Health care leaders expect precision medicine data will play an increasingly important role in health care over the next five years—but there are some caveats, according to an NEJM Catalyst survey.
The NEJM Catalyst Insights Council Survey on Care Redesign surveyed 682 health care executives, clinical leaders, and clinicians about the role of data in health care, both today and in five years.
According to the survey, today:
- 36 percent of respondents said their organization used data effectively in direct patient care;
- 32 percent said their organization used data not very effectively;
- 13 percent said their organization used data very effectively;
- 6 percent said their organization used data extremely effectively; and
- 8 percent said their organization did not use data at all.
Amy Compton-Phillips, who in an analysis of the survey findings for NEJM Catalyst, wrote that the survey data show that health care professionals are adopting "a more realistic vision of what sophisticated analytics can do to transform health care delivery." But which sources of data are most useful will change over time, according to the survey.
For instance, when respondents were asked what they currently consider to be the top three most useful sources of health care data:
- 95 percent said clinical data;
- 56 percent said cost data;
- 45 percent said claims data;
- 30 percent said patient-generated data;
- 25 percent said pharmaceutical data;
- 21 percent said patient preference data; and
- 17 percent said genomic data.
But when asked what the top three data sources would be in five years' time:
- 82 percent of respondents said clinical data would be the most useful type;
- 58 percent said cost data;
- 40 percent said patient-generated data;
- 40 percent said genomic data;
- 32 percent said claims data;
- 23 percent said patient preference data; and
- 17 percent said pharmaceutical data.
Taken together, Compton-Phillips wrote that the survey results suggest that "combining information from devices, patient feedback, and patient biomarkers will be powerful and will catapult care forward in a way we can't attain today." She added that survey respondents seemed to realize that "personalized medicine, powered by data, will reduce the costs of care while simultaneously improving patient outcomes."
These type of data-informed interactions, Compton-Phillips noted, are already the norm in other sectors of the economy. "We already rely on data to personalize consumer experiences throughout our lives, rarely making a purchase without comparative shopping or reviewing suggestions sent to us by retailers based on big data," she writes. "Health care can follow suit."
The need for transparency, interoperability
But to make that happen, health care professionals must embrace transparency. The survey found that health care professionals already support giving patients access to:
- Their medical records (93 percent);
- Fee and price information for comparison shopping (80 percent); and
- Outcomes information listed by hospital (73 percent).
However, there was comparatively low support for sharing outcomes information by doctor (63 percent)—with even less support for doing so specifically among clinicians (55 percent).
These types of data sharing and other innovations enabled by big data can only come to fruition if EHR systems become more functional than they are today, accoridng to Compton-Phillips. And a major challenge in that effort is a "lack of interoperability, which just over half of respondents (51 percent) say is weak in their organizations," Compton-Phillips wrote. A third of respondents also indicated there was room for improvement in ease of use and training for EHRs, respectively.
There also are moral issues that health care professionals must grapple with as big data become more important. For instance, some health care professionals are concerned patient outcomes data will prompt some clinicians to avoid "treating the highest risk, most vulnerable members of society," Compton-Phillips writes (Compton-Phillips, NEJM Catalyst, 3/9; Sweeney, FierceHealthcare, 3/10).
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