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Analytics & Social media impact on Healthcare
A view on how analytics and social media is used for shaping the healthcare industry
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Enabling organizational strategies with analytics could drive better patient outcomes

Enabling organizational strategies with analytics could drive better patient outcomes | Analytics & Social media impact on Healthcare |



Complete White paper:



While almost two-thirds of organizations across the healthcare ecosystem have analytics strategies in place, our research shows that only a fifth are driving analytics adoption across the enterprise.



The IBM Institute for Business Value has been listening to what members of the healthcare ecosystem around the world have been saying about their experiences with analytics.  We have surveyed 555 executives within the healthcare industry and are about to launch our latest point-of-view, Analytics across the ecosystem: A prescription for optimizing healthcare outcomes. This blog briefly explores just one of the aspects covered in the paper; ‘Importance of enabling organizational strategies with analytics’


The healthcare ecosystem is the convergence of otherwise separate entities, such as life sciences organizations, providers and payers, as well as social and government agencies. Going foreword, gaining and sharing meaningful insights from data across the entire healthcare ecosystem will be a necessity to correlate cost and quality of care. For example, increased interaction among providers, payers, life sciences organizations and patients can help reduce unplanned adverse events. Patients can benefit from more individualized care. Insights from analytics can facilitate continuous learning and promote quality improvement. However, organizations are still struggling with using advanced analytics for gaining such insights. Only 34% of our study’s respondents said they think in terms of analytics that can help gain actionable insight from data.


Enabling organizational strategies using analytics can lead to a significant impact. For example, in a recent IBM Institute for Business Value study about big data, the percentage of respondents in the healthcare and life sciences industries reporting a competitive advantage from analytics rose from 35% in 2010 to 72% in 2012, a 106% increase in two years.

To derive the most value, analytics must become an increasingly important factor in corporate strategy decisions. To position analytics accordingly, organizations must define the enabling analytics strategy, prioritize their roadmaps to address internal requirements and create strategies for future collaborative partnerships across the healthcare ecosystem. A comprehensive plan for governance is a foundational to drive adoption of any analytics strategy. High-level sponsorship of key analytics projects is an important success factor. The most effective analytics initiatives embed small, action-oriented analytics into key decision points of specific business processes that are used widely across the ecosystem. Metrics to measure success should be in place from day one and be tracked. To get the most out of these projects, organizations should focus on early insights that enable refinement of processes over time.


The point-of-view will explore this topic in further detail taking into context the requirements within the organization as well as across the entire ecosystem. Read the paper to learn more and discover the three areas of focus that can have a dramatic impact on your organization and entire ecosystem.



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Population health and consumer centric healthcare are here to stay

Population health and consumer centric healthcare are here to stay | Analytics & Social media impact on Healthcare |
Population health and the increasing retail and consumer-minded approach are arguably the biggest shifts in the healthcare industry today, and they show little sign of letting up anytime soon.

So says healthcare consultancy firm the Advisory Board in a blog post, detailing potential strategies for providers.

“The truth of the matter is, retail medicine and population health are real, and probably around for the long haul,” writes Ben Umansky, noting that hospital leaders can be successful if they adopt the right strategies.

“We identified three strategic objectives in particular that are relevant in both types of markets:convenient access, lean cost structures, and a smart partnership strategy.”


Convenience is a new concept in healthcare overall, so it’s not hard to understand why consumers, aka patients, won’t put up with the old guard ways of arbitrary, cloaked-in-secrecy pricing and long wait times for seemingly simple procedures. But it also has an indirect benefit for population health.

“When it’s easier for patients to get care, or even just information, when they need it, they’re more likely to follow care plans.That means better outcomes and lower total costs. Patients are also more likely to stay within your network if they can always access it, so you can be confident that the returns on your care management investments will accrue to you, not your competition,” Umansky writes.

Just as the concept of convenience shouldn’t be hard to grasp, the same is true of lean cost structures, but it’s more important than ever to actually achieve it with the turbulent road ahead.

Finally, with all the consolidation that has occurred, a smart partnership strategy is vital for any hospital’s survival.

“No matter the form it takes (and it’s not always M&A), a smart partnership can strengthen any organization’s appeal to retail consumers.”

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Novartis’ mobile health strategy poised to move from tracking to virtual care | mobihealthnews

Novartis’ mobile health strategy poised to move from tracking to virtual care | mobihealthnews | Analytics & Social media impact on Healthcare |

While Novartis’ recent partnership with Google and its longtime relationship with Proteus have indicated that the pharma company has an interest in digital health, a page on the company’s website, added this summer, lays out its broad vision and explicit interest in mobile health specifically. The company even has a mobile health strategy lead, Michele Angelaccio, who holds the title of Associate Director US Mobile Health Strategy at Novartis Pharmaceuticals.

“We have a unique understanding of the challenges doctors and patients are facing, and can help guide startups in building and testing proposed solutions,” Angelaccio says in the piece. “Partnering with these health technologists is the cornerstone of our mobile health strategy. It will continue to propel us forward as an innovator and it is the means by which mHealth will help us to meet our customers’ needs and solve some of the business challenges we’re facing.” 

In the post, Novartis highlights tracking and monitoring of patients as one of the biggest opportunities in mobile health. They mention the now-discontinued VaxTrak, for instance, as well asPodhaler Pro, an inhaler training app for cystic fibrosis patients.

Novartis currently has 13 iPhone apps in the Apple App Store, nine of which are patient or consumer-facing. The list includes two games, “Sickel Cell Iron Invaders” and “Marley’s World” which are designed to teach players about Sickle Cell disease and Multiple Sclerosis, respectively. It also includes MyNetManager and Clinical Trial Seek, two apps that launched last March.

The article also discusses a 2013 digital health challenge sponsored by Novartis, and ultimately won by home monitoring startup They add that work is continuing to build on’s platform, which is set to come out of beta later this year.

Novartis’s interest in tracking as the primary vehicle for making the most of mobile health opportunities is displayed by the deals the company has been involved with over the last few years. It sponsored some major trials with Proteus Digital Health, a company that aims to track patients with ingestible sensors embedded in pills. This year, Novartis has also partnered with TicTrac to help multiple sclerosis patients engage in self-tracking and, in a high profile deal, signed on tolicense Google’s smart contact lens to help people with diabetes track their blood glucose levels.

