Big Data – Love It Or Leave It

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Big data is coming, but will it be the “next big thing,” or is the healthcare industry doing the patients it treats a disservice?

A LinkedIn discussion started by Michael Gaspar (@MichaelGaspar), Associate Manager, Social Media at HIMSS asks, “As models for the use of big data begin to mature, how do you envision data playing a role in driving more quality outcomes in healthcare?”  A sampling of responses:

• Raul Recarey: “I believe the real challenge that our healthcare system faces and will continue to face isn’t with the need for more data or ways to identify what needs to get done, the challenge is how to actually motivate the patient to follow the recommended course of action.”
• Javier Maria Torres: “My bet on the "next big data thing" in healthcare is automated statistical analysis. Healthcare is all about statistical significance. Why should a doctor spend his time writing and defining a study in natural language, when a machine can try out lots of different analyses and then present the results to the doctor?”
• Danny Lieberman: “Big data is still mostly rubbish.”
• Kenn Moulynox: “With technology there is now an opportunity to aggregate data like never before. Better medication management, accurate diagnosis, and faster treatment are all beneficial outcomes of analyzing big data. Understanding patient behavior and lifestyle via de-personalized EHR and web portal data analysis will open up a new world for improving health in society.”
• David Druker: ‘The "gold" will be in the ability to use the free-form text in the doctor's and nurse's notes. Validating the EHR data and determining outcomes from both. Ultimately, this will put the patient back at the center.”

To the surprise of no one, there is no consensus. Big data is the future of healthcare, or is it of no use at all? It’s up to doctors to analyze and interpret big data, or will doctors never accept it? Big data’s future depends on patient acceptance, or it should never be shared with them?

Many healthcare industry leaders are siding with those who are embracing big data. After attending TEDMED 2013, Ken Congdon (@KenOnHIT) wrote an editorial for Health IT Outcomes noting, “Big data was such a hot topic it had an entire session dedicated to it (Session 2: How Can Big Data Become Real Wisdom?). However, the influence and promise of big data was palpable throughout the conference.” Congdon goes on to detail the work of two computer experts currently using big data in the fights against cancer, ulcerative colitis, and Crohn’s disease as testaments to big data’s contribution to quality healthcare outcomes.

Diana Manos, senior editor for HealthcareIT News, wrote about the same breakout session Congdon attended and noted presenter Deborah Estrin, professor of computer science at the new Cornell Tech campus in New York City and co-founder of the nonprofit startup, Open mHealth, talked “about how the use of ‘digital traces,’ or ‘digital bread crumbs,’ could help show signs of change in a person’s health and well-being, a sort of ‘digital social pulse.’” Manos continued, writing, “Information about a person's individual use of electronics is already being collected by service providers for marketing purposes. This data could provide indications of a decline in social or physical activity, something that is currently judged on a subjective basis. The data, which could reveal nuances in behavior, could be particularly useful in monitoring chronic diseases, such as depression or heart disease.”

A different way of looking at big data and its prominence at TEDMED was presented by Alessandro Demaio (@sandrodemaio) of PLOS Blogs who wrote, “Big data, small data, open data, crowdsourced data – this is the information backbone of science and the key to breakthroughs and innovation. Assuming the data is put in the right hands.” Demaio suggests the way to get big data in the “right hands” is open access.

“The term ‘open’ describes the unrestricted, uncontrolled provision of data or science to anyone, anywhere, anytime. Free from financial barriers,” Demaio writes. “Similarly, open access is about unrestricted sharing of scientific outcomes and findings.” Demaio goes on to quote TEDMED presenter Estrin as saying, “Open access to knowledge for students, doctors, and citizens cannot be separated by economics - access to science is good for science, business and society. The current system is outdated – a subscription or user-pays system is inequitable, ineffective, and regressive.”

While Estrin points out flaws with big data that need fixed, others take a more extreme view and want nothing to do with big data at all. This post on Pathcare responds to the McKinsey Institute’s report, Big data: The next frontier for innovation, competition, and productivity, by writing they “won’t dignify the report by publishing the link on the Pathcare blog.” The article goes on to attempt to show “how the McKinsey Global Institute report on big data is no more than a lengthy essay in fallacies, inflated hyperbole, faulty assumptions, lacking in evidence for its claims and ignoring the two most important stakeholders of healthcare – namely doctors and patients.”

Nassim Taleb, writing for Wired, warns us to beware of big errors of big data. “We’re more fooled by noise than ever before, and it’s because of a nasty phenomenon called ‘big data.’ With big data, researchers have brought cherry-picking to an industrial level,” Taleb writes. “Modernity provides too many variables, but too little data per variable. So the spurious relationships grow much, much faster than real information. In other words: Big data may mean more information, but it also means more false information.”

Along the same lines, Reed Abelson and Julie Creswell write for the New York Times about a HealthAffairs analysis of a RAND Corporation report indicating “The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care.” The article quotes Dr. Arthur L. Kellermann, one of the authors of the HealthAffairs analysis, as saying, “We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking. RAND got a lot of attention and a lot of buzz with the original analysis. The industry quickly embraced it.” The article goes on to say “Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money.”

Healthcare industry institutions appear to be embracing big data and the changes it will bring. The Bipartisan Policy Center (BPC) recently launched the “Care Transformation Prize Series, a national contest to address the most daunting data problems U.S. health care organizations face as they implement new delivery system and payment reforms.” The BPC says, in a press release announcing the launch of the contest, “The goal of this big data challenge is to help health care organizations more effectively use data to drive improvements in health care cost and quality.”

And while they’re not running contests, companies like EMC Corporation are coming down on the “big data is coming” side of the argument as witnessed by its offering specifically designed big data training. EMC notes the need for courses like these by citing results of a recent survey of over 1,000 IT professionals that found only 16% believed their management had strong skills in data science and big data analytics.