In five years, genomic data and patient-generated data will join clinical and cost data as the most useful sources of health care data, according to a survey of healthcare executives and clinical leaders.
That forecast comes from the latest NEJM Catalyst Insights Report on Care Redesign, which is based on a survey of 682 healthcare executives, clinical leaders and clinicians. The NEJM Catalyst care redesign report aims to get a read on the effectiveness of health care data, both today and in five years.
According to the report, survey respondents ranked what they consider to be the most useful sources of health care data today. The top three most useful data sources were ranked as clinical data (marked by 95 percent of respondents); cost data (56 percent) and claims data (45 percent). Other sources of data were ranked as the following—patient-generated data (30 percent), pharmaceutical data (25 percent), patient preference data (e.g. HCAHPS) (21 percent) and genomic data (17 percent).
However, in five years, the survey 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, according to the report.
Looking ahead to a five-year forecast, only 82 percent of survey respondents ranked clinical data as the most useful source of data five years from now (down from 95 percent) and cost data rises slightly to 58 percent. Claims data drops to 32 percent, compared to 45 percent today. As far as the top three most useful sources of data in five years, claims data is supplanted by patient-generated data, with 40 percent, and genomic data, 40 percent. According to the report author, Amy Compton-Phillips, M.D., lead advisor of NEJM Catalyst’s Care Redesign sector, and executive vice president and chief clinical officer at Providence St. Joseph Health, this points to “a big data future that includes more personalized medicine and where cost plays a bigger role.”
“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 decision support,” wrote Compton-Phillips.
According to the report, clinicians are more optimistic about the usefulness of patient-generated data today than executives are (34 percent versus 21 percent), but the situation is reversed looking five years out: 45 percent of executive respondents expect patient-generated data to become useful, versus 34 percent of clinician respondents.
The report also takes a look at the effectiveness of healthcare organization’s use of data for patient care. “Fewer than 20 percent 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 percent) or ‘not very effective’ (32 percent) leaving a tremendous amount of room for improvement. Another 8 percent call their organization’s use of data “not at all effective’,” Compton-Phillips wrote in the report
When survey respondents were polled about what they see as the top three biggest opportunities for use of data in healthcare, 81 percent cited care coordination, 79 percent cited improved decision support and 68 percent said predictive analytics. Forty-five percent of respondents cited precision medicine. However, only 58 percent of clinicians consider predictive analytics as one of the top three compared to 80 percent of clinical leaders and 76 percent of executives, according to the report.
Survey respondents identified lack of interoperability (72 percent) as the biggest barrier to better use of patient data. Interestingly, a higher percentage of executives (79 percent) cited interoperability as one of the top three barriers compared to clinicians (69 percent). Difficulty collecting data (cited by 62 percent) and a related challenge, time required (60 percent) rounded out the top three barriers to doing more with data.
As Compton-Phillips noted in the report, there is no shortage of complaints by healthcare professionals about the limitations of their electronic health record (EHR) systems, however, according to the survey results, functional capabilities are not the issue. When survey respondents were asked to rate aspects of their organization’s EHR system, only 22 percent rated their EHR’s functional capabilities as weak (76 percent rated the capabilities as strong or average). Interoperability was identified as the biggest challenge, as just over half (51 percent) of respondents described their EHR systems’ interoperability capability as “weak.”
”The industry clearly has a directive from its users to address interoperability before data can take on a more useful and prominent role in transforming care delivery. Ease of use and training, which each were labeled “weak” by a third of survey respondents, also must be tackled,” Compton-Phillips wrote.
Survey respondents also were asked to describe the current state of big data in healthcare, and only 18 percent of respondents believe that it is still “mainly hype.” A third of respondents (32 percent) report that useful applications are already in place today, and 44 percent forecast that useful applications are a few years away. Drilling down, 21 percent of clinicians consider big data to be “mainly hype” while only 14 percent of clinical leaders and executives consider big data to be hype.
"Over the past few years, executives, clinical leaders, and clinicians have been hopeful about the hype but disappointed by the lack of breakthrough progress from big data. But as we found in our latest Insights Report, the landscape is shifting from one of cynicism about overblown expectations to a more realistic vision of what data can do to transform care delivery,” Compton-Phillips wrote.
Regarding data transparency and patient access to health care data, survey respondents indicated that they are very open to data transparency when it comes to patients accessing their own health care records. Ninety-three percent of respondents believe patients should have direct access to their own medical records and 80 percent believe patients should have access to fee/price information for comparison shopping. However, only 73 percent of respondents agree that patients should have direct access to outcomes information by hospital and even less, 63 percent, believe patients should have direct access to outcomes information by doctor.