The article concludes, however, with the suggestion that the company is getting ready to go beyond just tracking to technologies that “could reach the market in the near future, including some that enable patients to undergo testing, diagnosis and treatment remotely.” Perhaps the company’s interest in, which reaches out to homebound patients with a virtual clinical avatar, points to the sorts of technology Novartis is pursuing.

“Through solutions like these, we intend to make a major change in the way care is delivered, and increase access to health services,” Angelaccio said.

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What is “Social Proof” and Why Should You Care?

What is “Social Proof” and Why Should You Care? | Analytics & Social media impact on Healthcare |
Social Proof is important to your business but many aren’t familiar with the term. It is also known as Social Influence and basically, it boils down to people looking for cues on what to do based on what others are doing. Although we pride ourselves on individuality, we are find comfort in numbers and groups and often look to what others are doing for assurance that we are on the track.

So how does this impact your business? If someone is uncertain if they should make a purchase, they will look to others who have made the purchase for guidance. The more people they can see have purchased and the more people that were happy with the purchase, the more likely they are to buy themselves.

Social proof comes in many different formats, with the most common being:

Storytelling – you use a story to share the experiences of the people that have already used your product or service.Video or written testimonialsReviewsCase StudiesComments on posts that indicate people are interested in what you have to say and offerSocial engagement numbers including your subscribers, followers, fans, tweets, likes, and other social sharesStatistics (while stats can be and often are manipulated, there is still trust built by sharing data – especially if it can be validated by a third party)Imagery (of people using a product or services)

Did You Know:

Over 70% of Americans say they look at product reviews before making a purchase

Nearly 63% of consumers indicate they are more likely to purchase from a site if it has product ratings and reviews.

Pretty powerful stuff, eh? Makes you want to work on building up your reviews and other forms of social proof, doesn’t it?

Some tips for implementing “Social Proof” into your marketing.

Images make testimonials, comments and stories more believable which makes them more beneficial to you.Most people subconsciously like things that “resemble” themselves. When reading reviews, our brains place more weight on those people we deem to be the most like us. In testimonials and case studies, avoid generic “Great service!” quotes. Outline your buyer personas and capture a moment where they described a specific pain that they solved with your product/service. Try to find a customer that represents your ideal customer. If your other customers can relate to them, the testimonial will benefit you more.Use storytelling.

What would persuade you more, a 5-star review or a detailed story of how a certain product/services was able to solve someone’s problem? Both are great forms of social proof, but one is far more powerful than the other.

Stories are persuasive and more trustworthy than stats because individual examples remain in our minds, but statistics don’t.

Stories work because our brains are primed to heed their advice.

Stories are persuasive because they are able to transport us to the tale being told. (Researchers say we tend to imagine ourselves in other people’s shoes during a story.)

Use Influencers to achieve the “Halo Effect”:

Since an “influencer” has already established a reputation, anything they involve themselves with is seen in a better light by association. Connecting yourself to people or brands with credibility, transfer some of that credibility and trust to you by association.

Less is not more:

People look at the social proof you make available to them and determine if it’s “enough” to be compelling. If you don’t have enough, you are better to go with none until you can bulk it up. With none people have nothing to judge, but with “a little” they start to wonder why there isn’t more.

Use Social Widgets:

Display your social networks and engagement numbers with widgets on your site or Blog.

Use Case Studies:

Case studies show what other people who were just like you are now experiencing as a result of making a decision to buy something that you have the option to buy too. If you see enough of these sorts of case studies you start to see the outcome as a forgone conclusion. Make this purchase and the result is yours, because it has happened to so many other people after buying.

Use Blogs and Social Media:

One of the simplest forms of social proof you will find on Blogs are comments. Comments are indicators that enough people are paying attention to what you are writing to reply. The same applies to the facebook “like” and twitter “tweet” buttons and before them, the Digg and Stumble buttons, and more recently Pinterest “Pin” button.

Gather your social proof:

Chances are you already have built up social proof. You may have received positive feedback emails from customers who have benefited from what you sold them – can they be your next case study? Do you have a lot of comments on a particular Blog post, or can you add a comment function to something to start building a social proof resource? Facebook comments? Pinterest followers? Etc etc.

If this isn’t something you have focused on, it’s time to start! You can almost instantly increase conversions when you effectively implement Social Proof.

By the way, you can use Social Proof on your site, landing pages, Blog posts, ad campaigns, social media marketing and more.


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Turning big data into better health outcomes

Turning big data into better health outcomes | Analytics & Social media impact on Healthcare |

Population health management is a multifaceted, many-layered endeavor that nevertheless has a common theme: the need for data and the ability to mine it for actionable information.


A broad spectrum of health care players -- individual providers, hospital systems, payers, local public health departments and federal agencies -- are all in some way addressing population health management. The approach involves identifying populations, assessing their disease status and developing appropriate responses, such as management programs for chronic diseases. Those activities require access to data -- and plenty of it.


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Via Andrew Spong
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JAMA report looks at what drives healthcare analytics | Vital Signs | The healthcare business blog from Modern Healthcare

JAMA report looks at what drives healthcare analytics | Vital Signs | The healthcare business blog from Modern Healthcare | Analytics & Social media impact on Healthcare |

The big hope for proponents of computer-enabled predictive analytics in healthcare is to one day see it in widespread use, at the point of care, in actionable form, to aid in real-time clinical decisionmaking.

But broad use implementation of eHPA is still in its infancy, say the authors of “Implementing Electronic Health Care Predictive Analytics: Considerations and Challenges. ”

Their piece is one of a series of articles on various permutations of Big Data in the current issue of the healthcare policy journal Health Affairs.

“The term infancy is relative,” says the article's co-author Bin Xie, health services research manager with PCCI, a Dallas-based not-for-profit corporation spun out of the healthcare data analytics work done at Parkland Health & Hospital System. 

The decades-old Framingham risk model for cardiovascular events and the APACHE II scoring systems to gauge the acuity of ICU patients are both well known examples of predictive analytics systems, the authors point out. 

But very few risk prediction models targeting hospital readmissions had been incorporated into an electronic health record system for easy use and reference, according to a 2011 survey report, published in the Journal of the American Medical Association and cited in the Health Affairs article.

“There are already many implementations across many hospitals in the country and across the world,” Xie adds in an interview. “It could grow into a big, giant adult, so, when we compare it to its potential, it's still in its infancy.”

