider communication and tear down delivery setting silos.  In addition, technology may help encourage but it cannot directly change individual behaviors that could go a long way to curbing chronic disease incidence.

I would really like to better understand how different organizations are addressing their technology strategy.  Is it still a wait and watch situation? Is the need to develop EHR/EMR technology enough to deal with right now? What concerns you the most about technology? Who is involved in that thought process?

Please take a moment to share your input – don’t be afraid to be first . . . somebody has to.  Hot smile

  ~ Sparky