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The Age of Data

By: | Tags: , , , , , , , , , , , , , , | Comments: 0 | October 7th, 2015

I recently read, with great joy, an article in the Wall Street Journal (WSJ) that noted Google Capital, the internet company’s growth-equity fund, had “invested $32.5 million in Oscar Health Insurance Corporation”, a start-up in the healthcare insurance industry. There are a couple of interesting things about this article. First, this “start-up” is valued at $1.5 billion (USD) and second, according to the article,“Oscar amassed a war chest of more than $350 million in its bid to use data and technology to make the insurance business work more like an internet service, drawing on the things such as telemedicine.” Oscar, you had me at “data.” 

It actually gets even better as Oscar has “hired 45 engineers [to] build better tools for matching patients with physicians.” Google’s representative is quoted as saying, “we’re most excited about companies that can transform the cost curve though technology.” You cannot imagine the smile this put on my face when I read it, as this has been my dream to see one of the largest and most powerful data driven companies in the world talk about transforming the cost curve in healthcare using technology. I have had that passion since the first year I entered the healthcare industry through a series of seemingly accidental events in 1991.

Google and Oscar – call me! 

The interesting part of healthcare and technology is that I believe there are few industries that can benefit more today than healthcare. Why? Healthcare is about the doctor and patient relationship and interaction, right? For two decades I have watched with horror how little data is exchanged in interactions between doctors and patients. I have given many speeches, lectures and written ad nauseam of this issue; but have developed few solutions. I have been CEO of companies that have medically serviced 20,000 members; visiting both doctors and medical centers, as well as case management staff; and it seems that even with the modern herculean push to electronic health record (EHR), the gap between our use of technology in healthcare versus other industries, has never been wider.

Once having a conversation with my son (an absolute numbers person) about healthcare, I pointed out that except for the brief interaction between the doctor and the patient (averaging about 7 minutes) most of healthcare was about numbers. Let me remind those that may not know that ICD-10, DRG, HEDUS, SNOMED, CPT, NPI, EOB, and MRA etc., all are about numbers. Every drug has a unique number, every doctor has a DEA number, every test has a number, every procedure has a number, and even every insurance company has an identifying number.

Here is the underlying problem, everyone has data, but little is getting done with that data. In the last 2 years the U.S. has released staggering amounts of data – literally detailed by hospital and doctor – all the payments Medicare has made. They have released drug utilizations by doctors on 49,000,000 beneficiaries. We have all the data – now we need to use that data.

I believe in my soul that healthcare desperately needs, and will have, a transformation. This transformation will be led by learning to use the data we have, and the use of said data will come from outside the industry (the next will be in how we pay for healthcare). Few companies have the ability to process data.

Let’s think about this; as a user of Google, I am confident they know the content of my 77,141 emails in 17.22 GB of data. By those emails, they know everything about my life. From the applications on my iPhone they know what I am interested in, what I am craving to eat, what my calendars say I am doing, how long my drive home will take, when I should be home, what time I go to sleep and, with my NEST, what the humidity is in my Florida home. They know, or can know, my life in and out of my home. When I’m home, due to my phone’s GPS, they even know if I am in my living room!

I believe my camera is mostly secure and I am ready to connect Google to my home appliances. My TVs are already connected with Chrome, so they know the TV shows I watch. Furthermore, Google may be able to predict my BMI based on where I eat and how often I go to a gym or a park. Finally, Google knows if I go on vacation and what my next destination is based on the confirmation email.

I’m not saying this is 100% accurate, and I realize they may know more or even less than I assume; but you get my point.

I am excited Google has invested in this space. I welcome them, and would like to talk to them about a few of our patents they can license. A new, powerful EHR platform designed to manage “big data,” some great experience we have in risk management and even behavior analysis and modification in healthcare. Even the financial giant, Goldman Sachs, “gets it” as they demonstrated in an investment research report they published on the “internet of things” and healthcare. In this report, Goldman Sachs predicted that a “digital healthcare revolution is coming-and it could save America $300 billion” (more on this report next time).  I am not a researcher, academic, or an analyst; but my experience has showed me that we gather mountains of data in healthcare, process very little of that data, and understand contextually even less. As I discussed here in an earlier blog, a single electronic data exchange company handled 6.5 billion healthcare transactions in 2014. Everyone received payment. What did we do with all that data as a society? I meet with doctors almost daily and they are swamped with the “demand” for more and more data. Last week as a country we converted from ICD-9 to ICD-10 increasing the number of disease codes from 14,000 codes to 70,000+ codes. What are we doing with all of this additional data?

I’d love to see what Google & Co. can do with it!

– Noel J. Guillama, President

http://www.wsj.com/articles/google-backs-startup-oscar-health-insurance-1442374756

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