In healthcare, we talk a lot about transformation, but what does that mean? Typically, these conversations come down to ‘better’ or ‘improved’ integration of care and funding models.
We don’t need ‘better.’ We need different.
As healthcare organizations, we agree that transformation needs to occur but where we start or how that looks is a mystery…until now. Big Data is here to stay and it’s time for it to lead the way to transformation.
Poor Data Leads to Poor Insights
Let’s paint a common picture. A patient tries to go to their family doctor but can’t get an appointment for more than a week so they go to a walk-in clinic. They wait two hours to see the doctor who proceeds to ask for all the same information their family doctor has already. Once done collecting information, the doctor proceeds with a preliminary diagnosis, a prescription for a medication, sends the patient to the laboratory for some blood tests and tells them to follow-up with the family doctor next week. But the family doctor, has no idea what the diagnosis was because they have no records from the walk-in visit or the laboratory test results.
Today’s patient is responsible for keeping track of their own records, visits, and medications. A bank can keep track of your purchases from around the world but healthcare providers can’t keep track of what happens to patients within a one kilometre radius.
This is because there is no standardized approach to collecting or sharing data. Data collection is provider-centred rather than patient-centred. As providers ask questions it’s up to the patient or family-member to answer despite this information residing in multiple provider datasets.
Although Ontario is generally a health-data rich province, using this data to inform decision-making and converting data into actionable insights is a gold-mine we’ve only started to tap.
Now we aren’t under the illusion that transforming this system is easy – care is complex, funding comes from multiple sources, science and technology is changing constantly. Data collection has increased drastically but the data remain siloed – hospital medical records are housed in one silo, family doctor records in another, public health in another, and the data are never brought together to create the patient journey, resulting in lack of visibility into continuity between settings (e.g. hospital to community care to home) or over time (e.g. transition from child and youth to adult).
Do these issues seem unique to healthcare? They aren’t. The retail sector, hospitality services, transportation services and so many more have all dealt with similar issues but they understood the value of using data to learn about their consumers to better serve their needs. This is the same business and cultural understanding that we have to embrace: understand the consumer to better serve the needs of your consumer. At the end of the day, patients are consumers of healthcare.
Use flight bookings as a gauge – most of us don’t use travel agents to book flights anymore. We look at a couple of travel sites like Expedia or Google Flights and pick a flight based on the best value. We use these sites because they aggregate data from various flight carriers and allow us to do our own cost-benefit analysis based on options for airline, date, and flight path. In other words, travel sites use aggregated data from multiple sources and organize the data around what’s relevant to the customer instead of having them visit one carrier page at a time. In understanding the needs of the consumer flight bookings were transformed for the better.
Addressing the Problem, not the Symptoms
Siloed data are a major barrier to transformation. The major risk is that siloed data cause us to mistakenly identify symptoms of the problem as the true problem.
To drive transformation, we first need to understand the problems. Symptoms are very important to observe but they are bread-crumbs leading us down the path to the root problem; they are not the destination itself. By ignoring data we will continue throwing resources at fixing the symptoms. Consider hospital capacity issues. Do we need more beds? Or do we need to redirect patients before they get to the hospital? We don’t know because we aren’t looking at the data.
Poor data collection and sharing prevents us from understanding our most devastating crises. Opioids are responsible for hundreds of overdose deaths a year yet the root causes are not well understood because we don’t survey prescriptions that are publicly and privately funded in one system. We can describe prescription patterns but we can’t actually tell what’s driving them.
There is Hope
Big Data methods “allow us to augment what can be understood from massive amounts of data like how a microscope enhances eyesight,” Harlan Krumholz, a professor at Yale University, argued in Health Affairs.
Big Data analytic platforms are necessary for the transformation of healthcare. They allow us to collect and purposely link data from various sources in various formats in order to analyze data faster, making meaningful insights that are actionable.
Initiatives such as Reconnect Community Health Services show the value of functional linkages with disparate datasets. Using their linked data for community health services they dispelled the hypothesis that patients were accessing the same service from multiple community health service providers. In fact, they found more than 80 percent of unique clients received services from one community health service provider.
Their dataset also enables them to show a single client’s journey through separate health service organizations over a longitudinal time period. These seemingly simple insights allow us to observe critically important issues and to dig deeper into the real problem.
It’s time to transform healthcare by answering the known-unknowns (questions we currently have without answers) and start to discover the unknown-unknowns (things we could discover and knew nothing about, but would truly surprise us).
The Big Data wave has arrived – and one of the many forms it comes to us in is a problem-identification-enabler which can lead the transformation we need.