Health Informatics and Data Analytics are burgeoning fields following on the footsteps of ehealth efforts. Big Data is now touted as the solution to solving health care costs by mining for numbers and patterns. Some influential people believe that the "Watsonization" of health care is also at hand whereby computers will diagnose the disease or advise on next steps.
I can't help think of how the car industry has evolved from mechanics to computer identification as to why the dashboard is flashing various lights....problem is that patients aren't cars or widgets with replaceable mother boards. They are a complex combination of emotional, psychological, physiological matter held together with bones and flesh. And our brains...way more than grey and white matter with some synapsing neurons and a few sulci.
As always the devil is in the details and at a time when clear communication and positive relationships are acknowledged as key to patient well being and patient satisfaction, efforts are in full swing to mine for data from health records or any other data that various networks and health systems can get their hands on.
Whether it is analysis of care coordination, readmissions or even medication compliance we should acknowledge upfront that numbers don't tell the whole story. Human behaviour is as complex as our physiology and when we combine the complexity of providers with the complexity of patients and the complexity of our environments we have something that even Big Data cannot fully elucidate.
For providers it means a system of payment more focused on generating data that can be tied to funding either positive or more likely negative as economies fail to grow.
As provider funding is tied to data and generating patient indices or outcomes deemed "positive", expect a greater attempt by providers to choose more optimum practice locations or select patient populations. The law of unintended consequences will be in full swing.
When governments tie financial incentives to patient selection for various kinds of care including the murky "end of life care", we can expect Liverpool Care Pathway type events to occur.
Providers incented to select patients for end of life pathways and hospitals provided with funding to deny patients care is not a recipe for trust.
Who will the patient trust to give them medical advice on their care when the physician or nurse or other is conflicted in their attempt to preserve the system or limit care?
How do we ration based on evidence or quality or value when there are so many unknowns?
When do we determine that a patient should have an "end of life discussion"?
Why does any decision-maker in health care believe that Big Data can take the place of the relationships that humans seem to need so deeply?
When will the public and patients come to the realization of the risks inherent in the sharing of their personal data for government rationing efforts?
What does Big Data do to caring and compassion?
None of this is to say that evidence isn't important in creating understanding of medical science. Neither is it to say that we don't need statistics and facts.
It's just to say that as we create more complexity and try to comfort ourselves in data, we are mixing a recipe for more costs and not better outcomes either in patient satisfaction or in eventual quality of life.
As always, I'm grateful for your insights!