“We think in five to 10 years, it could really become a big thing in healthcare, especially when we address the difficulty of containing costs and improving the quality of care and the challenge of the growth in the number of senior citizens,” he said.

Just as government penalties for hospital readmissions captured the attention of many early implementers of eHPA efforts, “payment reform is one essential piece to drive this growth” in the future, Xie said.

Predictive analytics has four component parts, according to the authors—acquiring data, validating the risk-prediction model, applying it in a real-world setting and scaling up the model for broader use in a healthcare system. Their article focused on the latter two and the challenges of bringing them to fruition.

Among those challenges are setting up an appropriate oversight mechanism with the right balance between enough control to keep the program operating properly and also affording it enough breathing room to grow and respond to daily events, the authors said. Another is stakeholder engagement, which includes patient consent, particularly when the risk models are still in the early stages of development. 

“The first time you go out and experiment, you do need a rigorous framework of the patient's right to know, just as you do in research study,” Xie said. 

Other issues that data analytics program planners must address are data quality assurance, patient privacy protections, interoperability of the technology platform and transparency of the risk model. 

“Whenever possible, clinicians, in particular, need to be able to 'see into' a risk-prediction model and understand how it arrived at a certain prediction,” the authors advise.  Transparency builds needed trust in the model, and it might encourage “crowd sourcing” to improve the model or expand its use to other organizations or settings.

Follow Joseph Conn on Twitter: @MHJConn

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FDA Looks to Urge Companies to Tweet Drug Risks

FDA Looks to Urge Companies to Tweet Drug Risks | Analytics & Social media impact on Healthcare |

e FDA is looking into a new way to regulate drugs and medical devices—by using social media. The agency has drafted social media guidelines that would urge drug companies to use platforms such as Facebook, Twitter, and YouTube, to educate the public about the risks of their prescription drug or medical device.

The draft guidelines, which are currently under review by the agency, propose that companies be required to use the “character space constraints” on social media platforms such as Twitter to tweet the risks, along with the benefits, of a product. The guidelines also recommend that manufacturers include a link that takes readers to more information about the product. In the case of Twitter, that information should all be included in a single tweet.

The document states:

If a firm concludes that adequate benefit and risk information, as well as other required information, cannot all be communicated within the same character-space-limited communication, then the firm should reconsider using that platform for the intended promotional message.

If approved, the guidelines will become the first formal recommendation by the agency regarding manufacturers’ use of social media.

Lara can be reached at Follow Lara on Twitter: @BostonLara
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Digital Agenda for Europe

Find here the most recent analysis and data by country. A selection of key documents and graphs are shown about topics such as broadband, internet activity and skills, egovernment, e-health, ICT in schools, research and innovation, as well as other main indicators.  

Via Philippe Marchal/Pharma Hub
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Twelve innovative population health management projects

Twelve innovative population health management projects | Analytics & Social media impact on Healthcare |
As part of its Health Innovations Award program, twelve projects focusing on population health management, care coordination, interoperability, and financial and clinical analytics will receive up to $110 million in combined funding from the Department of Health and Human Services.  At the same time, HHS has made up to $730 million available to states seeking to transform their public and private health insurance structures to meet accountable care goals and encourage innovation across the healthcare delivery system.  “As a former governor, I understand the real sense of urgency states and local communities feel to improve the health of their populations while also reducing health care costs, and it’s critical that the many elements of health care in each state – including Medicaid, public health, and workforce training – work together,” outgoing HHS Secretary Kathleen Sebelius said.  “To help, HHS will continue to encourage and assist them in their efforts to transform health care.“These efforts will strengthen federal, state, and local partnerships, encourage broad stakeholder engagement, and capitalize on federal resources to ensure greater transformation of delivery of health care services,” added CMS Administrator Marilyn Tavenner.With an average award size of about $9 million, the twelve projects receiving funding in Round Two of the program include academic institutes, professional societies, and healthcare providers across the country.  Some of the recipients include:North Shore-LIJ Health System on Long Island, New York, which will use its $2.5 million award to help coordinate the care of patients with late-stage chronic kidney diseases by using patient education, home dialysis, depression screenings, and other population health management techniques to reduce costs and preempt medical errors.Icahn School of Medicine at Mount Sinai, awarded $9.6 million to test its Mobile Acute Care Team (MACT) as a way to integrate the hospital-at-home model to reduce unnecessary admissions.  The MACT team will help treat patients for acute needs at home while integrating community care providers and providing appropriate referrals to non-hospital-based services.The Association of American Medical Colleges was granted $7.1 million to test the scalability of electronic consults and referrals across five academic medical centers.  Integrated into its Epic EHR systems, the consortium will use standardized referral templates to ensure that patients receive the specialty help they need.Regents of the University of Michigan will use $6.3 million to implement the Michigan Surgical and Health Optimization Program (MSHOP), which allows for real-time risk stratification for patients undergoing abdominal surgery.  Over the next three years, the system will be implemented at 40 Michigan hospitals.
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How the patient portal is changing medical practice

How the patient portal is changing medical practice | Analytics & Social media impact on Healthcare |

"Medical practice has begun its inevitable journey toward this transformation when, unless an exam or a procedure is required, most medical questions and answers, as well as virtually all medication refills and renewals, appointment requests, interpretation and discussion of the implications of lab and imaging results will be conducted online rather than in the office.


The reimbursement system in the health care of the future will simply have to take this into account, as we slowly transition to a fee-for-service to a care management."

Via Andrew Spong
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Practices in West Cornwall to [pilot] allow local A&E & OOH GP service with access to patients’ GP records

Practices in West Cornwall to [pilot] allow local A&E & OOH GP service with access to patients’ GP records | Analytics & Social media impact on Healthcare |

Eight practices in West Cornwall will pilot a data sharing scheme using Microtest’s Guru to allow local A&E clinicians and the local out-of-hours GP service with access to patients’ GP records.

Penzance GP Dr Matthew Boulter, who is leading the project on behalf of NHS Kernow Clinical Commissioning Group, said the pilot comes from GPs’ frustrations at their patients being unnecessarily admitted to hospital due to a lack of information sharing.

“A GP puts in place what we thought were pretty detailed plans to avoid admittance, only to find out they’ve been admitted because the admitting physician didn’t know about the plans, and had no way to find out.”

