Visioning the Future of Big Data in Healthcare: A Search for Value?

June 24, 2013
An April article by leaders at McKinsey & Company looks at the future of big data in healthcare, and frames that future in terms of large investments that span the gaps in patient engagement, care management, clinical performance improvement, payment reform, and other areas. Is their broad vision one that CIOs and CMIOs can translate into reality?

An April article by Basel Kayyali, David Knott, and Steve Van Kuiken of McKinsey & Company, entitled “The big-data revolution in U.S. healthcare: accelerating value and innovation,” offered a variety of perspectives on a revolution that the articles authors definitely declare has begun in earnest in our industry. The authors note that the increasingly unsustainable healthcare cost curve is one of the major factors leading to the accelerating interest in healthcare in the concept of big data, while noting that the growing shift towards evidence-based medicine is also playing a role in the acceleration of interest.

What’s more, the authors write that, “Although the healthcare industry has lagged behind sectors like retail and banking in the use of big data—partly because of concerns about patient confidentiality—it could soon catch up. First movers in the data sphere are already achieving positive results, which is prompting other stakeholders to take action, lest they be left behind,” the authors note. Then they ask this question: “These developments are encouraging, but they also raise an important question: is the healthcare industry prepared to capture big data’s full potential, or are there roadblocks that will hamper its use?”

Well, healthcare CIOs, CMIOs and other IT leaders could easily list numerous roadblocks in their way on the journey towards the full leveraging of big data tools. For one thing, more and more, healthcare leaders on the provider side realize that their hospital, medical group, and health system organizations still lack some of the key types of data needed to be successful at accountable care, bundled-payment, patient-centered medical home, and other ventures; health insurers have the claims data needed to complete the big data equation. Beyond that core problem, most hospital- and physician-based patient care organizations simply lack the correct constellation of tools to pursue the patient engagement, care management, clinical performance improvement, payment reform, and IT-facilitated innovation work that the McKinsey authors urge them to pursue. Hospitals, medical groups, and health systems lack the data warehouses and data marts, the robust data analytics and business intelligence capabilities, and above all, the interoperability, needed to turbocharge their efforts.

Yet once the serious investment is made, the McKinsey authors note, IT investment can lead to a blessed cycle. They note that “The value pathways evolve as new data become available, fostering a feedback loop. The concept of right care, for instance, could change if new data suggest that the standard protocol for a particular disease does not produce optimal results. And a change in one pathway could spur changes in others,” they note, “since they are interdependent. An investigation into right value, for example, could reveal that patients are most likely to suffer costly complications after an appendectomy if their physician performs few of these operations. This finding could influence opinions not only about value but about the right provider to perform an appendectomy.”

Interestingly, among the three specific examples the authors cite of strong IT-facilitated innovation, one example is from the pharmaceutical world (AstraZeneca), one is from a health insurer (Blue Shield of California), and only one is from a provider organization, and that is the unique provider/health plan system Kaiser Permanente, for its creation of HealthConnect.

And in that case, the Kaiser organization has spent literally several billion dollars in toto for its combination of electronic health record, care management, patient engagement/online connectivity, and interoperability capabilities.

So—what are the lessons to be learned here? The analysts from McKinsey have a 50,000-feet-up view of things, which has both plus and minus factors to it. On the “minus” side, they aren’t looking at the street-level operational complexity that healthcare CIOs, CMIOs, and other IT leaders on the provider side are facing; on the “plus” side—well, that’s also the “plus” side…! That is to say, sometimes it’s very important to look at the bigger picture and get away from the day-to-day concerns in order to think more broadly about where everything is going.

And clearly, it will be important for IT leaders from the provider side of healthcare to think holistically, to see across and beyond the provider sector, in order to plan for the broader future of healthcare IT. It will be fascinating to see how all this plays out over the next few years. I don’t think that anyone is advocating wild, haphazard investment in information technology for IT’s sake. At the same time, some significant investments will need to be made on the provider side of healthcare in order to get to where everyone needs to get to. And we’ll need to look to experts like those at McKinsey to offer thoughts from 50,000 feet up as we all move forward on the path.

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