Healthcare Data Analytics: What Would Francis Bacon Think?

Photo: Francis Bacon,, 2013

Photo: Francis Bacon,, 2013

There have been a lot of articles lately about how big data is going to revolutionize business, particularly the healthcare industry. Hospitals are going to be able to record, access and analyze exponentially more data than they could in the past, but instead of easing fears of data paralysis, analytics vendors seem set on creating angst. Bad strategy, for two reasons.

First of all, “the sky is falling” won’t help them sell, because few businesses enjoy being revolutionized. Major changes in the way an industry conducts business are usually not comfortable or pleasant – ask Best Buy how it feels about mobile retail, or ask how Tower Records feels about digital music distribution. The last thing a business owner wants is a market shift that’s going to radically and rapidly change their comfortable way of doing things.

Second, the storyline demonstrates a lack of understanding of data. For most industries, including healthcare, big data is not a revolution – it’s an evolution, allowing businesses to do what they already do better and faster. Doctors and hospitals have been using data and empirical observation to improve patient outcomes since the scientific method was established 400 hundred years ago. Big data doesn’t fundamentally change that premise; it just provides doctor and researchers with (exponentially) more information to work with.

Imagine that the philosopher Francis Bacon, one of the figureheads of the scientific revolution, could travel to a modern hospital and have access to all the benefits big data provides. Though the tools would be radically different, Bacon would essentially be following the same process as he laid out in his 1620 work, Novus Organum Scientiarum: gathering data, isolating variables and testing hypotheses. The changes big data is making for healthcare are differences in degree, not in kind.

It’s important to tell the story of big data in a positive way – rather than focusing on how it’s going to shake up and revolutionize businesses, vendors should emphasize how big data gives users access to a quantity and quality of information that past scientists could only imagine. Access to and study of this data makes it easier for doctors, insurers and hospital administrators to create better strategies and improve their operations.

Think about what WellPoint is looking to do in the healthcare space with IBM’s Watson supercomputer. By using the Jeopardy! winning machine’s incredible analysis capabilities to compile, analyze and make accessible unprecedented amounts of medical data, Wellpoint hopes that Watson will help doctors and insurers make more informed decisions, from choosing treatment options to accurately assessing risk.

This is what big data really is: another tool that gives healthcare professionals access to information that they can use to improve patient outcomes, lower costs and reduce waste. The introduction of the scientific method was a revolution that changed the central processes of healthcare; big data analytics are just the next evolutionary step. This difference may seem purely semantic, but as Lena Boroditsky of Stanford University’s Department of Psychology argued in this paper, these seemingly minor narrative changes can have a big difference on how a product is perceived.

Big data analytics are a remarkable and important new discipline that allows healthcare providers and insurers to access, manage and evaluate more information, leading to better informed research and improved patient outcomes.  They’re the next step in more than 400 years of scientific thought; Mr. Bacon would be impressed.

Zach Pearson is a Consultant at Greenough. Follow him on Twitter: @zach_p_pearson

With Great Potential Comes Regulation Uncertainty for Medical Mobile Apps

Photo:, 2012

Photo:, 2012

Ask the average smart phone user and he can probably show you a whole slew of apps he uses, providing a range of different services,  from keeping track of his schedule to streaming custom radio stations to paying for a meal with the scan of a barcode. But what about using your phone to monitor or diagnose your health? According to Research2Guidance, a mobile industry market research firm, approximately 247 million mobile phone users worldwide downloaded a health-related app in 2012.
Health apps are on the rise, providing users with software to log exercise, count calories and even assess moles to decide whether they warrant a visit to the dermatologist. Some apps target doctors, allowing them to view X-rays on the go or communicate digitally with their patients. The US FDA noted that there were 17,288 health and fitness apps on the market in mid-2012, along with 14,558 medical apps. However, these mobile apps are the subject of debate as policy makers sort out how to ensure these health resources are credible and safe for consumers to use.

Currently, as is often the case in the tech world, health app technology has outpaced regulation. Heath-related mobile apps represent the intersection of consumer technology, communication, and medicine, making it unclear as to who the responsible regulatory body should be. Both Apple’s App Store and Google Play require that app developers meet some standards, but their guidelines do not currently pertain to content quality or validity. The FDA regulates medical devices, and provides oversight to certain health apps that in effect converts a phone into a medical device. “There are apps today that change a mobile platform into an EKG machine. When it’s being used to diagnose patients, it’s a medical device we believe is subject to FDA oversight,” explained Dr. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, in an NPR interview. But that still leaves the oversight of thousands of less technical apps up in the air.