Dr Boulter said allowing doctors and out-of-hours services to view a patient’s GP record can have an enormous benefit, reducing unnecessary admissions and costs to the healthcare system.

“Information is power – the more information you’ve got, the better decisions you can make.”

He said the CCG is aware of concerns about information governance and patient consent, and spent nine months developing an agreement for all the practices to agree to.

Each practice is able to dictate how much information it shares, while access is restricted to those on the local GP performers’ list with no temporary locums allowed to use it.

As part of the safeguards, the Guru system, which can also be used on mobile devices, has a consent screen that pops up when a user tries to access a patient’s records, asking them to confirm whether or not the patient has given their consent for the service.

Dr Boulter said the system includes an override option for access in emergency situations, but doctors who use this are required to fill in a free-text box justifying their access of the records.

Clinicians have read-only access to the records, and practice managers will get a weekly read-out with information about which patients’ records have been accessed by whom to ensure there are no abuses taking place.

Dr Boulter said the pilot is in the middle of going live, with doctors going through training before they receive their log-on details and use the service.

The trial will last for 12 months, with three-monthly audits taking place to consider feedback and make necessary changes so the pilot can continue past the trial’s end if it is a success.

“What we don’t want to do is have the system stop at 12 months while we navel-gaze and analyse the data.”

If the pilot is a success, Boulter said the CCG could look to extend access to ambulance services, Macmillan nurses and others who can benefit from the data sharing.


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NHS Lanarkshire use analytics apps for enhancing clinical operational efficiency

NHS Lanarkshire use analytics apps for enhancing clinical operational efficiency | Analytics & Social media impact on Healthcare |

NHS Lanarkshire has launched a range of analytics applications to give staff easier access to data.

The Scottish health board has developed the dashboards together with MicroStrategy to provide access to systems data about a range of departments across its three hospitals.

Alan Lawrie, the health board’s director of acute services, told EHI the applications interface with the board’s “relatively robust” clinical systems to provide easily viewable data to clinicians.

“With [the applications], we can get it easily rather than having to delve into the deeper, darker parts of the system.

“If you’re a busy doctor or nurse, you can sit in front of your computer and take a look with a couple of clicks.”

Lawrie said one of the applications is a module displaying real-time data from the hospitals’ emergency departments, allowing staff to adjust their focus as necessary.

“You can get a feel for what the heat of the department is and what’s happening on an hour-by-hour basis, right in front of you and in a very visual way.”

The board also has a suite of dashboards with planned care information like inpatient and outpatient bookings to help meet treatment targets, as well as a bed-management dashboard to show in real time how many beds are available in each ward and each hospital.

Lawrie said a ward dashboard with information from the previous month, such as staff sickness levels, complaints and compliments, provides senior charge nurses and ward teams with information about the quality of care.

The applications can be accessed by desktops, laptops and other mobile devices that are linked into the board’s network.

He said the applications have a “modest” cost, with a budget of about £100,000 for the A&E dashboard, while adding value to the existing systems.

“They’re an add-on, rather than duplicating what’s already there.”

Lawrie said the board started work on the emergency dashboard in 2012 before it went live in August 2013, and has received positive feedback from clinicians.

He said the board is planning to make the ward dashboard “a little more real-time” to improve the timeliness of the information.

One of its other major IT projects is its e-casenote electronic patient note project, which Lawrie said is part of the move towards a paperless system over the next 18 months.

Lawrie said the board is starting to back-scan a significant number of historical records and documents to be displayed within its clinical portal, which already includes data from some clinical systems.

The scanning includes basic optical character recognition to allow some search facilities, while the scanned documents will be placed in different sections for test results, correspondence and other categories.

Lawrie said the electronic clinical notes will go live at Hairmyres Hospital at the end of June, with the next phase of the project focused on moving information from GP systems into the portal.

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Patient Engagement Framework | NeHC | HIMSS

Patient Engagement Framework | NeHC | HIMSS | Analytics & Social media impact on Healthcare |

The Patient Engagement Framework is a model created to guide healthcare organizations in developing and strengthening their patient engagement strategies through the use of eHealth tools and resources.

The Framework is designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies. This Framework can help your organization that treat patients as partners instead of just customers.

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Analyst: Apple's financial impact on mHealth worth billions

Analyst: Apple's financial impact on mHealth worth billions | Analytics & Social media impact on Healthcare |

Apple's foray into mHealth, given its reported upcoming iWatch device, its moves into electronic health record technology and the development of its HealthKit platform, will have a dramatic impact on healthcare and advance mHealth like few other initiatives, according to a report at Product Design & Development.

Via Alex Butler
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IBM Sees Broader Role for Watson in Aiding Research

IBM Sees Broader Role for Watson in Aiding Research | Analytics & Social media impact on Healthcare |

Watson, the IBM system that won “Jeopardy,” has shown promise in answering some kinds of questions. Now the company sees a broader role, a bit like the deductions that helped its namesake’s famous partner solve fictional crimes.

The company on Thursday is announcing advances in the technology and the availability of what it calls IBM’s Watson Discovery Advisor, a cloud service that it says can help research teams analyze vast troves of data to come up with new research ideas.

IBM is also pointing to a peer-reviewed case study to back up its claims. It describes how a tool based on Watson–developed at Baylor College of Medicine in Houston–was able to sort through about 70,000 scientific papers for relevant data about a particular protein and generate hypotheses that could be tested by scientists.


Watson is a collection of algorithms and software that runs on IBM’s Power line of servers, available for customers to use from its own data centers. Its components are designed to derive meaning more human language, and learn from data and other observations as opposed to being explicitly programmed to carry out instructions.

The company hasn’t generated a lot of measurable revenue from Watson so far, but it is betting that the extension of the technology from answering questions to generating hypotheses should help.

“Discovery is a lot more subtle,” said John Gordon, vice president in IBM’s Watson group. “You are trying to find connections.”

In the study, biologists and data scientists using the technology were able to identify proteins that modify p53, a protein related to many cancers. But the broader point was to show the potential of letting computers analyze data and make useful suggestions about it, amid a flood of research being generated by companies and other institutions.

“The literature is immense,” said Olivier Lichtarge, a professor of molecular and human genetics at Baylor who was the principal investigator on the study. “It is very difficult for any researcher to thoroughly master.”

