WASHINGTON — Insurers will soon reassess how they predict costs; patients will let doctors know what medications won’t work with their particular genomes; and researchers will look at hospital records in real time to determine the cheapest, most effective ways to treat patients — all because of developments in what is known as big data.
Driven by industry trends and the Affordable Care Act, the analysis of large sets of data, such as medication usage or hospital readmissions, has enabled health care providers and policymakers to make smarter decisions and predict future trends. Electronic medical records and decisions by governments and companies to share data have made for smarter decision-making that can save money and provide better care, experts say.
“We’ve been working with 15- to 20-year-old technology,” said Winston Hide, associate professor of bioinformatics and computational biology at Harvard School of Public Health. “It’s creakingly slow. We’ve got a completely new paradigm coming.”
Arijit Sengupta, CEO of data analysis firm BeyondCore, recently used big data to determine that the young-and-healthy expected to balance out the insurance pools in the federal and state exchanges may actually cost more than expected as they gain access to mental health care — also a provision in the Affordable Care Act.
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“It took two hours to run an analysis,” Sengupta said. “We can actually go in and ask a crazy question without any hypothesis. We need to figure out what is happening in health care.”
Often, the results are the opposite of what’s expected, as was the case with a flurry of high readmission rates for diabetic patients. Everyone assumed it was older people forgetting to take their insulin. Instead, Sengupta said, it was young women trying to lose weight, so they skipped their insulin.
Last week, during a White House conference, two businesses, MedRed and BT Health, announced they would work together on a new “health cloud” project. The data cloud will include “de-identified” information — or data scrubbed clean of any identifying personal information — from the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services, along with data from the United Kingdom’s National Healthcare Service.
That cloud will be used by universities, pharmacologists and hospitals systems for research. Will Smith, CEO of MedRed, said that information could be used to see if those with mental health diagnoses receive best-practices treatments, to look at the prescribing patterns or physicians, or to compare the outcomes of two groups of patients using two different medications to treat diabetes.
Neal Stine, principal consultant of BT Health, said the data may show which prescriptions are cheapest or most cost-effective — and it might not always be the generic prescription. “That would be a sea change in how formularies are developed now,” he said.
The information could also help predict what kinds of drugs need to be developed, whether people should be treated as inpatients or outpatients, and to answer questions about what practices in Accountable Care Organizations work best or what the health habits are of the newly insured.
Hide and other researchers said they see tremendous opportunity in genetic research that can show the best treatment for a patient. Sequencing the human genome, Hide said, is becoming faster and cheaper.
Date: November 24, 2013