Reforming health care, I think we can all agree, involves improving care for individual patients and also significantly improving the mechanisms and methods to deliver that care,” says Cedars-Sinai Health System’s President and CEO, Thomas Priselac.
“We’re living in unprecedented times — unprecedented change and discovery, the pace of change in both medical care and care delivery, and along with that, the emerging capacity that is the focus of today’s event: deployment of data and analytics, artificial intelligence, and all those related technologies fueling that rapid change,” he says.
Priselac shares reflections on the potential impact of this emerging capacity and its implications for certain groups in health care.
Data and Analytics in Health Care Impact
“The potential impact has to do with our obligation to honor the trust that individual patients place in us — and the American public places in us — as we deploy data and analytics in health care,” he says.
Among the many assets of health care, three in particular have brought the American health care system to where we are today, according to Priselac:
- Providing high-quality, cost-effective care to those who need it
- The capacity to innovate
At the same time, these assets remain largely aspirational. But, says Priselac, “Effective use of data analytics has the ability and the potential to fulfill those aspirations.”
The first asset, providing high-quality care in a cost-effective way, is the central purpose of health care. “When we live up to that ideal, it really represents the best in all of us,” he says. Using data and analytics to help get us there means focusing on the Quadruple Aim. It’ll also give health care providers an opportunity to turbocharge benefit gain from the billions of dollars spent in proteomics, genomics, and other aspects of medical research, along with benefit gain from the billions spent on electronic medical record (EMR) implementation and the billions more likely spent on facilitating interoperability.
The capacity to innovate has certainly been true with medical innovation in the U.S. over the past half century. Turning that innovation toward health care, Priselac says, “We need to make sure that we leverage the data and analytics work to build on what is best described as a remarkable sick care system to build on a wellness-oriented system that we all want to see created, one that is more uniformly high in quality.”
We’re seeing transparency in medical research, health services research, and performance reporting. But, says Priselac, “As we go into this era of data and analytics, it’s going to be equally important that there is transparency around the algorithms, the assumptions — what’s built into the work of data and analytics — so that the work that is produced has the credibility that will be necessary to generate change.”
“Data and analytics then has the potential to take all of these to the next level and improve the care that can be provided to everybody,” he adds.
Implications of Data and Analytics in Health Care
Priselac next shares thoughts regarding the implications of this emerging data and analytics capacity for three groups involved in making this change successful: those in leadership, those on the front lines, and policymakers.
“Leadership is about driving change,” says Priselac. “It’s going to be critical that people in leadership positions assure that the data and analytics work is very focused, like a laser, on the strategic goals for the organization in terms of quality, safety, clinical, and operational efficiency.” This is true no matter the leadership role: board, executive, clinical, or other types of leadership. “It’s going to be important that everyone in a leadership role recognize the need to look at our data assets and value them as highly as we value our human assets and physical assets of the organization and appreciate what can come from it.”
“It’s also going to require pragmatic innovation,” he adds, “which is crucial to optimizing the results of this capability.” Pragmatic innovation in data and analytics work requires the same disciplined thinking that leaders apply in other areas of optimization such as professional satisfaction and staff performance.
“I want to emphasize my own personal belief in the value and the potential that all of this work has, but I would also caution us all that, in my experience, there are no silver bullets,” Priselac says. “I don’t think that data and analytics will be any silver bullet, but it will be an extremely powerful tool in the toolkit.”
To yield the promise of data and analytics, leaders must support the adoption of clinical and operational changes that result from the work of its implementation. “All of this work points us in certain directions; it gives us a place to go,” he says. “Those changes that require the organization to change are oftentimes the place where this fails. Leadership is about making sure that where this information points us makes it into reality.”
The second group are those on the front lines: physicians, nurses, and other caregivers; data analysts and IT experts; and quality, operations, and improvement staff. “This is the group that’s going to make the difference,” says Priselac. It will require the same team-based approach that is becoming prevalent in health care.
“What I hope for, what my wish is, is that the work that’s done in this arena helps make room to the benefit of both the patient and also the caregiver to optimize the human experience, optimize the human element of the care experience, as much as anything else,” he says.
In the third group for whom there are implications are policymakers and legislators. “I can’t overstate the central role this group is going to play, because they’re going to determine two of the most important aspects of successfully deploying data and analytics,” says Priselac. One is the amount of money needed to carry out this work well. The other is making sure that that money is distributed and available on an equitable basis.
“Unfortunately, as has become true in other elements of American health care, we have ‘have’ and ‘have-nots,” he says. “The concern is that this same issue is going to arise with regard to organizational capacity to execute in this area.”
This is not a small problem to overcome; significant segments of the care delivery system don’t have the foundational EMR or other foundational capacity on which to conduct data and analytics work. Without that capacity, they won’t be able to contribute to and potentially won’t benefit from data and analytics innovations.
“If we meet the challenge that I’ve talked about today, I really think we can fulfill the promise of data and analytics so that that field can play its appropriate role to strengthen the American health care system, to address issues of disparity, to strengthen the trust in American health care both by individual patients and the public — and for data and analytics to play the critical role in improving the health of all Americans,” Priselac concludes.
From the NEJM Catalyst event Provider-Driven Data Analytics to Improve Outcomes, held at Cedars-Sinai Medical Center, January 31, 2019.