“Big data” has been a hot topic for the past several years. The term can refer to making use of any massive, complex collection of information, but one important application is that of building and then “mining” massive databases of information about consumers. This form of big data is supposed to provide organizations with insights about their customers that can help with creating, improving and selling products and services. That includes health care, where big data is envisioned as allowing crunching through a vast ocean of patient information in order to lower the cost and raising the quality of health care.
On the other hand, big data has been getting some mixed press lately. An article in The New York Times, for example, noted how big data hasn’t always delivered on promises to make cities more livable. A CIO magazine article was among those reporting how the person who masterminded the Obama campaign’s brilliant use of technology in marshaling supporters online recently declared that “big data is BS.” And a long, thoughtful article in Foreign Affairs (behind a pay wall) detailed some of the reasons why big data, though in many ways an exciting development, may in some cases be hard to pull off and disappointing in what it can deliver.
I do happen to believe big data will be a boon to health care. As health care focuses more and more on chronic illnesses such as cardiovascular disease, cancer, diabetes and Alzheimer’s, a lot of provider emphasis will shift away from expensive hospital-based treatments for acute episodes (such as cardiac surgery), and toward ongoing, simple, outpatient and even home-based preventive efforts (such as controlling diet and monitoring blood pressure). The latter sorts of care can be much more successful if big data is there to alert clinicians as to which patients need outreach or close watching in order to head off serious illness, and to generally keep patients healthier—all at a much, much lower cost than waiting for these patients to become seriously ill and require hospitalization.
But having said that, I agree that a certain amount of skepticism is appropriate when it comes to treating big data as a panacea, or even a game changer. For starters, data mining won’t be able to catch all the complexities of which patients need what interventions. No computer yet invented can match the power of the computer sloshing around in the skull of a highly trained clinician when it comes to recognizing that a patient may be heading for trouble, and deciding what steps—including simple monitoring—need to be taken to maintain or restore that patient’s health. Big data may help keep many patients from slipping between the cracks of health care attention, but the need to get patients in front of good clinicians won’t go away, and may in fact increase.
Equally important, the sorts of big changes we need to make in health care in order to significantly lower costs and improve outcomes must go far beyond doing a better job of gathering and analyzing patient data. We need to be able to provide far more primary care. We have to completely revamp the way health care providers are reimbursed. We have to get consumers to adopt healthier behaviors, and make wiser choices about how to spend their health care dollars—and we should get employers and insurance companies to give them plenty of incentive for doing so.
So yes, let’s push ahead with pulling together more data and doing more with it. But let’s not allow our hopes for it to justify putting off tackling the bigger challenges in front of us.