Rethink Data, Transform Healthcare - Unlocking The Value Of Health Data

By Freddie McMahon | July 9, 2015

The rise and rise of quantified-self and the Data Context Broker

We are all consumers of healthcare and therefore have a vested interest in its future. As an observation, being an outsider to this sector, the healthcare global system looks increasingly broken as the rate of change and complexity increases. At the same time, my empathy is with those people working inside the profession that provide high quality, compassionate healthcare, and support. But maybe more help is needed to handle the relentless challenges and changes at the edge.

Let’s look at some numbers

In 2015, the population of the world is 7.3 billion people and in 30 years it is expected to reach 9.3 billion. According to the World Bank around one billion people suffer from extreme poverty with 40% being represented by just two countries India (30%) and Nigeria (10%). Extreme poverty means appalling healthcare, whereby individuals may rarely see a doctor in their lifetime.

Today, our world spends $6.5 trillion on healthcare, which is increasing year by year. This is a very large number, so what is the worry? One country, the United States spends approximately 44% of the world’s health budget covering only 4.4% of the world’s population. Even, this small percentage coverage of the world’s population is actually an exaggeration, as around 50 million Americans are below the healthcare poverty line.
My first reaction was that this is extremely unbalanced as it suggests most of the world’s population suffer from healthcare poverty. My second reaction was concern about the 50 million Americans that could not afford a basic healthcare service.

By examining and comparing US healthcare data to data from the United Kingdom (UK), provides interesting insights related to the value generated, the cost of errors or poor judgements, and why changing behaviors at scale means taking a customer-centric perspective. The following data led to a line of thinking to whether some challenges could be addressed at a global scale regardless to whether people are rich or poor.
The US spent 17.9% GDP on healthcare during 2013, which is equivalent to $2.9 trillion. This is a considerable amount of money, but, is this money being well spent?

According to the Institute of Medicine, the US spends $750 billion a year on unnecessary tests. The improper and unnecessary use of medicines within the US costs a further $ 200 billion. Thus, $950 billion is being wasted every year due to errors of judgment – in other words poor decision-making. Europe fares not much better, for instance 8% to 12% of hospitalizations result with medical errors and health-care related adverse events.

Let’s think again about the global healthcare spend of US$6.5 trillion a year.
Another interesting fact related to those that receive healthcare is that 70 million people worldwide are affected by serious medical errors every year, some leading to premature deaths. Serious medical errors leading to premature death covers the whole of life. For instance, 75% of premature babies’ deaths are preventable. Preterm birth is the No.1 cause of new-born deaths and the No. 2 cause of death for children under 5. Other serious medical errors result in more than 400,000 Americans dying from preventable medical errors each year.

Medical errors are caused by a failure to correctly diagnose or deal with a condition caused by treatments that should have never been considered let alone administered because of safety concerns. Again this is evidence of poor decision-making. However, is the causality due to the data and the knowledge being now too complicated to understand within a time-pressured working environment?

This pattern of poor decision-making becomes more problematic as context deepens involving more and more permutations of data. Healthcare decisions are highly dependent upon understanding all of the relevant data and applying the right procedural interpretation. Before examining this further, let’s switch perspectives to examine healthcare through the eyes of a consumer.

Consumer behaviors matter

Whether a country is rich or poor in healthcare provision, there is little doubt the behavior of the consumer towards their personal healthcare matters. The more pre-emptive and self-sufficient a consumer becomes, the less of a strain there is on the healthcare services. But why is the consumer perspective more important to consider now?

According to John Cawley, Cornell University, believes obesity adds $190 billion a year to the cost of healthcare in the US. As cited in The Journal of Health Economics, the healthcare costs of an obese person are $3,271 versus $512 for individuals who are not obese. This additional cost, six times higher, becomes critical when the percentage of the population impacted is absorbing a disproportionate amount of the healthcare budget compared to other conditions. According to the Journal of the American Medical Association in 2008, the obesity rate among adult Americans was estimated at 32.2% for men and 35.5% for women. By 2012, the number of adults aged 20 years and over who are overweight including obesity was 69% and these numbers are increasing year by year.

Obesity is a non-communicable disease, which by definition is non-infectious and non-transmissible among people. However, behaviors do influence other behaviors and therefore social interaction and group pressure becomes an important factor for consideration. But then again, can something be done to address these challenges? According to the World Health Organization, 80% of the risk factors due to Non-Communicable Disease (NCD) also referred to as chronic chronic diseases can be prevented by making lifestyle changes. The implications are profound. Changing consumer behaviors in the area of obesity matters and so does for other chronic diseases like cardiovascular diseases, cancers, diabetes, and mental illness.

Socioeconomic costs of chronic diseases

Before examining a blueprint for changing consumer behavior at scale, it is important to understand further some of the facts about socioeconomics of chronic diseases and illness. The World Health Organization puts the cost of chronic diseases to the global economy at $47 trillion by 2030. This includes lost productivity. This number is colossal by anyone’s standards – remember the current global healthcare spend is ‘just’ $6.5 trillion.

Further evidence shows that from a global perspective, 60% of deaths worldwide, 36 million people each year, are due to chronic diseases. Chronic diseases cause 90% of premature deaths in both the United States and the United Kingdom.

