Everybody seems to agree that “big data” holds much promise (or potential) for better healthcare. To this end, the Affordable Care Act made it a priority to create more, and presumably, better health care data. However, with the rapid development of devices, tracking systems and data tools, who will benefit from this data: Patients? Plan sponsors (or payers)? Insurance companies? Healthcare providers? PBMs? Pharmaceutical and device manufacturers? Other enterprising service providers?
The potential benefits are huge: better predictive information, better treatment strategies, fewer treatment errors and better outcomes ― maybe even healthier people and lower healthcare costs. Yet, for those who want to profit from this huge sector of the economy, big data can also become both an engine for product and service sales, and something to carefully shield from the payers (maybe by hiding behind the shield of HIPAA?).
Employers who harness the power of available healthcare data may be able to better manage healthcare costs and contribute meaningfully to the wellbeing of their plan members. These benefits are unquestionably worth pursuing, but a number of major obstacles stand in the way.
First, data security. Will future systems (and data sharing policies) be able to provide the value and services desired while maintaining privacy and data integrity? Next, data reliability. Will the collection and reporting of data accurately and meaningfully reflect what is happening? Last, and arguably most important, is data interpretation and use. Will users be able to interpret and act upon the available data in value-added ways? This is partly a user issue and partly a vendor issue.
Through our work, we have encountered an unwillingness to share data, bad data, and a reluctance to act upon meaningful data. In fact, we can argue there is actually no shortage of data and that security, reliability, and correct application are the bigger barriers to plan management.
In the end, it will be up to employers/plan sponsors to get the right information from their vendors, to interpret it well, and work with their vendors to make meaningful changes ― changes that will reduce the cost of coverage and improve the wellbeing of their plan members. In the meantime, you can be assured that the profiteers have a head start on you!