“The Social Dilemma”—the recent Netflix documentary that reveals how big tech companies mine personal data to anticipate preferences and manipulate behaviors—is both alarming and educational.
And for those of us in healthcare, it’s also somewhat aspirational.
We have a data problem in healthcare: Too much of it is useless. Patients can’t make heads or tails of it, doctors can’t retrieve it when they need it, and little of it is leveraged in a way that makes America healthier.
Why is that? Largely, it’s an issue of our data not synchronizing with our healthcare objectives and with the needs of our patients.
Facebook, YouTube, and Amazon know exactly what data they need, and which levers to pull, in order to sell you products and keep you glued to your smartphone. Their business incentive is quite clear and well-aligned with the customers they serve.
But in healthcare, our alignment is off.
What we need is transparent, frictionless, semantically meaningful data. What we have instead is a constant firehose of information—clinical data, financial data, even genomics data—that is less than the sum of its parts.
Healthcare is inherently complex, and on top of it, we work within an exceedingly complex regulatory environment. Running a retail enterprise is not the same thing as running a hospital; getting an Amazon shopper to buy a new pair of shoes is a much simpler task than convincing a patient to make lifelong dietary changes.
Still, our industry shares ambitions with the social media giants. We are all trying to find the signal in the noise, and we are all trying to nudge behaviors and outcomes.
The reason that “The Social Dilemma” is unsettling is because social media’s ultimate data motive isn’t our common welfare—it’s to create more loyal consumers. Imagine if we could use our data to create an intensely personalized healthcare framework for our patients, driving the behavior modifications that we’re seeking.
To do that, information has to be functional for all, preferably on a self-service basis. That’s true for those of us working in healthcare operations, trying to generate clinical reports. And it’s doubly true for the patient, who won’t bother looking at the information unless it’s easily accessible and intuitively beneficial.
Right now, through our patient portals, we give patients an undifferentiated barrage of information: appointment dates, how much they owe, lipid panel results, even doctors’ notes. All of it is important, but none of it sheds light on a person’s total health picture.
So before we can modify behaviors, we have to modify the data we present to our patients and doctors. Otherwise, our health suffers, and the ping from MyChart will lose out to the Facebook notification every single time.
How do we get there? First, we must devote the necessary resources. There’s a reason big online vendors devote such a substantial percentage of their spending to data and analytics. In healthcare, we’re lagging by comparison, at 5% to 6%. Second, we have to get serious about payment reform.
Much has been made about our industry’s transition from an episodic, fee-for-service environment to one that rewards quality health outcomes.
But we’re not there yet. Inertia is hard to overcome. Over the last 50 years, we’ve created a system that doesn’t give incentives for healthier communities. Instead, it gives clinicians incentives to produce enough diagnostic codes to get paid each month. ICD-10 and RVUs might mean something to insurers, but they don’t mean much to the people we’re supposed to be serving.
What we need, and soon, is a system where the payer, the provider, data systems and patients are all in lockstep regarding what exactly they want to produce—which is better experiences and healthier families along with workplace environments that free doctors to be providers of outstanding care rather than producers of opaque codes.
Otherwise, our national healthcare dilemma may never be solved.