We are launching a conference at the intersection of health, health care, and data. Why?
Our health care system is in crisis. We are experiencing epidemic levels of obesity, diabetes, and other preventable conditions while at the same time our health care system costs are spiraling higher. Most of us have experienced increasing health care costs in our businesses or have seen our personal share of insurance premiums rise rapidly. Worse, we may be living with a chronic or life-threatening disease while struggling to obtain effective therapies and interventions — finding ourselves lumped in with “average patients” instead of receiving effective care designed to work for our specific situation.
In short, particularly in the United States, we are paying too much for too much care of the wrong kind and getting poor results. All the while our diet and lifestyle failures are demanding even more from the system. In the past few decades we’ve dropped from the world’s best health care system to the 37th, and we seem likely to drop further if things don’t change.
The very public fight over the Affordable Care Act (ACA) has brought this to the fore of our attention, but this is a situation that has been brewing for a long time. With the ACA’s arrival, increasing costs and poor outcomes, at least in part, are going to be the responsibility of the federal government. The fiscal outlook for that responsibility doesn’t look good and solving this crisis is no longer optional; it’s urgent.
There are many reasons for the crisis, and there’s no silver bullet. Health and health care live at the confluence of diet and exercise norms, destructive business incentives, antiquated care models, and a system that has severe learning disabilities. We aren’t preventing the preventable, and once we’re sick we’re paying for procedures and tests instead of results; and those interventions were designed for some non-existent average patient so much of it is wasted. Later we mostly ignore the data that could help the system learn and adapt.
It’s all too easy to be gloomy about the outlook for health and health care, but this is also a moment of great opportunity. We face this crisis armed with vast new data sources, the emerging tools and techniques to analyze them, an ACA policy framework that emphasizes outcomes over procedures, and a growing recognition that these are problems worth solving.
Data has a long history of being “unreasonably effective.” And at least from the technologist point of view it looks like we are on the cusp of something big. We have the opportunity to move from “Health IT” to an era of data-illuminated technology-enabled health.
For example, it is well known that poverty places a disproportionate burden on the health care system. Poor people don’t have medical insurance and can’t afford to see doctors; so when they’re sick they go to the emergency room at great cost and often after they are much sicker than they need to be. But what happens when you look deeper? One project showed that two apartment buildings in Camden, NJ accounted for a hugely disproportionate number of hospital admissions.
Targeting those buildings, and specific people within them, with integrated preventive care and medical intervention has led to significant savings.
That project was made possible by the analysis of hospital admissions, costs, and intervention outcomes — essentially, insurance claims data — across all the hospitals in Camden. Acting upon that analysis and analyzing the results of the action led to savings.
But claims data isn’t the only game in town anymore. Even more is possible as electronic medical records (EMR), genomic, mobile sensor, and other emerging data streams become available.
With mobile-enabled remote sensors like glucometers, blood pressure monitors, and futuristic tools like digital pills that broadcast their arrival in the stomach, we have the opportunity to completely revolutionize disease management. By moving from discrete and costly data events to a continuous stream of inexpensive remotely monitored data, care will improve for a broad range of chronic and life-threatening diseases. By involving fewer office visits, physician productivity will rise and costs will come down.
We are also beginning to see tantalizing hints of the future of personalized medicine in action. Cheap gene sequencing, better understanding of how drug molecules interact with our biology (and each other), and the tools and horsepower to analyze these complex interactions for a specific patient with specific biology in near real time will change how we do medicine. In the same way that Google’s AdSense took cost out of advertising by using data to target ads with precision, we’ll soon be able to make medical interventions that are much more patient-specific and cost effective.
StrataRx is based on the idea that data will improve health and health care, but we aren’t naive enough to believe that data alone solves all the problems we are facing. Health and health care are incredibly complex and multi-layered and big data analytics is only one piece of the puzzle. Solving our national crisis will also depend on policy and system changes, some of them to systems outside of health care. However, we know that data and its analysis have an important role to play in illuminating the current reality and creating those solutions.
StrataRx is a call for data scientists, technologists, health professionals, and the sector’s business leadership to convene, take part in the discussion, and make a difference!