Everywhere you turn today you are slammed with analytics and not all of it is correct or related properly.  If you read here often enough, this old data base person might offer a few words of wisdom in this area since Iimage used to write the stuff and work with doctors on software creation.  The crap you hear is the news is just that when it comes to expectations sometimes.  Also keep in mind this is only one element of the re-admissions puzzle, so we don’t know what happened in the other areas.  It is also important to note that patient demographics play a role here as well with taking into consideration not only the level of education of the patients but also poverty levels as that makes a difference.  I read this article and it’s a nice focus for a change as it was focused on the positive moves they made.

The hospital also had some nice grant money from the Gordon and Betty Moore Foundation who are constant philanthropists since Betty Moore a few years ago almost died due to a medical error with getting insulin shots she didn’t need as she’s not a diabetic.  Sure they used some analytics but used them wisely but after that portion was initiated the human side came in to play with educating patients better on their conditions.  Communication with email and phone calls, etc. was a big thing here and with the 2 nurse coordinators all could see at any time where the progress was. 

People get sucked in to Algo Duping and former HHS secretary Leavitt appears to have had that happen as well as you have this $3 million dollar carrot going on looking for that magical “flipping algorithm” as a solve all problems.  Don’t worry, he’s not alone as our current HHS Secretary gets drug in there too with that silly Facebook contest earlier this year and it happens when you have people in executive positions today that don’t know any different and have no IT or computer science background, they are like everyone else getting Algo Duped and then you have the media that builds all of this up like the next best thing to sliced bread and it’s hard. 

So What’s Going on Over at the Heritage Health Prize Competition to Predict Who Ends Up Being Re-Admitted to the Hospital–A Lot of Mathematical Algorithms For One…

Here’s a screenshot of the $3 million dollar race for the algorithm…hmmmm..we have players over here…not developers per se as it looks you think? 

So how in the world do you expect people who hate math and fear it to make these types of decisions?  You can’t and that's part of what’s going on.  I said in a couple other posts this is why Wall Street wins all the time as they have no fear and I think anyone can attest to that.  So, on this subject we actually have a PLOS One study that defines this.  Yes you might want to take it a little tongue and cheek but damn the MRI images and the extensive research they wrote seems to have a lot going for it as I do when I mention a little math watch all run away in groves.  It is what it is.  You know what though a little admittance here, I feel a lot of pain too when faced with some very complex coding but I don’t fear it:)  This study stated the the neural regions of the brain got active when a math problem was introduced. 

“Algo Duping” – PLOS One Journal Publication Explains Why The Fear of Math Plays a Big Role As One Underlying Reason We All Get Duped And Those Who Don’t Fear Math Take All the Money, Gradually, Using “Mathematical Formulas & Algorithms”

“This journal report was just an absolute “gift” of an explanation for me to include and look at the GOP these days with their interpretations…the 50 shades of rape and I guess when thinking math and experiencing pain for some reason or another and this is especially dangerous when creating laws or when campaigning,  they go to something they can think about controlling and from what you have seen on the news and ridiculous statements made, I’m guessing “math” and this substantiated fear really had them running for the hills.”

Do you think I’m tired of the abuse and misuse of math by design or by accident?  You’re right and nobody else has enough common sense to ask questions sometimes…hmmmm…let’s see that formula has square root in it and few other important looking items…well gee it must be right”…wrong:)  This is a good place again for the “Charlie” video, “it’s all about context” so keep that in mind because some of the stuff out there is nowhere near the proper context and some code is written just to make and move money.  He tells you too in the first few minutes that Algo Duping (my word there) is so successful too as people don’t like math. 

By the way he just sued and won a case to get “public” information from the NIH too, so a nice thumbs up there.  Listen to him address the algorithm for the perfect butt:)  How much nonsense have you soaked in with being Algo Duped.   For those of you into anatomy, the perfect butt algo becoming national news will have you rolling on your side. 

Now back on track, this worked for the UCSF hospital so why don’t we give some grants to other hospitals to see if we can make this work elsewhere to deal with that crazy readmission penalty algorithm that sucked in the government as a magical formula.  Instead we are taking the money from the hospitals when they need it, does this make sense?   Again there is not magical algorithm fairy out there.  We get smarter with information but we also need to know how to use and apply the data. 

Quantitative analytics are not always the complete answer.  If you want to know more on that topic and how you get duped in other places, just watch the other videos in the left hand column of this blog or use this link to see all of them at Algo Duping 101.  I have more articles relating to this topic and you can search and find them by keywords and please don’t be afraid of asking questions…and let that math give you physical pain if you can help it:)  Here’s one more study to where a scientist wrote about how to figure out if in clinical and other medical studies if the authors “fiddled” with the P Values and if you watch the video above, Charlie explains enough of this in layman’s terms so you know what it is.  We won’t be fooled again! 

PLOS One Abstract–Methodology for Detecting Manipulation of “P Values” To Show Significant Statistical Value, “Inappropriate Fiddling” Which Can Lead to “Algo Duping” Situations And Numbers

So let’s be smarter about all of this and use the data we get in context and not look for that magical one stop shop algorithm because it’s not there and we certainly don’t want to grow to the extent that was demonstrated in Italy with the citizens convicting their scientists of manslaughter for not properly warning and predicting an earthquake as as that is Algo Duping deluxe if you will.  I live in southern California and we have a lot of smart people here and believe me if that were the case someone long ago would have convicted Cal Tech scientists of manslaughter and wanted a lot of money for goodness sakes.

Digital Illiteracy and Algo Duping Alive and Well in Italy With Scientists Convicted of Manslaughter for Failure to Predict and Warn of An Earthquake…

I cite this incident in Italy as it is the absolute proof that people are being Algo Duped and sucked in to analytics and formulas that don’t fit the occasion or those that are designed to take your money.  You don’t see it as they run on servers 24/7 and it’s the silent battle, but as mentioned above government gets sucked in as well and the construction of this re-admission set of algorithms and parameters doesn’t fit very well and it written to penalize instead of helping.  Furthermore with people in executive or secretary positions without one stick of IT or computer science knowledge roaming around the US this further puts us as risk as they get duped, that is my risk assessment for the US right now and I think it’s a good one, it certainly is true.  BD

According to McCarthy, the program consists of two heart failure program nurse coordinators, supported by a multidisciplinary team comprising a cardiovascular service line director, hospitalists, cardiologists, clinical nurse specialists, case managers, social workers, pharmacists, dieticians, chaplains, educators, primary care physicians, skilled nursing facility staff, home care nurses and outpatient nurse practitioners.

“Not every hospital can hire coordinators but are there lower cost ways to create this approach? Communicating with post acute care providers is important. It’s something that everyone needs to work together on to focus on the entire care episode,” he said. “It improves quality of life for patients and saves money.”



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