Healthcare is complicated. A look at just one piece of the puzzle — data — can shed light on just how far we are from a reality where more data equals more value to the user, whether that user is the doctor or the patient. And with the recent announcement of Amazon’s Halo, we might be looking at yet another tool that increases the amount of data collected and stored but does nothing to drive improved (or even altered) patient outcomes.
The healthcare data paradox
In healthcare, there are two very conflicting and non-compatible issues happen when it comes to patient data: There is a ton of it available, and yet there is not enough.
If you try to put two circles into a Venn diagram, they will never overlap or even come close to each other. The information that’s really important for clinical care. For example, a person’s A1C levels are important but often don’t make it to a physician in a way that makes sense or is useful to treat the patient. On the other hand, there’s a bunch of interesting information but doesn’t matter as much, such as the number of steps a person takes each day.
In other words, there’s a ton of data but not enough analysis of – or access to – it. And until we have a way to integrate the data collected into the delivery of care seamlessly, we will continue to see tools and technologies come along and, eventually, fizzle out.
The cart before the horse
To unlock innovation in healthcare, we have to build with innovation and patient-focused open access at the center of everything we do. So, we can’t just write off the innovators that come along and push the cart a little farther down the road. After all, the innovators push the boundaries on what kinds of data we collect that ultimately end up being valuable for delivering care.
Healthcare is a tribal science. New data comes along and changes the way we look at the answers we had before. If we didn’t continue to learn based on new data, tools, and knowledge, we would have moved on from improving the way we treat heart disease.
But we learn continuously because we gather data and review new information continuously. Therefore, we need the innovators to help us figure out how to collect the data, and we need science to make assumptions and test hypotheses based on that data.
Is Amazon’s Halo the cart or the horse?
When it comes to outside companies entering healthcare, they’ve rarely done the due diligence and thought through the process of new technology becoming a valuable part of a person’s care path. More specifically, rarely do tech companies understand that it has to be part of a person’s medical chart for a tool to become widely used. Amazon understood that and announced Halo in partnership with Cerner, an electronic health record (EHR) company.
While, supposedly, that is more than any other tech company has done to date, partnering with just one EHR vendor hardly makes it ubiquitously useful for patients and doctors across the country, especially when there are more than a dozen.
Is there anything about an open API or enabling access for other vendors? So, at this point, the data is really only valuable for the patients who visit or receive care from a clinic or hospital that uses Cerner’s EHR.
So, it’s still up in the air whether the Amazon Halo is the cart or the horse. While this moves in the right direction, it’s not doing anything particularly relevant for the larger population. For the population for whom this is relevant, we’re just going to silo their data into a warehouse where it sits and collects dust. But we could be collecting data and information that will drive significant improvements in outcomes at some point in the future.
Can we really overlook the fact that we have to wonder if a person even knows which EHR their healthcare provider uses?
It’s usually just healthcare IT workers who pay attention to a hospital’s back-end system and all the data stored there.
For patients, more data isn’t better.
Consider this example: Every month, we receive a bill from our utility company with a report of how much energy we’ve used the previous month. The way those reports are broken down and presented delivers a great deal of value.
For example, knowing how I compare to my neighbors helps me understand how my energy use compares to those around me. The report also tells me what appliances use the most energy and offers insights for how I can better manage my monthly energy usage.
Now, imagine if that report broke that usage down by the minute. That’s a lot of data to sort through — with no context. What’s the “so what?” Without insight into what the numbers mean, and what we can do with the new knowledge, it’s useless and irrelevant. And do you really want your utility company checking you out all the time? Do you want these people to have access every minute into your life? Do you care what electricity your neighbor uses? Do you want your neighbor to have your stats and data? Who gave them permission to gather that information in the first place?
What about health stats and data?
The same is happening right now with all the data we’re collecting about a person’s health. A patient might be able to recognize patterns and start to make changes — say, making efforts to take more steps each day — but there’s nothing from a clinical perspective saying that’s the right thing for that individual.
On the provider side, we don’t have systems that make it possible for a physician to review the deluge of data we’re collecting. A doctor doesn’t have the time to go through pages of a report to search for the tidbits of information to help deliver better care to her patient.
How Amazon and other tech companies can have a real impact
Let’s play something out. If you are a patient who monitors your glucose levels and gets a reading that requires action, your doctor will not show up at your door. Nor is your doctor going to go through page after page of your glucose levels between visits.
That’s where innovators and tech companies can have a real and lasting impact. We need device manufacturers and vendors – e.g., health IT, hardware, software – to design and integrate easy-to-read models into their tools.
That way, providers can look at and analyze the [most relevant] data that has been collected in less than a minute. Inconsistencies? We need to be able to look at what they have in common — a time of day, following a meal, with activity – via easy-to-understand models that highlight what a doctor should focus on.
In addition to the big tech companies and innovators of new tools, there’s another group that bears responsibility for the lack of useful data: EHR vendors.
Given the doctors own all patient data, they play a critical role in ensuring the seamless integration between remote, wearable devices and their systems. Are Doctors and clinics in a unique position to drive the kind of innovation that can impact the state of healthcare in America? Is there a better way to drive improved outcomes for patients? It would be nice to see this happen proactively, rather than through a forced regulatory framework.
Cultivating the wasteland
Yes, we have a lot of unused data right now – and we continue to add to that with the introduction of devices like Amazon’s Halo – but not all is lost. For many, such as people with chronic conditions or disabilities, wearable devices can prove extraordinarily valuable.
The need for human-centric patient engagement strategies, tactics, and tools will continue to grow; wearable devices are well-positioned to drive a new level of engagement that today’s patients-as-consumers are demanding.
The reality is, we don’t know what we don’t know. While some wearables will end up in the wasteland, many will provide the kinds of data that will drive the future of healthcare and positively impact health outcomes.
When we get there, we’re going to look back with gratitude that innovators kept innovating and pushing the industry further so that we could turn that wasteland into a shiny city on the hill.
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