At the moment, federal legislators are working to move a bill through Congress that would help clear up this regulatory ambiguity. Congressman Mike Honda (D-CA) has introduced The Healthcare Innovation and Marketplace Technologies Act, which proposes creating an Office of Mobile Health within the FDA. Establishing this new department would ensure that health apps actually provide users with credible and safe information.

We are inevitably going to see a shift towards mobile healthcare and a greater use of health-related consumer technology.  Local health care system Partners HealthCare has already established an entire Center for Connected Health to focus on efficiently and safely developing and implementing mobile health solutions. The recent focus on how to best regulate this new technology is a step in the right direction. The safety and security it will provide will enhance consumer confidence and ultimately accelerate the technology’s adoption.

Lucy Muscarella is a Consultant at Greenough. Follow her on Twitter: @lucymuscarella

The Rise of Retail Clinics

Photo: Minute Clinic, Rockford Register Star 2011

Photo: Minute Clinic, Rockford Register Star 2011

The severe flu season currently underway has been all over the news and, as a result, the topic has been peppered throughout our office chatter for the past couple of weeks.  After an especially sniffle, sneeze, and cough-filled “T” (subway) ride to work one morning last week, I hopped onto CVS’s website and, after about 45 seconds, had an appointment to get my flu shot the following night.  Later in the week, I heard from a few colleagues who, after hearing how easily I signed up, had also gotten their vaccines at a CVS MinuteClinic.  This sparked thought on retail clinics and the role they’ll play in the future of healthcare.

Retail clinics, like those in popular drugstore chains and superstores like Target and Walmart, have rapidly grown in popularity in recent years.  According to HealthDay News, the first retail clinic opened in the U.S. in 2000, and there are now more than 1,350 such clinics operating around the country.  An American Medical Association news report says CVS opened 68 clinics from December 1, 2011 to December 1, 2012. With 620 locations, MinuteClinic accounts for approximately 44 percent of American retail clinics.  Clinicians at MinuteClinics have seen an astounding 14 million patients since 2000.

While retail health centers are not the answer to all health issues—obviously people with more serious symptoms like chest pain, shortness of breath, etc. should call their doctor or head straight to the emergency room— consumers should consider them as an option more often.  Until now, most retail clinics have addressed routine needs like flu shots, prescriptions, and blood pressure checks, but many clinics can also meet a variety of other health needs such as sports physicals, strep throat cultures, and diabetes testing.  Clinics are typically staffed by qualified nurse practitioners, and, in Massachusetts, they are regulated by the Department of Public Health to ensure the safety of all patients.

As a result of healthcare reform, more people now have access to insurance and will be seeking medical attention.  Outsourcing minor procedures and tests to retail clinics could ensure that a greater number of people will receive the care they need and at a lower cost.  Affordable clinics in convenient locations with convenient hours, short wait times (and sometimes no need for an appointment at all) staffed with qualified personnel, seems like a win-win situation to me.

Lucy Muscarella is a Consultant at Greenough. Follow her on Twitter:@lucymuscarella

Note to CES: More Innovation in Digital Healthcare, Energy Efficiency and Sustainability Please

Photo: Lotus flower, Flickr Creative Commons 2013

Photo: Lotus flower, Flickr Creative Commons 2013

In Greek mythology, the “lotus-eaters” were a race of people inhabiting an island near North Africa who subsisted on lotus flowers, a known narcotic that caused them to sleep in peaceful apathy. In the movie Percy Jackson & The Olympians: The Lightning Thief, the main characters barely escape a life of perpetual apathy in – wait for it – modern-day Las Vegas. As CES gets into full swing in the “Sin City,” it finally hit me that, like Percy, it may be time for another heroic escape.

Let me begin by confessing that I love technology. My mobile device is never more than a year or so old, I strategically position myself for the newest laptop at work and my home is as digitally tricked-out as my wallet allows.

Recently, however, I’m finding it harder to summon the same enthusiasm for consumer tech. Somehow the joy of moving from 720 to 1080p seems trivial in the face of a global water crisis, rising healthcare costs and government gridlock. This year, much of the reporting that I’ve read/seen coming from CES is mere sycophantic drivel. It’s as if I’m watching Percy eat lotus flowers, slipping into a mindless trance as he’s seduced by the surreal theater surrounding him.

But all is not lost. While entertainment-related gadgets such as the new Asus Qube still dominate CES (because we so need to enhance our TV-watching experience with the help of Google TV), consumer electronics innovation isn’t for entertainment alone. And that’s enough to excite me.