Gordon said a related motivation is that many research dead-ends generate data that ends up on the cutting room floor. With the aid of Watson, companies could better mine that private information and combine it with scientific data in the public domain.

One company studying such possibilities to evaluate medications and treatments is Johnson & Johnson, IBM said.

But the company sees applications beyond the health realm, including making automated suggestions based on financial, legal, energy and intelligence-related information, IBM said.


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How transparency of medical records can lead to enhanced outcomes

How transparency of medical records can lead to enhanced outcomes | Analytics & Social media impact on Healthcare |

The woman was sitting on a gurney in the emergency room, and I was facing her, typing. I had just written about her abdominal pain when she posed a question I'd never been asked before: "May I take a look at what you're writing?"

At the time, I was a fourth-year medical resident in Boston. In our ER, doctors routinely typed visit notes, placed orders and checked past records while we were in patients' rooms. To maintain at least some eye contact, we faced our patients, with the computer between us.

But there was no reason why we couldn't be on the same side of the computer screen. I sat down next to her and showed her what I was typing. She began pointing out changes. She'd said that her pain had started three weeks ago, not last week. Her chart mentioned alcohol abuse in the past; she admitted that she was under a lot of stress and had returned to heavy drinking a couple of months ago.

As we talked, her diagnosis — inflammation of the pancreas from alcohol use — became clear, and I wondered why I'd never shown patients their records before. In medical school, we learn that medical records exist so that doctors can communicate with other doctors. No one told us about the benefits they could bring when shared with patients.

In fact, before the Health Insurance Portability and Accountability Act, a federal law enacted in 1996, patients generally had to sue to see their records. HIPAA, as that mouthful is abbreviated, affirmed that patients have a right to their medical information. But the process for obtaining records was often so cumbersome that few patients tried to access them.

In 2010, Tom Delbanco, an internist, and Jan Walker, a nurse and researcher, started anexperiment called OpenNotes that let patients read what their primary care providers write about them. They hypothesized that giving patients access to notes would allow them to become more engaged in their care.

Many doctors resisted the idea. Wouldn't open medical records inhibit what they wrote about sensitive issues, such as substance abuse? What if patients misunderstood the notes? Would that lead to more lawsuits? And what would patients do with all the information anyway?

After the first year, the results were striking: 80 percent of patients who saw their records reported better understanding of their medical condition and said they were in better control of their health. Two-thirds reported that they were better at sticking with their prescriptions. Ninety-nine percent of the patients wanted OpenNotes to continue, and no doctor withdrew from the pilot. Instead, they shared anecdotes like mine. When patients see their records, there's more trust and more accuracy.

That day in the Boston ER was a turning point for me. Since I started sharing notes with my patients, they have made dozens of valuable corrections and changes, such as adding medication allergies and telling me when a previous medical problem has been resolved. We come up with treatment plans together. And when patients leave, they receive a copy of my detailed instructions. The medical record becomes a collaborative tool for patients, not just a record of what we doctors do to patients.

The OpenNotes experiment has become something of a movement, spreading to hospitals, health systems and doctors' offices across the country. The Mayo Clinic, Geisinger Health System and Veterans Affairs are among the adopters so far. (The OpenNotes project has received funding from the Robert Wood Johnson Foundation, which also provides financial support to NPR.)

But there are new controversies arising. Should patients receiving mental health servicesobtain full access to therapy records, or should there be limits to open records? What happens if patients want to share their records on social media? Will such "crowdsourcing" harm the doctor-patient relationship? What if patients want to develop their own record andvideotape their medical encounter? Are doctors obligated to comply?

Delbanco tells me that he considers OpenNotes to be "like a new medication." Just like any new treatment, it will come with unexpected side effects. In the meantime, patients and doctors don't need to wait for the formal OpenNotes program to come to town. Patients can ask their doctors directly to look at their records. Doctors can try sharing them with patients, in real time, as I do now. It's changed my practice, and fundamentally transformed my understanding of whom the medical record ultimately belongs to: the patient.

Wen is an attending physician and director of patient-centered care research in the Department of Emergency Medicine at George Washington University. She is the author of"When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Care," and founder of Who's My Doctor, a project to encourage transparency in medicine. On Twitter:

FamilyCaregiverAlliance's curator insight, August 20, 2:37 PM

Why caregivers and their loved ones should not be hesitant but straightforward about what they want to know from doctors at  medical appointments . . .

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Laura Kolodjeski on how Sanofi US created a patient-centered blog in a highly regulated industry

Laura Kolodjeski on how Sanofi US created a patient-centered blog in a highly regulated industry | Analytics & Social media impact on Healthcare |

This post features a case study by Director of Patient Insights, Laura Kolodjeski at our Member Meeting in Boston where she shared insights from Sanofi US’ content hub created for the diabetes community. Laura’s been a member since 2010.

You don’t need us to tell you that leading social media in a heavily regulated industry is difficult.

You can see it in Laura Kolodjeski’s opening slide in her presentation: A legal disclaimer saying the views of the presenter do not necessarily represent those of Sanofi US.

“I did say I worked in a regulated industry,” Laura laughs.

But despite the restrictions on social in the pharma industry, Sanofi US has a thriving diabetes community online.

In her case study presentation, Laura describes how their content hub, The Diabetes Experience, or “The DX,” has helped write the rules for pharma in social media. She says it all started when Sanofi US decided to make the center of their social strategy their patients — not their products.

“We’re publishing content by the people, for the people. It’s not to market our products, but to enhance our overall value to our customers,” Laura says.

What does that look like? A blog full of original and curated content on anything from nutrition and fitness to relationships and lifestyle.

“It had never been done before for pharma, because anything we publish has a very stringent review process and content has to be vetted,” Laura explains. “It took a lot of conversations with our stakeholders to make sure they understood the vision, the purpose, and why we were asking to do something like this.”

Laura says they’re extremely proactive about finding the right content.

“We created The DX to offer a place for the community to engage around life and the aspect of that life with diabetes. We did not want it to be about diabetes, and we certainly did not want it to be about diabetes treatments,” she says.

To curate that content, they take a creative approach to listening. Laura says search data and unmet queries tell them a lot about what information patients are looking for. Laura’s team also keeps in close touch with patient advocates and online communities to understand more about caregivers and healthcare providers.

“And what we don’t hear through social listening, we ask.”

