The more you know about your patients, the better you can serve them. That's the underlying assumption of companies like Carolinas HealthCare Systems, which invest in using data to identify obstacles to health and find solutions.
Dr. Michael Dulin, chief clinical officer for analytics and outcomes research at Carolinas, believes that the more data healthcare providers have on their patients, the better the outcome for their health. I was in both email and phone contact with him about current uses of data and potential uses in the future.
The data Carolinas uses looks at factors like socio-economic circles, neighborhood limitations, and cultural affiliation that could shape one's access to healthcare. Dulin referred to the studies done to improve care in "Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care." The report, from the National Institutes of Health, details how "asthma disproportionately affects vulnerable populations such as certain socioeconomic status and ethnic minority groups."
The barriers to getting medical attention within these populations can be attributed to a multitude of factors such as language barriers, environmental triggers, cultural beliefs, insurance, and genetic factors, according to the report. Becoming aware of which factor is at play makes it possible to offer "culturally tailored" approaches to treatment.
One example of that was identifying why patients in one particular area were not coming in for regular doctor visits. It turned out that the area didn't have reliable public transportation to a doctor's office. After identifying the geographic problem, Carolinas HealthCare set up a doctor in the neighborhood itself.
Dulin confirmed that he believes getting more specific information on patients can prove beneficial: "For example, we do not currently know if our patients actually fill their prescriptions. I would imagine that this could be an important piece of information that, if shared directly with a provider, could enhance care."
He explained that analytics can also track the correlation between those who end up in hospitals with the failure to adhere to one's prescribed treatment. A practical application that could emerge from such analysis could be a directive to "give away the medications in certain situations in order to keep people healthy and out of the hospital."
Our phone conversation clarified that Dulin favors what he sees as being "more proactive" in preventing the need for emergency or more expensive service. He said, "lower socio-economic status, higher crime, higher rate of low acculturation" can increase the likelihood that someone ends up coming through the emergency room for what could have been addressed in "preventable treatment." With nearly 1 million people in his organization's care systems, he declares that "even a small improvement can help thousands."
When asked about the possibility of someday utilizing the type of personal data that tracks individual consumer behavior, as described in sensationalist articles like Bloomberg Businessweek's "Hospitals Are Mining Patients' Credit Card Data to Predict Who Will Get Sick," Dulin said he wouldn’t take it off the table. However, a Carolinas spokesperson said the organization isn’t doing so.
In Dulin’s view, "Being innovative does sometimes put you at risk." He sees Carolinas as innovative and as being transparent about both the type of data used and its "potential benefits." So what do you think? Is more information better for the patient as well as for the business?