Analysis of the fourth NEJM Catalyst Insights Council Survey on Care Redesign. Qualified executives, clinical leaders, and clinicians may join the Insights Council and share their perspectives on health care delivery transformation.
By Amy Compton-Phillips
Over the past few years, physicians and provider leaders have been frustrated with the limitations of health care data. Much like the anticipation over EMRs in the early days, providers expected big data to solve all of health care’s problems. When it didn’t, disillusion set in.
In our newest NEJM Catalyst Insights Report on Care Redesign, we took a read on the effectiveness of health care data, both today and in five years. We found that the landscape is shifting from one of despair over the unfulfilled promises of big data to a more realistic vision of what sophisticated analytics can do to transform health care delivery.
Look at what our survey respondents — who consist of health care executives, clinical leaders, and clinicians — consider the most useful sources of health care data today and in five years. Today, clinical data (marked by 95% of respondents), cost data (56%), and claims data (56%) make up the top three most useful sources. In five years, however, respondents predict the usefulness of claims data will drop off, while clinical and cost data will be joined at the top of the list by patient-generated and genomic data (each scoring 40%). Combining information from devices, patient feedback, and patient biomarkers will be powerful and will catapult care forward in a way we can’t attain today.
This rejiggering of the top useful sources of health care data tells us that people realize cost matters. What’s more, they expect that personalized medicine, powered by data, will reduce the costs of care while simultaneously improving patient outcomes. With patient-generated data and genomic data, we will be able to create true “n of 1” medicine with options specific to each patient’s needs, giving a boost to priorities such as care coordination and improved clinical decision support.
We already rely on data to personalize consumer experiences throughout our lives, rarely making a purchase without comparative shopping or reviewing suggestions sent to us by retailers based on big data. Health care can follow suit.
Big data relies on transparency, though — pulling back the curtain on the inner workings of the practice of medicine. Fortunately, the push toward big data in health care coincides with a willingness by executives, physician leaders, and clinicians to support greater patient access to their own medical records (marked by 93% of respondents), fee/price information for comparison shopping (80%), and outcomes information listed by hospital (73%).
But the curtain closes somewhat when the discussion turns to outcomes information listed by doctor (63%). Clinicians are more negative on this point, with only 55% supporting outcomes information by doctor. There is real concern that individualized outcomes information will result in “cherry-picking” — dissuading physicians from treating the highest risk, most vulnerable members of society.
Before we in health care can reap the full benefits of big data, we have problems to solve, not the least of which is unleashing the functionality within EHR systems. A big stumbling block is lack of interoperability, which just over half of respondents (51%) say is weak in their organizations. The survey also finds room for improvement in ease of use and training for EHRs; each is labeled weak by a third of respondents. Both issues must be resolved for health care big data to flourish.
We have entered an exciting era where big data has the potential to become a game changer for health care. Providers are poised to put data into the hands of consumers and payers to drive a value-oriented care delivery system that enlightens patients about their health and the path to affordable care.
VERBATIM COMMENTS FROM SURVEY RESPONDENTS
How will advanced information sciences, such as precision medicine, artificial intelligence, and machine learning, change the future delivery of health care?
“Big data will help research, but none of the above will help a physician alleviate morbidity or mortality.”
“It will advance care and allow for standardization in health care. However, it will pose new issues with healthcare that will require new models of research. It will also challenge the ethical delivery of care and set new precedence for new generations to build upon.”
“Unsure, still need that human interaction as we are individual beings.”
Download the full report for additional verbatim comments from Insights Council members.
Charts and Commentary
by NEJM Catalyst
We surveyed members of the NEJM Catalyst Insights Council, comprising health care executives, clinical leaders, and clinicians about data in health care. The survey covers the most useful sources of health care data today and in five years, the effectiveness of organizations’ use of data for patient care, the biggest opportunities for use of data in health care, the biggest barriers to better use of patient data, the effectiveness of organization’s electronic health record (EHR) systems, the current state of big data in health care, and patient access to health care data. A total of 682 completed surveys are included in the analysis.
Fewer than 20% of survey respondents believe their organization’s use of data for direct patient care is “extremely effective” or “very effective.” Most believe their organizational effectiveness lies somewhere between either “effective” (36%) or “not very effective” (32%) leaving a tremendous amount of room for improvement. Another 8% call their organization’s use of data “not at all effective.” As the barriers uncovered in later survey results, such as interoperability and difficulty collecting data, are overcome, effectiveness ratings may improve.
Download the full report to see the complete set of charts and commentary, including data segmentation, the respondent profile, and survey methodology.
Join the NEJM Catalyst Insights Council and contribute to the conversation about health care delivery transformation. Qualified members participate in brief monthly surveys.