October 31, 2018

Data Driven Healthcare

Travis Good, MD

Co-founder & Chief Technology Officer

Two months ago, six of the biggest technology companies in the world came together at a White House press conference to pledge their commitment to making health data more interoperable and accessible. Google, Microsoft, Amazon, Oracle, Salesforce, and IBM made clear their commitment to easing access to healthcare data through a standards-based approach using FHIR and the work from projects like Argonaut.

Interoperable and accessible health data would be wonderful. It was a stated goal that did not happen as a part of Meaningful Use. But the industry, largely made up of care delivery organizations and payors, want easier access to data. Patients also expect better healthcare services enabled by data and technology and are often shocked they don’t yet exist in this digital world. And now, with this recent White House announcement, very large technology and solutions providers — many with a focus on the cloud — want to do more in healthcare and are pushing to make the flow of data easier. Healthcare data holds value to many interested and influential parties.

Healthcare data in this context means clinical data — data stored in Electronic Health Records systems (EHRs) that is largely the result of the delivery of healthcare services (clinic visits, hospital stays, tests, etc). The EHRs hold this treasure trove of data and getting access to it is hard. There are some good reasons why access to clinical data is so difficult, mainly around privacy and integrity of the data. There are some not so good reasons why access to clinical data is hard, mainly to protect the EHR businesses from disruption.

Regardless of the reasons, the pressure to provide access to EHR data is mounting and the standards for accessing this data are maturing. FHIR isn’t perfect but it’s good.

Why have so many groups taken up the cause of interoperable healthcare data?

Access to data is an essential enabler of the future of healthcare — one that will be largely data-driven. Clinical data, the data referenced above, is one very important piece of the puzzle of data-driven healthcare. There are other pieces to the data puzzle including genomics, images, and IoT. Data-driven healthcare is enabled by putting these four pieces of data together:

  1. Clinical
  2. Genomics
  3. Images
  4. IoT

What is data-driven healthcare?

Today it is a lot of buzzwords like machine learning and precision medicine. It is a promise without much practical impact. That’s ok because those buzzwords represent real value once they are powered by the right data.

A move from population health to individualized medicine

Instead of focusing on cohorts, or populations, of people for analysis and insight, data-driven healthcare enables interventions to be proactively targeted at individuals based on their profiles (a mix of data from those four sources above); data-driven healthcare moves us from population health to individualized medicine.

A move from risk pools to precision risk

Risk can be precise as well, opening new models of behavior incentives and even insurance (and some potential downsides that we will have to solve for people with higher risks); data-driven healthcare moves us from risk pools to precision risk.

Shifts us from treating conditions to precision medicine

Treatment regiments, instead of being condition-specific, can be tailored specifically to individuals based on their profiles; data-driven healthcare moves us from treating the condition to precision medicine.

Reduces unnecessary and redundant testing

Testing can be done when it is actually needed, not redundantly and not for medical-legal reasons; data-driven healthcare reduces costs from unnecessary and redundant testing.

There are countless examples within each of those data-driven healthcare examples above and many more that aren’t in that list. But, we can only get to that promise if we have the data to enable it. That data-driven future holds incredible value to the companies that can enable it by providing access to the data and creating the platforms and tools to leverage that data. The cloud is going to be the underpinning of these data-driven healthcare platforms.

The writing is on the wall that data needs to flow more freely. Now, it’s a matter of time to see how this future is shaped and who shapes it.

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