Just three chronic diseases account for 44% of total healthcare expenditures in the US: $863 billion for cardiovascular diseases; $245 billion for diabetes; $185 billion for cancer. This amounts to an expenditure of $1.3 trillion dollars from just three chronic diseases. We need to urgently reverse these trends and this starts by looking at healthcare through the eyes of the consumer.

Changing consumer behavior with data and knowledge

Much investment in global healthcare has been driven top-down by healthcare providers. Despite significant investments, delivering successful changes has been a challenge. One of the primary challenges is the volume, variety and volatility of the data involved. For instance, the Government of the United Kingdom ended their project to develop a single patient record system within their National Health System (NHS) in 2011. The costs of the project at the time of cancellation was approximately 11.4 billion British pounds.

However, a national patient record system, even if successful would contain insufficient data to tackle the challenges identified including chronic diseases. To move from reactive, to proactive, to pre-emptive health care needs a different way of thinking … Systemic improvements at a global scale need to start with the individual. This should not be confused or treated from an institutional perception of patients but start from an empathy perspective - looking at matters through the eyes of the person.

This is a paradigm shift in thinking. Everyone is a consumer. Changing the consumer behavior needs to be about empowering every individual with the right data and knowledge, at the right time, and at the right place. But there are barriers to overcome. For example, who pays for this investment? Though this is challenging, new business models such as social networks, portals and search providers, have all contributed to new ways of thinking, financing and delivering value.

The rapid emergence of the quantified-self

There will be 1.91 billion smartphone users across the globe by the end of 2015, which is expected to increase another 12.6% to near 2.16 billion in 2016. The United Nations’ sustainability goals beyond 2015, states that universal Internet access, especially via mobile, sits alongside education and health at the core of a future development agenda. Its aim is to “provide universal and affordable access to internet in LDCs [least developed countries] by 2020”. The UN believes smartphone users will provide development agencies and healthcare organizations with vital, relevant data, whereby user behavior can be analyzed to reveal patterns and provide actionable insight. For example, health organizations can analyze search patterns that provides early warning of when an influenza outbreak is coming.

Smartphones are already providing apps that cover healthcare knowledge and generate data. For example, there are more than a dozen apps related to Diabetes such as Azumio and Sanofi-Aventis. These apps already collect healthcare data. More and more healthcare apps are appearing continually such as for interactive procedures providing the know-how for fast and frugal decisions.

These Smartphones are already linked to the Internet of Things (IoT), which collect and process data such as the Apple Watch and the Philips toothbrush that both send data to consumer apps for analysis and advice. According to the Gartner Group there will be 30 billion IoT devices by the end of 2020 … many of these will relate to healthcare. According to MarketResearch.com, the healthcare IoT market segment is poised to hit $117 billion by 2020.

These changes are well underway and are unstoppable. This is called the Quantified-Self, which is a movement in its own right. Outside forces are changing healthcare on a global basis without prejudice to how the $6.5 billion a year is spent on healthcare.

Why the Data Context Broker is so important

Two of the leading analysts at the research firm Gartner Group, Yefim V. Natis (VP & Gartner Fellow) and W. Roy Schulte (VP Distinguished Analyst) have identified the Data Context Broker as an emergent trend within the Big Data market. They position, a Data Context Broker as a service that is designed to gather reachable, relevant data of a variety of types, sources and velocity; it then applies conditioning, integration, rules and analytics to derive the reduced prepared context data, actionable at a point of business decision by a system or a human.

The ability to sense and respond to emergent patterns provides the basis for healthcare change that ranges from early warning systems to accelerating treatment discovery. In other words, the answers to the global healthcare crisis lie all around us, in data, from the consumer’s use of apps and intelligent devices to healthcare institutionalized siloism. The context broker unlocks the value of data by collecting it from consumers and institutions alike, and adapting and processing the data to support decisions in context to each stakeholder’s need.

This can lead to reducing wastage and unnecessary spend, developing more effective treatments, or better proactive and pre-emptive actions regarding chronic illnesses. Through contextualization — or desiloization — of stakeholder data, the context broker is able to unlock a whole new level of health and lifestyle-related intelligence. Holistic, data-driven intelligence can then be accessed by the various stakeholders to enhance their own personal or commercial value.

A final thought

Governments around the world are in a state of panic, and rightly so — healthcare costs are spiraling out of control. The irony is that the answers for many of the biggest healthcare problems we face today cannot be found in hard cash, but in the data and decision-making capability that already surrounds us. Siloed data is of limited worth, whether it is held by an individual or institution.

Instead, we need to create healthcare data ecosystems where a wide range of traditional healthcare players and consumers, via the app providers, millions of ‘quantified selves,’ feed in data that, as a whole, is far more valuable than the sum of the parts. And because this data is ‘living’, stakeholders can respond to key ‘data moments’ as they emerge.

However, the main challenge for traditional healthcare players is to overcome the psychological barrier of sharing their data. But if they can do this, while protecting sensitive personal data, the prospects of not only containing but reducing the healthcare crisis are far stronger, which will benefit us all. Sharing, as the saying goes, is caring.

We are in a data driven economy. Improving global healthcare for everyone is a dream that can now be realized. As Jean Jacque Rousseau stated "Man is born free, and everywhere he is in chains." For global healthcare it’s time we started to break away from ‘data’ chains and find new ways of using data and knowledge to improve healthcare everywhere!!

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