Why Big Data Doesn’t Replace Big Ideas

by JHI Staff on July 2, 2013

“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.


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Why Big Data Doesn’t Replace Big Ideas | jhublogs
July 2, 2013 at 4:41 pm
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Kay Keesecker July 17, 2013 at 2:47 pm

Your two summary points: revamp provider reimbursement system; and change behaviors are both tall orders. On the reimbursement side I believe most would agree that improved access to primary care, coverage for prescriptions, patient education and follow up would save not only health care dollars but lost time from work, and reduction of physical pain and suffering. Perhaps the incentive component applies here as well: designing changes to permit primary care physicans to be more engaged with a reduced number of patients vs. a system that drowns the doctor in paperwork and squeezes interaction to 15-minute consults.
On the second point, consumer behaviors, I grew up with ubiquitous nicotene consumption in daily life, movies, TV billboards, ads, etc. I am aware of that now from watching recently aired programs on METV from those early years. News anchors, late night hosts, everyone it seemed has a cigarette in their mouth or their hand. If we managed to change that cultural milieu, how many lives would be saved going forward if we only refused to stand for the relentless glorification of illegal drug use, guns as solutions to interpersonal problems, and violence as a way of life. We have been marinating in this poison for far too long - at what cost?


Scott Barclay July 5, 2013 at 4:14 pm

Steve, A very nice article, though I disagree with a fundamental contention, however:
"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."

I think this is already partly untrue. The solutions now exist, though in early form, they are just not yet distributed. Can give several examples, include MEDgle where I am involved, but as an ecosystem such next generation clinical analytics engines this will significantly power the next phase of value creation. I would prefer Khosla's language that such tools will surpass doctors on many fronts and amplify them on others.


Steve Thompson July 9, 2013 at 4:47 pm

Scott, Thank very much for your comment. Glad you found your way to my blog. I do agree that we are well on our way to these data tools showing their real value and power. My comment was more a reflection on what I see in use today. I look forward to great things in the near future.


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