October 11, 2013
It’s hard to imagine that technology could be a friend to Obamacare, given the dismal performance of its official website last week. But it turns out that the high-speed crunching of a huge amount of information—aka Big Data—could ensure that one of the principle tenets of health care reform, known as “accountable care,” can become more than a catchy phrase in a policy paper.
U.S. hospitals have begun shifting their way of doing business. It’s long been the case that the payments hospitals received from Medicare largely were based on the tests their doctors ordered and the procedures they performed. So, strangely enough, the sicker a hospital’s patients were, the more money it tended to receive. But the Affordable Care Act is designed to change that, instead providing incentives that reward positive results. And, that seems to be prompting hospitals to move from focusing solely on treating sick people to helping patients take better care of themselves in the outside world. They want their ex-patients to stay ex-patients.
It’s crunch time
Case in point is Mount Sinai Hospital in New York. Not long ago it hired a 30-year-old named Jeff Hammerbacher to try to work wonders with the hospital’s new supercomputer. His previous job was as Facebook’s first data scientist, so you know he knows how much wisdom can be gleaned from mountains of information—if you have computers powerful and fast enough to make sense of it.
So far, the hospital has developed a computer model that crunches all the data it has on past patients—from why they were admitted to how many times they’ve been there to everything that happened during their stays—and from that, it’s able to predict which ones are most likely to return. But instead of just waiting for those patients to come back, Mount Sinai, like more and more hospitals, is turning proactive, reaching out to those frequent patients with follow-up calls to make sure they get to their doctor appointments or avoid the bad habits that end up sending them to the hospital. In one pilot program, Mount Sinai was able to cut re-admissions in half. If you don’t think that hospitals can put a serious dent in health care costs by slashing the number of repeat patients, keep in mind that nationwide, 1 percent of patients accounted for nearly 22 percent of health spending in 2009.
Methodist Health System in Dallas is going down a parallel track. It’s been analyzing patient data from 14,000 patients and 6,000 employees to identify people who are most likely to need expensive health care in the future, and it’s reaching out to help them take preventative measures before they develop costly ailments.
Here are a few other recent findings that have come from hospitals crunching Big Data:
- A health care provider in Southern California using data on the behavior of staff doctors found that one physician was using a certain antibiotic much more often than the rest of the staff—potentially increasing the risk of drug-resistant bacteria.
- At Memorial Care Health System in California, hospital management has begun tracking how doctors there perform on such things as immunizations, mammograms and blood glucose control in diabetic patients. That and other doctor data helped reduce the average patient stay from 4.2 days in 2011 to four days in 2012.
- Use of full-time nurses, rather than contract or temporary ones, coincided with higher patient satisfaction scores, according to Baylor Health Care System.
- Researchers in Ontario are working with IBM on a system to detect subtle changes in the condition of premature babies that could tip off the onset of infection 24 hours before symptoms appear.
- In another case, data analysis was able to determine which doctors were costing the most money by ordering procedures and other treatments. Hospital administrators reviewed the results with the costly doctors and suggested ways they could cut back on duplicate tests and unnecessary procedures.
Ultimately, hospitals hope to get to the point where, based on analysis of all the data of every patient who’s ever walked through their doors, they’ll have a very good idea of the risk facing each new patient who arrives.
To your health
Here’s a smattering of other recent research on hospital treatment:
- With luck, you’ll forget about the ICU: Researchers at Vanderbilt University found that 75 percent of people who spend time in a hospital’s intensive care unit suffer some level of cognitive decline. In some cases, according to the study, they can experience Alzheimer’s-like symptoms for a year or longer after leaving the hospital.
- Still need a reason to stay out of hospitals?: According to a recent report in the Journal of the American Medical Association, treatment of infections people develop in a hospital adds $9.8 billion to America’s health care costs every year. The Centers for Disease Control has estimated that one out of every 20 patients gets an infection while in the hospital. About a third of the cost comes from infections following surgery—they add an average of $20,785 to a patient’s medical bills.
- Here’s another: A study published in the recent issue of the Journal of Patient Safety estimates that as many as 210,000 to 440,000 patients each year who go to the hospital suffer some type of preventable harm that ultimately contributes to their death. If that’s the case, it would make medical errors the third-leading cause of death in America, behind heart disease and cancer.
- Must be the food: After crunching results from 4,655 hospitals, a health care economist from Thomas Jefferson University Hospital in Philadelphia found that the best hospitals, in terms of medical results, generally don’t receive the highest satisfaction rankings from patients. Instead, the top hospitals, which often are bigger and busier, tend to get only lukewarm ratings from people who spend time in them.
- But they found no link between moon cycles and back hair: Believe it or not, researchers at Rhode Island Hospital contend that their analysis showed that cardiac surgery, specifically aortic dissection, is less likely to result in death if performed in the waning of a full moon. They also said that patients who had the surgery during a full moon tended to stay in the hospital for shorter lengths of time.
Video bonus: Here’s another way Big Data is being used to predict human behavior, in this case, what we’re likely to do when we enter a store.
Video bonus bonus: And, in advance of Halloween, a little macabre hospital humor.
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