For The DX’s original content, Sanofi US looks to big influencers in the diabetes community like journalists, bloggers, and dieticians. They help create expert content from several areas of diabetes as well as connect Sanofi US to their own social followers.

Laura says, “It’s an amazing way to build relationships with your key influencers. As they’re writing for you, you’re building a very personal connection over time.”

Laura says her team’s favorite question is “Why?”

She explains how they’ve been able to push into new territory in social media and do groundbreaking work because they’re willing to ask questions when they’re told “no.”

“We respect our other stakeholders. They’re there to assess risk and ensure that we’re compliant,” Laura says, “But if you keep asking why, ultimately, you might get to a point where you can compromise or shape the conversation.”

Say hi to Laura on Twitter or check out the video of her full Member Meeting presentation here. 

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Lessons Learned: Bringing Big Data Analytics To Health Care

Lessons Learned: Bringing Big Data Analytics To Health Care | Analytics & Social media impact on Healthcare |

Big data offers breakthrough possibilities for new research and discoveries, better patient care, and greater efficiency in health and health care, as detailed in the July issue of Health Affairs. As with any new tool or technique, there is a learning curve.

Over the last few years, we, along with our colleagues at Booz Allen, have worked on over 30 big data projects with federal health agencies and other departments, including the National Institutes of Health (NIH), Centers for Disease Control (CDC), Federal Drug Administration (FDA), and the Veterans Administration (VA), along with private sector health organizations such as hospitals and delivery systems and pharmaceutical manufacturers.

While many of the lessons learned from these projects may be obvious, such as the need for disciplined project management, we also have seen organizations struggle with pitfalls and roadblocks that were unexpected in taking full advantage of big data’s potential.

Based on these experiences, here are some guidelines:

Acquire the “right” data for the project, even if it might be difficult to obtain.

We’ve found that many organizations, eager to get started on a big data project, often quickly gather and use the data that is the easiest to obtain, without considering whether it really goes to the heart of the specific health care problem they’re investigating. While this can speed up a project, the analytic results are likely to have only limited value.

For example, we worked with a federal agency experimenting with big data analytics to identify cases of perceived fraud, waste, or abuse. The program’s analysts focused on data they already had on hand and currently used to direct audit and investigation activity. We encouraged project staff to identify alternative data sources that might reveal important information about compliance history or “hotspots” for illegitimate activity.

We learned that historical case reports and online provider marketing materials were available and were a potentially valuable source for information to aid in fraud detection. However, the project analysts had decided it would take too long to incorporate that information and so had excluded it.

Many organizations – both inside and outside of health care – tend to stick with the data that’s easily accessible and that they’re comfortable with, even if it provides only a partial picture and doesn’t successfully unlock the value big data analytics may offer. But we have found that when organizations develop a “weighted data wish list” and allocate their resources towards acquiring high-impact data sources as well as easy-to-acquire sources, they discover greater returns on their big data investment.

Ensure that initial pilots have wide applicability.

Health organizations will get the most from big data when everyone sees the value and participates. Too often, though, initial analytics projects may be so self-contained that it is hard to see how any of the results might apply elsewhere in the organization.

We ran into this challenge when we helped a federal health agency experiment with big data analytics. The agency’s initial set of pilots focused on specific, computationally complex and storage-intensive challenges, such as reconfiguring a bioinformatics algorithm to run across a large cluster of processors and developing a data-capture approach to access and store data in real time from a laboratory instrument.

While each pilot solved a big data analytics challenge, the resulting capabilities did not provide examples that would be powerful enough to push transformational change across the organization, as the organizational leaders had hoped.

In subsequent pilots, we advised the agency to focus on less rigorous but more far-reaching pilots. In one project, the agency piloted an unstructured natural language processing and text search utility across a number of disparate data archives. In another project, we deployed a data platform that could rapidly generate millions of records of synthetic data for algorithm testing.

In each case, organizational decision-makers could more easily see the applicability and potential of big data analytics and more clearly understand the potential of big data to transform their organization.

Before using new data, make sure you know its provenance (where it came from) and its lineage (what’s been done to it).

Often in the excitement of big data, decision-makers and project staff forget this basic advice. They are often in a hurry to immediately start data mining efforts to search for unknown patterns and anomalies. We’ve seen many cases where such new data wasn’t properly scrutinized – and where supposed patterns and anomalies later turned out to be irrelevant or grossly misleading.

In one such case at a federal health agency, information contained in a data source suggested that there was a significant uptick in the number of less-experienced clinical investigators associated with a set of therapeutic areas. Project staff identified this as an important trend to aid in risk analysis for the agency and prepared to brief senior decision-makers.

However, when the findings were presented first to the administrator for the data source, he suspected that the trends might coincide with the roll-out of new address fields.

As a result of a data-field change, when new address information was added for an investigator, it didn’t append to the original file, but created an entirely new file – making it appear that there were many new investigators, when in fact the number of investigators had slightly decreased over time.

This scenario could have been avoided through an investigation and annotation of candidate data sources with provenance and lineage information prior to operational use. With big data analytic techniques, such details can be prospectively or retrospectively annotated to data records, indicating the prevailing process and data standard at the time of collection.

Then, data miners can leverage this factor in data mining efforts and predictive models to test whether the data-collection process is causing a significant effect in the outcome variable of interest.

Don’t start with a solution; introduce a problem and consult with a data scientist.

Unlike conventional analytics platforms, big data platforms can easily allow subject-matter experts direct access to the data, without the need for database administrators or others to serve as intermediaries in making queries. This provides health researchers with an unprecedented ability to explore the data – to pursue promising leads, search for patterns and follow hunches, all in real time. We have found, however, that many organizations don’t take advantage of this capability.

One federal health agency we worked with, for example, invested in big data analytics to enable network analysis of nodes in a supply chain. Instead of giving its subject-matter experts free rein to look for new and unexpected patterns, the agency stayed with the conventional approach, and simply provided canned business-intelligence reports and visualizations to the end-users.

Not surprisingly, the outputs of this approach disappointed organizational decision-makers in terms of generating new insights and value. We strongly encouraged the agency to make sure subject matter experts could have direct access to the data to develop their own queries and analytics.

Once this was provided, the user community rapidly grew, and there was an associated increase in new capability, training requests, and overall value for the organization.


Health organizations often build a big data platform, but fail to take full advantage of it. They continue to use the small-data approaches they’re accustomed to, or they rush headlong into big data, forgetting best practices in analytics.

