There’s more than one area to address here and this is in part what’s making doctors crazy as they have to work within all these parameters. First and foremost so much of it is driven by the insurance industry. I realize they have to keep costs in line and they have done that for years, but instead they have this data addiction where they somehow feel that if they miss one little stick of data or code, they could be saving millions. 
Everything they are collecting and using today does not put money to the bottom line and has doctors and patients jumping through hoops, like we are numbers on a spreadsheet moved around to save money. Sure there’s some of that with every business but not to the extent of what we are seeing today as it’s insane.
Fact of the matter is it’s driving everyone crazy and pushing limits with people that shouldn’t be there. It’s the complexities of the data world and there are more quants working at insurers anymore than ever, some used to work at hedge funds. Models are models and those folks can build healthcare models as well with math as they already know how to fiddle and play with risk, that’s what they all do in the financial markets. I often wonder what insurers pay for all the voice algorithms they use at call centers too. Humana, a couple years ago was so proud of the fact they were using the analytics to determine what your current state is when you are on the phone. I wonder what insurers pay companies like Argus to get all our credit card transactions to rummage through as that’s can’t be cheap as Argus applies all kinds of analytics to yours and my data before they sell it to insurers.
How Long Before the Data Scientist Demand Begins To Slow? About Half of the Analytics Investments Will Be A Wasted Investment As Some Data Will Prove To Be Non-Relevant to Solving “Real World” Situations At Hand
We are reaching a point where we are going off the cliff, not only ethics wise but also money wise. As complex as the IT and coding world is today, it takes a lot more time and code to create models and subsequent analytics to work. Insurers themselves long before Obamacare were well into a complex world of math and with the changes they just had to alter complexities in a little different direction. At the link below there’s a couple short videos from some former financial quants that just flat out tell you they guess sometimes when complexities overwhelm. Paul Wilmott tells you right out that finance has too much math in it and you know what, so does healthcare anymore:) Sure there’s some that’s needed and necessary but I seem to see a pattern here of developing a new model that sits on top of the old model and that’s what adds complexities. It builds on itself, just like software does that carries out the actions of the models.
When The Models Are Too Complex With Too Many Bits of Data-Sometimes quants, Data Scientists Just Guess and Assign a Number Value And “That’s Not Science At All “
I’m sure you have read all over about big data and certainly there’s some value in many places but not everywhere as some seem to think. You don’t just go scoop up some big data and hire a quant and say “go find some value and profits” in it; although I might venture to say there’s a bit of that out there when it comes to making money selling data.
I have watched the Medicare Advantage doctors being cut by United and holy cow some of their data gets screwed up too from what I am reading. In one area they company is doing some obvious predictive analytics to help patients find a new family practice doctor and they are being referred to gynecologists and neurologists for their new family practice doctor. I’m thinking their matching is all screwed up as they don’t have all the tables correct and are trying to match certain characteristics in one area and mess up in another. I saw one example too where they bid and won a contract but had no doctors in network to see the patients and then there was the $175,000 hammertoe procedure they paid for, so what’s happening with their data and analytics? I’m sure that’s happening all over the place too as the bigger the data sets the more chances you have for error. We also know that insurers buy and sell a lot of data for income too, and with that comes more selling of “scores” on consumers, but how much are they really using for their decisions? Are they trying to make use of it because they can buy it, like credit card data? This stuff is all expensive to process.
The True Dangers With Corporate Obsessive Algorithmic Scoring of US Consumers - It Creates More Flawed Data For Sale And Makes Banks and Companies Wealthier As the Pace of Inequality Accelerates …
Hospitals are chugging along here and of course are bit more conservative but they are caught up in needing a certain amount of software and systems for government reporting and just operating. Some don’t have the money to do much anymore as you may have read this was the worst year in a while for non profit hospitals and many are closing up shop.
I like technology too and there’s a lot of good stuff in healthcare but there’s also a lot of junk and I can’t tell you how many articles I have read about apps, wearables, etc. that have that data selling model built in when they go to a VC and ask for money. It’s been abused and lead to so much of the data selling we have today.
Humana now is going to need a government bail out of $450 million as they had losses. Seventy five percent of their policies are Medicare Advantage, so here we go again back into the senior area and you know what, we get old and we will be more expensive than most younger people so that we need to just live with as you can’t change it unless you start finishing us off earlier:) Next year I read where WellPoint, which is now renamed “Anthem” will need about $5 billion? Let’s not forget that most of these insurers also have venture capital subsidiaries as well. If WellPoint is going to need that kind of money, what in the world are they doing with starting a California HIE? That’s crazy and they won’t see any ROI on it with interoperability. They need a new HIE model like Zoeticx that requires no data warehouse and provides interoperability between any EMRS with legacy ok.
Anthem Blue Cross & Blue Shield of California Going to Create “Yet Another Big Data Base of Patient Medical Records” - Be Ready for Premiums to Go Up As Health IT Eats Up the Healthcare System
It’s a data selling epidemic and it’s getting so engrained into healthcare and you even have hospitals that need money or anticipate shortages giving insurers their EMR records to create yet more data bases for paying clients like Boston Scientific to dig through. All who are owners there at Optum Labs, which the hospitals join as owners do get some money out of it, so we had to set up this bit of data selling and expense here to keep more data money rolling in.
Today we have more maps on where the obese people live and I realize some general information and stats on measurements on how the US is doing is needed but darn we go from there to heat maps, infographics all to show you where fat people live and I said “what are we doing”. I have no problem recognizing obesity and neither does anyone else so what’s the deal with the maps? Is all about the talent of the people who make them? Obesity is very visual so what’s with all the maps as obesity keeps growing? Are we getting stupid because have data to play with? I used to write code so I see some of the real nonsense at times where there’s no value because as a developer I was a query monster as well and was in the constant search for value, and sometimes it’s just not there beyond a “pretty infographic”.
Obesity Just As Big As Ever In the US–More Failed Ineffective Models As Technology Is Not The Cure With, Many Proof of Concepts Not Working, Obesity Algorithms Are Not the Answer
So we come back to “relative data” and what we need to accomplish and not put every stick of data in a big drag net and think there’s value
as we can’t sustain this and need to focus on good clinical care with the relative data that helps with those decisions. A lot of this is also very upsetting to the consumers, self included as you know when you just rip data on us, score us secretly, etc. insurers are just ripping out our dignity from underneath us. Instead of being constructive it’s like they have become the bottom feeders in the data world, second only to the data brokers, and they buy data from them too.
So is non relevant data going to drive us off the data and money cliff while stealing away consumer dignity in the process? It sure looks like that’s where we are headed and it’s all about money and not better care and we see it. The data selling models are breaking as there’s way too many in the game and more data is getting flawed all the time. Insurance premiums have to pay for some of this as well. I like good data and good software with value but that’s not the majority of what we are getting with start ups as it’s about a 1 to 100 ratio, one being the good stuff and the rest just go away and some big corporation buys their code cheaply, I call it cash for code.
If you like, kick a few dollars in the privacy campaign. There’s two reason for it, one to give consumers a look up list and require data sellers to be licensed and two to maybe put a lid on some useless data selling and focus on good software and analytics that we needs in healthcare, otherwise we’re going off the money cliff quickly. BD
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