Medical metrics: The digital health revolution is on, but patients need more than operational efficiencies

Stethoscope by Shutterstock.com

HAVING SPENT decades in search of the next wonder drug, American medicine has started to think about improving the way care is actually delivered, and has begun to dig deeply into the processes of health care. The science of operational improvement is on the rise. There's been an explosion of interest in measurement, metrics, and analytics, as researchers try to figure out how best to improve the quality of care.

The pursuit of quality is powerfully enabled by the emerging "digital health" sector, which develops the tools and technologies that enable improved health data collection and sophisticated analysis, and permits us to contemplate the transition of medicine from an episodic, symptom-driven practice to a more holistic vision focused on presymptomatic care and a more continuous assessment of health.

The rapid evolution of digital health has been driven by an impassioned cadre of entrepreneurs hoping to bring the dazzle of tech start-ups to the challenges of contemporary health care. The recently reported acquisition of Humedica, the Boston-based clinical informatics start-up, by insurance giant UnitedHealth highlights the value accorded to innovation in this space, and offers a useful lens into the way many digital health start-ups are thinking about problems.

Traditionally, medical information - physician notes, diagnostic images, lab tests, and prescription orders - has been dispersed in manila folders scattered in offices and file rooms across a sprawling care network. As providers (led by large hospital systems) embrace electronic medical records, these disparate data are increasingly stored electronically; however, extracting the stored data points and organizing them in a useful and actionable way remains a significant challenge - which is where analytics companies such as Humedica come in.

Humedica is hired by large hospitals to extract information from their electronic medical records system and perform fairly basic analyses that assess the quality of patient care and suggest areas of improvement, pointing out instances, for example, where patients inadvertently have been prescribed medications known to interact, or where a provider forgot to order a key diagnostic test or veered significantly from accepted best practice. By identifying and correcting these problems, hospital systems hope to ensure each patient receives the best care possible while avoiding unnecessary, potentially harmful treatments.

Digital health entrepreneurs hope that through the right combination of improved measurement (often using "smart" sensors), sophisticated analytics, and user engagement, they can help find ways to make the best use of today's treatments, and ensure each patient consistently receives the best and most cost-effective care available. Entrepreneurs also hope to progressively raise the bar, applying the empirical intelligence of operational improvement to further elevate the quality of health care delivery.

As lofty as these aspirations are, we worry this view of quality - ambitious as it is - isn't quite ambitious enough.

Consider how today's community of digital health entrepreneurs would likely respond were polio still unpreventable and widespread: Start-ups would focus on refining the design of the iron lung, increasing the efficiency of scheduling, improving the transparency of costs, and analyzing the operational performance of each unit while tracking its location by GPS.

Without question, these tweaks would significantly improve the patient experience, and might reduce the cost of care. However, none of these approaches would have either the clinical or the economic effect of a radical new therapy - in this case, the polio vaccine.

Even as we strive to incrementally elevate health care quality through gradual operational improvement, our audacious goal must include figuring out how to use digital health's technology, data, and computational tools to increase our fundamental understanding of disease and generate profound new treatments.

Sound familiar? It should: Medical scientists held out similar hopes for genetics, only to discover that, as Nobel laureates Brown and Goldstein famously observed, "a gene sequence is not a drug," and getting from one to the other was far more difficult than many experts had anticipated - though the occasional success story reminds us of the promise.

Similarly, turning digital data into profound clinical impact will not be easy. However, combining genetic and digital data - integrating our knowledge of the building blocks of life with a dynamic picture of how the pieces are behaving - may prove particularly powerful, offering unprecedented insight into health and disease, and enabling us to develop radically improved therapies.

By then, our operationally improved health care system should be ready to efficiently deliver these treatments to patients, who have waited far too long to receive them.

 

Also Visit
AEIdeas Blog The American Magazine
About the Author

 

David
Shaywitz

What's new on AEI

In year four of Dodd-Frank, over-regulation is getting old
image Halbig v. Burwell: A stunning rebuke of a lawless and reckless administration
image Beware all the retirement 'crisis' reports
image Cut people or change how they're paid
AEI on Facebook
Events Calendar
  • 21
    MON
  • 22
    TUE
  • 23
    WED
  • 24
    THU
  • 25
    FRI
Monday, July 21, 2014 | 9:15 a.m. – 11:30 a.m.
Closing the gaps in health outcomes: Alternative paths forward

Please join us for a broader exploration of targeted interventions that provide real promise for reducing health disparities, limiting or delaying the onset of chronic health conditions, and improving the performance of the US health care system.

Monday, July 21, 2014 | 4:00 p.m. – 5:30 p.m.
Comprehending comprehensive universities

Join us for a panel discussion that seeks to comprehend the comprehensives and to determine the role these schools play in the nation’s college completion agenda.

Tuesday, July 22, 2014 | 8:50 a.m. – 12:00 p.m.
Who governs the Internet? A conversation on securing the multistakeholder process

Please join AEI’s Center for Internet, Communications, and Technology Policy for a conference to address key steps we can take, as members of the global community, to maintain a free Internet.

Thursday, July 24, 2014 | 9:00 a.m. – 10:00 a.m.
Expanding opportunity in America: A conversation with House Budget Committee Chairman Paul Ryan

Please join us as House Budget Committee Chairman Paul Ryan (R-WI) unveils a new set of policy reforms aimed at reducing poverty and increasing upward mobility throughout America.

Event Registration is Closed
Thursday, July 24, 2014 | 6:00 p.m. – 7:15 p.m.
Is it time to end the Export-Import Bank?

We welcome you to join us at AEI as POLITICO’s Ben White moderates a lively debate between Tim Carney, one of the bank’s fiercest critics, and Tony Fratto, one of the agency’s staunchest defenders.

No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.