With comparatively less fanfare, companies such as iHealth, HealthSpot and Ideal Life (which announced a partnership with ADT during CES) are bringing innovation to Las Vegas that promises to solve real problems, not just entertain. The iHealth Wireless Smart Gluco-Monitoring System includes a detachable dongle that snaps onto an iPhone, iPod touch or iPad to simplify blood sugar monitoring. Convenient, yes, but there’s no reason it won’t also lead to better doctor-patient communication, better disease management and, ultimately, lower healthcare costs.

The HealthSpot Station is a cutting-edge “tele-health” system that provides high-quality medical diagnostic technology to patients anytime, anywhere. The private, walk-in kiosk increases access to diagnosis and treatment by board-certified doctors via high-definition videoconferencing and interactive digital medical devices. This is high-definition, interactive TV that doesn’t entertain; it improves health.

What’s missing? Beyond the exciting and transformative healthcare solutions, I’d like to see something related to water and/or sustainability, starting with technologies to help rapidly build out “smart water grids.” Next year, it would be nice to see companies such as Itron, Cisco and their potential partners – including companies such as Zonoff (which is at CES this year) – showing off technologies to a CES audience that push water conservation and “individual sustainability” deeper into the consumer consciousness.

I’m guessing that I’m not alone in hoping for innovations in consumer technology that aspire to more than just better entertainment. Since we rely on CES to set the tone for upcoming year, I’m hoping the glimmer we see in healthcare technology is just the beginning of even greater changes in 2014. After all, if we continue to wantonly worship “lotus flower tech,” innovation that simply encourages our society’s precipitous lull into peaceful apathy, we’re missing a heroic opportunity. Percy eventually woke up and escaped the lotus eaters, so should we.

Scott Bauman is executive vice president at Greenough. Follow him on Twitter @sbauman

Electronic Medical Records are Worth the Growing Pains

Photo: Discovery News 2012

Photo: Discovery News 2012

The implementation of electronic medical records (EMRs) has become a hot-button topic in the medical arena. This New York Times article published in October nicely lays out both sides of the ongoing debate.

The fact that EMRs have the ever-elusive bi-partisan support, and wide industry support as well, makes them seem fail-safe; but the complicated initiative brings up a number of hurdles ranging from privacy concerns to the new maze of questions and options doctors must navigate for each patient.  Some of the biggest concerns (challenges which all digital databases face) are vulnerability to crashes and hacking.  Hospitals will have to create contingency plans for how to access records if the system fails, and systems must come equipped with major privacy and anti-hacking mechanisms. The biggest complaint from the doctors’ side is that the interfaces are not completely user-friendly and were seemingly created with little input from doctors themselves.  The databases can be awkward, often not quite fitting exactly what the doctors need.  And clicking through all of the questions and menus is often time consuming resulting in the physician spending more time interacting with the computer instead of the patient.  As one doctor put it in a Wall Street Journal article, “it seems as if this is all about taking care of the chart, as opposed to taking care of the patient. Documentation is important, but the pointing and clicking and cutting and pasting we are so focused on in demonstrating meaningful use of EMR may be getting in the way of meaningful encounters with our patients.”

There are definitely growing pains that come with implementing an EMR system, but in my view the benefits far outweigh any initial difficulties.  New equipment and protocols always take getting used to, but the value of having an individual’s entire medical history on record is immeasurable.  These digital records offer tremendous convenience when it comes to refilling a prescription, scheduling an appointment, or even emailing your doctor a quick question, rather than having to make a phone call or wait for an appointment.

A recent Huffington Post article details a prime example of how one individual used his EMR online system to get a hold of prescription information he needed while traveling abroad.  I actually have personal access to the PAMF My Health Online site he refers to in the article and can confirm how helpful it is.  Not only is it a luxury to have easy access to all of your medical information, but in the end, I believe it results in better care for patients.  If someone is taken to the ER, even a doctor who has never worked with that patient before can pull up his or her entire medical history, allowing for easier diagnosis and better treatment.  Having that wealth of information on hand for all doctors’ visits ensures that nothing is missed, and ultimately improves the quality of care.

Our home state of Massachusetts, often looked to as a pioneer in the healthcare arena, has been taking steps forward to make easy access to medical records a reality.  It recently launched its Health Information Exchange, inaugurated by Governor Deval Patrick ceremoniously sending his records from a hospital in Boston to one in Springfield.  The program began with the participation of nine healthcare providers, including Partners Healthcare, Beth Israel Deaconess Medical Center and Network Health, and now has “over 40 organizations that are in our pipeline to bring on board,” reported Laurance Stuntz, director of the Mass HIE, in a recent Healthcare IT News interview.