It’s important to aim for initial pilots with wide applicability, a clear understanding of where one’s data comes from, and an approach that starts with a problem, not a solution. Perhaps the hardest task is finding the right balance.

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Big Hitters in Health: Social, HCP Comms and Big Data

Big Hitters in Health: Social, HCP Comms and Big Data | Analytics & Social media impact on Healthcare |

Digitally Sick are back and have taken the opportunity to look at the three big hitters for digital health in 2014: Social. HCP communications and big data (with the exception of mobile health which needs a pod of it's own).


Social media is now almost passé but over the last decade has revolutionised all aspects of pharma communications from patient support to clinical trials. In 2014 we are still struggling with how we should communicate with HCP's and finally big data, or data, is now the most exciting frontier in healthcare, what are the issues and how can this be leveraged by pharma?


Via Alex Butler
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Health Data's Future: 6 Paths to Health Data Maturity | HL7 Standards

Health Data's Future: 6 Paths to Health Data Maturity | HL7 Standards | Analytics & Social media impact on Healthcare |

Every year around the time of the health and government data extravaganza in Washington, Health DataPalooza, it’s reason to do an accounting of how far we’ve come in terms of accessing health data and using it as a foundation for value-based medicine. NPR says we have reached our “Awkward adolescence” (echoing Susannah Fox) with health data—lots of amazing things happening, but not a lot of impact.

Of course there’s plenty more work to do to make health data more accessible, more liquid and more private, but the progress since Health DataPalooza started less than 5 years ago is amazing, and we should take note, then come back to the paths forward.

This year, the big news was the FDA announced “OpenFDA”, available via an open API, with information on adverse drug events. Time will tell what the release will mean in terms of delivering health, but with over a thousand datasets now release by HHS alone, we are seeing a wave of new capability, even if data stories take time to tell.

Meanwhile, 80% of healthcare is now digitized, more than doubling from just a few years ago.

Samsung and Apple see the potential for accessing and harvesting health data and are moving into the fray to create personal health tracking hubs. There are many more examples showing that health data has, indeed, reached the limelight. Big health data, is now often called “the new oil”, and it’s already serving as a key resource in driving economics and powering countless new companies.

But that’s not what this post is about.

All this data is great, but it doesn’t take big data or rocket science to figure out what’s killing us, and how it might be prevented.

If you’d like to see what is killing us, check out this (small) data tool:

Stop the presses: It’s us.

You take smoking, diabetes, obesity, cardiovascular disease and alcohol out of the mix, and the vast majority of those in the developed world would live to 90+. For data to really have an impact on health, it’ll have to have an impact on us. Many of these disease are diseases of behavior. We can debate how difficult it is to change behavior, or what biochemistry, genetics or other factors drive behavior, but most of our health problems could be prevented by making different choices. Consumers are going to need to care about it and use it.

There are bright spots that this is possible. Engagement rates reach 70% among institutions who do it well, but it takes leadership.

The reorganization of the ONC without a consumer office doesn’t show a lot of confidence that they are going to lead the way.

How do we fix this?

We’re nearing the point where we’ll be able to capture someone’s vital signs every minute of every day via Samsung, Apple, and many others. Will all this measurement save us from ourselves? Can we truly get prevention, or do will we just get better at heading off problems at the last minute? While preventing heart attacks is great, as a new iWatch is rumored to do, it would be even better if we could fix the unhealthy state that makes them possible before a last-minute intervention is necessary.

With that in mind, here are my wishes and a few predictions for the next phase of health care and health technology (now forever linked) and the road to solving health care with health data:

1. We need to create tools that can actually measure and impact behavior on what goes into us, not just stats on where we are and how we’re moving.

At the end of the day, we’re going to need to measure and provide feedback on input on intake as much as output. We’ll need to not only sense motion and vital signs but also what we’re putting into our bodies in terms of food, drink and chemicals, and start to change it. There has been work on tooth sensors to measure intake and Apple and others appear to be working on hydration sensors. It’ll be exciting to see developments in these areas in the coming years.

2. We need to better understand what drives metabolic disease. Metabolism-related killers are becoming our primary killers, but many normal weight people, in addition to obese people, die of metabolic disease. There’s still a lot we don’t understand about prevention and the disease. Yet metabolic disorders such as diabetes are taking an ever-greater toll and half the country will be at risk for diabetes by 2020. That’s a lot of suffering, a lot of death, and an enormous cost.

3. We need to prepare for the fight of a generation. Metabolic diseases are killing us in ever-larger numbers. The more we measure what’s driving costs, as we collect more and more Health Data, we’re going to run straight into a very big wall of conclusion: sugar is killing us.

With the release of FedUp, the idea of sugar as a culprit for our health care woes is starting to hit the mainstream.  If the fight against control of tobacco was tough (and by no means won), the fight against sugar will be 10x harder.

4. We need to correlate outcomes and environment. That means we need to understand what networks behavior of the health care system.  We’ll learn a lot from the 125,000 people who die per year from not adhering to their medications. Why aren’t they taking them on time? What’s preventing people from treating themselves?

For that we need to understand things at a systems level and better correlate with the social determinants of health. As Atul Gawande pointed out, yet again, at health DataPalooza, the overall vulnerability of a population is what’s drives our biggest health costs. The intersection of socio-economic/social determinants and network behavior will help us solve major hotspots, major sources of cost and suffering.

5. This one might be obvious, but we need to be better at predicting with data. EHRs like their name implies, are records, focused on the past. We need electronic health systems that are predictive. Apple and Samsung or others will do it, and they appear to be correctly focused on a new kind of technology for the new business model of health care, focused on risk spread among all players (and value place on prediction).

Dave Chase, CEO of Avado,  now part of WebMD, issued a stern warning to healthcare providers and their approach to healthIT on Susannah Fox’s blog:

“Just as it was easy to dismiss Google, craiglist, ebay, groupon, foursquare, facebook, etc. so too are the Iora Healths, Caremores, HealthCare Partners, Edison Health, One Medical, Surgery Center OK, Paladina Health, etc. ,but their value proposition is compelling. All of those players are deploying health IT in a radically different way than incumbents. Those orgs and their supporting technology take it for granted that patients are a core member of the care team, have access to their data and generally are using IT for competitive advantage.”

