For consumers, the digital and data revolution is well underway. From your smartphone, you can access everything in your personal and work lives: paying bills, transferring money, or ordering any conceivable product on Amazon—all while sipping that latte at your local café. But what you can’t do is access or manage your health records. That requires a phone call to the doctor’s office, a request form that needs to be faxed, resulting in hard copies that need to be mailed. All accomplished in roughly 2-3 weeks if you’re lucky.
Unless you feel nostalgic for the bygone era of curly paper and the screeching/whooshing noise of the fax machine making a connection (which always elicited a satisfying grin), this way of handling patient data is, let’s just say, suboptimal. The problem goes well beyond consumer convenience, as the same lack of access limits clinician’s ability to better understand a patient’s medical history. Furthermore, with records locked away in file cabinets, there is no opportunity to anonymize and aggregate data to better understand correlations between treatments or procedures and outcomes across patient populations. Right now, Facebook and Google are capturing data on virtually every online activity and likely have more digitized personal and behavioral data on consumers than any health organization.
Healthcare Data Gap
In their Age of Analytics study on the adoption of data-driven practices across industry sectors, Mckinsey Global Institute (MGI) found that U.S. healthcare lagged other industries in “capturing value from data and analytics.” Not surprisingly, location-based data (GPS) and U.S. retail led the way in value capture (see chart), as turn-by-turn directions and one-click purchasing have now become essential capabilities on smartphones. According to MGI, U.S. retail has been able to capture three to four times the value as healthcare, with GPS presenting an even a stronger case, at roughly five to six times.
These sectors were able to leap ahead due to the widespread adoption of standardization and integration of technology. Standard protocols for GPS technology, first established by the military, have been around for decades. The accelerated growth of mobile platforms that drove online retail was made possible by standardization on operating systems (iOS and Android) and coding languages like Python and Ruby on Rails, that armies of developers used to accelerate development cycles and enable interoperability.
The question remains, how does healthcare catch up? How does the industry start to capture greater value from digital technologies, data, and analytics? Let’s start with what’s getting in the way.
Barriers to Adoption
In their research, MGI identifies several barriers to greater adoption of analytics in healthcare, these include:
- Lack of incentives,
- Difficulty of process and organizational changes,
- Shortage of technical talent,
- Data-sharing challenges, and
Scanning this list, you start to understand perhaps why healthcare lags behind, say, retail in adopting analytics. Let’s face it; healthcare is a beast. It’s highly regulated, decentralized, specialized, complex and fraught with risk (legal, financial, ethical). Purchasing diapers and batteries online is not exactly open-heart surgery.
While direct comparisons are difficult to make, perhaps we can draw some parallels to the underlying conditions within certain sectors, like retail, that drive the wider use of data and analytics to improve decision making and create better customer experiences. Personalization, choice, and consumer control is the hallmark of successful retailers today— particularly the online, digital native firms. Beyond the obvious example of Amazon, there are specialty retailers like Warby Parker, Zappos, and prepared food providers like Blue Apron that combine choice, convenience, and personalization fueled by data (customer profile as well as purchase history). To make this work, consumers today have a tacit understanding with online retailers—they know with every interaction these companies are collecting more information about them. They are fine with this to the extent the companies are using this information to understand consumer’s needs, wants, desires, and preferences and deliver something of value in return. As Google discovered with Gmail ads, when the value exchange becomes unbalanced — i.e., pummeling your inbox with random ads— consumers will rebel.
The fact remains that the digital revolution of the last decade was consumer-focused and consumer-led. The customer was at the center of the action. This is where incentives must be focused. The fundamental difference with healthcare is that historically the consumer has been a bystander, as providers and payers interacted to control the type of care, determine prices, and handle payments. The industry has looked and acted more like traditional B2B, slow to innovate, adopt new technologies and experiment with radically new ways of doing business. Until the consumer is front and center, informed, empowered and able to make their own decisions, things won’t change. Healthcare needs to gets personal.
Personalized Health Using Data
The proliferation of portable monitoring devices—be they commercially-available heart rate monitors or sophisticated diagnostic equipment—will produce vast amounts of new data. The question is, will this just create more “noise” or lead to changes in patient behavior, more effective treatment options, and better outcomes. There are some early signs of progress. Essentia Health instituted home monitoring for patients with congestive heart failure and saw a significant drop in readmission rates (2% vs 25% for industry average).
The answer to whether data can make a difference lies in the level of actual or perceived value the patient gets out of the data-sharing deal. In a consumer-focused world, it’s all about what’s in it for me—convenience, choice, cost savings. If consumers are going to make an effort to share their data (not to mention overcoming privacy concerns), what do they get in return? What they need first is to feel like they are in control, that they can influence the process. It’s no secret why buying a car or a house are two of the most stressful and least satisfying consumer experiences. They involve complicated, consequential decisions with very little control and limited access to information. Online players like TrueCar and Zillow have started to chip away at the this, offering greater transparency through access to historical price comparisons, enabling consumers to make more informed decisions.
For the data revolution to take hold in healthcare, this same level of consumer control, driven by data transparency, will need to become a reality. Only then will consumer demand begin to grow such that payers and providers will have to innovate and compete based on publicly available data on quality of care and cost, and private, consumer-controlled patient profiles. The result will be better outcomes for all.