As information once held closely by providers becomes available to health plans, employers, and consumers, old hierarchies are disintegrating. “The democratization of health care,” as the National Academy of Medicine has labeled it, brings with it new roles and rules that challenge health systems to successfully combine high-tech analytics with sophisticated high-touch outreach. As complex clinical care information spreads outside conventional professional channels, it will disrupt traditional roles of providers, payers, patients, and others. To thrive in this new environment, provides will need to understand how roles and interactions are evolving and how new kinds of rules will govern them. To do this, analytics that allow sophisticated measurement and management will be key to surviving and prospering in an era of artificial intelligence and distributed data.
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If you’re a healthcare executive or physician, think of medicine’s dawning Information Age as analogous to watching your adorable preteen morph into a teenager. As your old sense of control slips away, new roles, rules, and relationships will begin to redefine your world. Healthcare data and analytics must become a core competency in order to continue to thrive and remain competitive.
Historically, healthcare has been defined by its control of a specialized body of knowledge “relatively inaccessible to lay people,” as medical sociologist Eliot Freidson put it. The knowledge needed for diagnosis and treatment, and the ability to put that knowledge into practice through something as simple as dispensing advice or as complex as a fully equipped hospital, is what sets the provider community apart.
The proverbial Google search is mutating, as sophisticated healthcare data analytics become easily accessible on the Web and through new apps. The lay public is increasingly able to access medical information that’s evidence based, personalized via artificial intelligence (AI) algorithms and, critically, often outside the control of the traditional healthcare system. While this certainly represents the “democratization of healthcare,” in the words of the National Academy of Medicine, it also signals a sea change far more significant than healthcare “reform.”
“A reform is a correction of abuses,” the Victorian-era parliamentarian Edward George Earle Bulwer-Lytton wrote. “A revolution is a transfer of power.”
Imagine an individual’s health data from multiple sources aggregated in one place and then mined for information on physical and emotional health. There’s a dashboard that “Dr. Mom” can use to access this information with user-specific guidance. All of this comes from a vendor that sells to providers, but also to employers and insurance brokers.
Or imagine a woman with breast cancer who gets a personalized analysis based on real-world cancer outcomes of patients with a similar clinical presentation. That analysis includes a dashboard with data on the expected cost, quality of life, complications, and survival of “best treatment.” Again, all of this comes from a vendor selling to providers, but also to employers and other payers.
Or the woman on her own might enroll in a community such as PatientsLikeMe, accessing information on the perceived effectiveness of possible treatments and their side effects based on reports by others with a similar diagnosis and similar personal characteristics.
Or maybe it’s the health plan or employer insisting that the physician or health system provide patient-reported outcome measures, such as functional status post-treatment.
The quality improvement pioneer W. Edwards Deming famously declared, “In God we trust—all others must bring data.” Organizational survival in the Information Age requires following the Socratic dictum, “To know thyself is the beginning of wisdom.” At a time when value-based payment is ascendant, “know thyself” is crucial to ensuring earning enough margin to enable the mission. You need to know your strengths and weaknesses more quickly, more deeply, and in a broader scope than any payer, competitor, or other outsider can.
In the movie, The Graduate, actor Dustin Hoffman’s character is famously given terse advice on the hot trend of the future: “One word: Plastics.” Today, to enable fast and deep self-knowledge, that one-word tip might be, “Analytics.”
Rich data, however, only constitutes a starting point. As with teenagers, sharing control means managing new relationships and the new roles and rules that go along with them. For instance, a health system’s relationship with a company selling AI-powered clinical quality analytics will likely be very different than its relationship with a distributor of surgical scalpels. Not to mention how the roles and rules of “patient-centered care” shift when the patient sitting on the exam table is brandishing a personalized treatment recommendation on her smartphone.
Accountability demands are on the rise, driven by the economic pressure of high healthcare costs, rapid technological change, and new activism by payers, patients, government, and information technology companies. Informed adaptability, however, can build a better future—just like what happens with most teens once the hormonal turbulence ebbs. The increased transparency of the Information Age is, in the end, about healthcare data and analytics that challenge us to live up to our ideals. As the author and poet Antoine de Saint-Exupéry wrote, “As for the future, your task is not to foresee but to enable it.”
Interested in learning more? Watch an on demand webinar, “Out of Control: The Challenge of Healthcare’s New Roles, Rules, and Relationships.”
Michael L. Millenson is a Senior Advisor to Health Catalyst, president of Health Quality Advisors LLC and the author of Demanding Medical Excellence: Doctors and Accountability in the Information Age.
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