From my millennial perspective, it seems ludicrous not to have such important data electronically recorded somewhere.  I understand there are imperfections in the new system, but if the only source of information I have on my vaccine history is that little piece of yellow cardstock that has been following me since my early childhood – that seems incredibly inadequate.  I envision the transition to digital health records will be much like the switch to online banking.  Initially people feared having personal financial information on the web, but now couldn’t imagine not to being able to pay their bills online or check their account balance on their phone.

There is always a “breaking-in” period when a major overhaul happens, especially when it involves a system that has been in place for decades. Kinks always take a little time to work their way out of new software, but medical records, and the quality care that will come from easy-access to them, are too valuable to keep stored in file cabinets.

Lucy Muscarella is a Consultant at Greenough. Follow her on Twitter: @lucymuscarella

Hospitals Are Now Accountable for Great Communications Too

Please fill in the blanks for this simple statement: My local hospital __________is great because it ______________. Don’t have affinity for a local hospital, you say? That’s too bad. Wouldn’t attach the qualifier “great” to the hospital you most frequent? That too is unfortunate.
One of many ways the Affordable Care Act is meant to transform healthcare is by putting the onus on hospitals to keep patients away. Yes, keep them away. And the reimbursement model to facilitate this – accountable care organizations (ACOs) – places financial responsibility on providers to improve care management and limit unnecessary expenditures without compromising favorable patient outcomes. No easy task.

Without arguing the merits of ACA provisions or ACOs, one fact stands out: hospitals must quickly adapt communications practices to patients to whom they are accountable WITHOUT necessarily knowing who those patients are. Try building a campaign for that. Since the population is undefined, hospitals can’t just communicate with known patients – they must, in a sense, speak to everyone.

Another name for “speaking to everyone” is marketing, and marketing, especially advertising, can theoretically reach everyone if infinite budget exists. But infinite budgets are fantasy. So that’s why today’s forward-thinking hospitals must become increasingly creative. So are they?

To be fair, it may be too early to judge our Massachusetts-based ACOs, which include Atrius Health, Beth Israel Deaconess Physician Organization, Mount Auburn Cambridge Independent Practice Association and Partners Healthcare. Certainly, as hospitals that comprise these ACOs mature in the new model, we’ll likely see more evidence that accountability has fundamentally changed how they communicate.

For starters, Facebook, Twitter and YouTube pages are de rigueur across the hospital landscape. But what else can/should they be doing? Do best practices even exist? The answer is yes.

Brigham and Women’s Hospital in Boston, part of the Partners ACO, has its Health Hub Blog and is actively experimenting with Pinterest. I’m sure Brigham doesn’t think its Pinterest page is THE answer, but who’s to say it won’t contribute meaningfully to better health and fewer visits. Sure, so far only one person has “re-pinned” the story about flu vaccine, but what if that one person avoids a hospital visit this year? You see, pins can add up.

Photo: Brigham and Women's Hospital - Pinterest Page 2012

Photo: Brigham and Women’s Hospital – Pinterest Page 2012

I’m not suggesting that social channel activity is the litmus test for ACO success (or success for non-ACOs either). Harvard Vanguard Medical Associates, as part of the Atrius ACO, provides access to the MyHealth Online Mobile App, from which patients can view test results, reply to messages from a clinician’s office or view upcoming and past appointments. This is just one of many new ways smart devices and applications have already evolved from differentiator into necessity.

We’re still in the early stages of ACA transformation, ACO transition and patient revolution, so the best is certainly in front of us. So whatever your opinion is of the ACA, it’s time to acknowledge that the train has left the station. Now, as a communicator, you must play an active part in making this grand experiment work. After all, effective, highly integrated communications that encourages new behaviors and promotes long-term patient engagement will one day be remembered as a critical success driver of healthcare reform. You’re not a bystander in all this!

If you’re unsure of how to get started or why, think back to the fill-in-the-blanks exercise above. If you’re the local hospital patients think of first (i.e., they won’t go outside the ACO) and your people and facilities have a reputation for greatness (quality, efficiency, wellness), it’s likely your brand story is resonating. And if it’s resonating, it is just as likely that your business-sustaining campaign – stay healthy and stay away – is working too.

Scott Bauman is executive vice president at Greenough. Follow him on Twitter @sbauman