6. We need better rules on ownership and rights around health data, we could start with a Health Data Bill of Rights. In the consumer space, the rise of Snapchat and Whatsapp are indicative of a rise in the awareness and need for privacy. In health care, it will take time, but as health data gets “consumerized” with Apple and Samsung entering the fray, I predict the needs will become more and more apparent.

We need to work on rules and awareness to make health data more private and at the same time more easily exchanged. I don’t know exactly what that will look like but I, like many others, get the sense the answer may come through the blockchain. Fred Wilson at Union Square Ventures sees it as driving the next big investment cycle, after social and now mobile. He says, “our 2014 fund will be built during the blockchain cycle”. More on that in an upcoming post.

What do you think? What do we need to solve health care with health data?

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Patient engagement – we need to live it, not talk it - Health Foundation

Patient engagement – we need to live it, not talk it - Health Foundation | Analytics & Social media impact on Healthcare |

Patient engagement is much talked about. Thankfully. However, casting my mind back 20 years when organising The King’s Fund’s Promoting Patient Choice conference, I recall having no difficulty in finding two doctors to get up in front of the 300+ audience and argue that ‘patients should do what they’re told’.

Some healthcare professionals may still think and act like that, but few, if any, would now get up on a stage to proclaim it in public. I’d suggest that’s quite a far way to come in 20 years in terms of reversing medical paternalism.

But it’s not far enough.

The call for patient-centred care, 6Cs, experience based design, co-production, collective and individual participation, patient experience, etc, etc, has never been louder. That’s great for those of us who have worked in the field for a long time. And even more importantly for patients, for staff and for the system (as the evidence overwhelmingly proves). But it’s also frustrating.

Why? Because in some senses, the gap between this louder rhetoric and real practice has got wider. Whether it’s self-managing my own two long-term conditions, being an informal carer for two mental health service users in Salford, or caring for my own loved ones (resulting in me being in three different hospitals over the last six days), it’s just not happening on the ground. Or at least the ground I’m treading on.

I have experienced no care plans, no patient decision aids, no health coaching, motivational interviewing nor appreciative enquiry. There are some leaflets. There is some communication. But this is mainly transmission. A protocol to get through. A monologue not a dialogue. A mouth, sometimes a rushed smile, big hands but no ears. A heart that too often seems so deeply buried that, when one does appear, it’s sadly the exception not the rule.

As a clinician and management consultant, the full potential of ‘individual participation’ (to coin the phrase within NHS England’s laudable Transforming Participation Guidance) has yet to move beyond a few well-intentioned early adopters.

So how do we get better – both patients and the people/systems that treat them?

It’s actually really easy. And that’s what makes it so hard.

It’s simply about becoming people again. It starts with basic things like ‘Hello, my name is...’ (hats off to Kate Granger). Names are part of what make us human. The most successful encounters over my past six days as a carer/parent/patient started when the staff members introduced themselves. When you say your name, you usually smile. This personal information and associated positive body language gets the whole conversation off to a great start.

Next, the caregiver asks the patient and also the relative carer, ‘How are you doing?’ Next, ‘Is there anything you need?’ Then they go on to outline what they’re there to do (hopefully with the patient/carer’s blessing/‘informed consent’).

But this is where things fall down. Staff know what the process is. But too often – far too often – patients and carers simply don’t know what’s supposed to happen next. They know how to make a cup of tea, they know how to make retail choices. But they don’t know what the stages are in their care journey/pathway/experience. And no one has told them.

So they’re left in the dark with no or very limited expectations: How long am I supposed to wait here? What’s happening next? They said they’d come back and tell me what I have wrong. Without setting expectations, patients don’t have a benchmark to know what is good or bad, what’s right or wrong, what’s too long a wait or just right. No wonder 64% of the nearly 1 million patients reported in the December 2013 GP–Patient Survey state they are as involved in decisions as they want to be; yet only 3% have a care plan. They don’t know what they don’t know.

Staff, therefore, have to think of patients as people and not just body parts (the MI in bed 6; the liver in bed 12, and so on). Soft stuff – such as dignity, respect and compassion – is important. But we need to go deeper and better our understanding of what makes our patients tick. We need to reflect (and record?) the following with regards to our patients:

health beliefs – is diabetes just the 'touch of sugar' that Granny had, or the disease that took Dad too early?are medicines miracle cures, or poisons foisted on us by a profiteering, disease-mongering pharmaceutical industry?what’s their level of health literacy eg when telling a patient to ‘choose a hepatologist’ – what is choice, what’s a hepatologist, does the data exist and is it presented in a digestible format?what’s their level of motivation – can they bothered with health or are they too busy with even more basic needs such as food, shelter and warmth?

Without insight into and measurement of what our patients are really thinking and capable of, and helping them set expectations, we’re firing blanks at the ‘self-management’ target with our eyes closed. We’ll talk it, but we won’t live it. And neither will our patients.

So lets’ go back to being people. To being honest, caring and communicative. Simple, eh?

Mark is a clinician, management consultant and patient advocate,

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Five things the NHS must learn about empowering patients

Five things the NHS must learn about empowering patients | Analytics & Social media impact on Healthcare |

Half of all patients in hospital say they aren't as involved in their care as much as they would like. This figure hasn't improved in a decade.

There's been a lot of talk from recent governments about giving more power to patients. The latest commitment is that the NHS will get "dramatically better" at involving people in their own care, but the change so far has been anything but dramatic.

Despite all the structural overhauls to the NHS there has been very little change in the areas that matter most: how involved people feel in the big decisions about their care, and whether patients' voices are heard when things go wrong, or are ignored as we have seen in several high profile scandals.

I recently led a coalition of MPs and peers concerned about health to look at what we could learn from other countries that were trying to solve this problem. Across over 100 examples we looked at, five key lessons stood out.

Knowledge is power

In Denmark, everyone has the ability to see and interact with their medical records online. This gives people the power to really understand their health and treatment. Giving British patients this ability needn't mean another huge national IT project. In Malawi all patients carry hard copies of their records. We already do this for maternity care – why not other areas too?

Make shared decision-making the easy choice for clinicians

Many clinicians are cautious about sharing decision-making more. They worry that empowered patients will be more demanding rather than more independent. Partnership with patients needs to be the easy choice, which means making consultations smarter rather than longer. Massachusetts general allows doctors in the hospital and community to prescribe decision support tools for patients to use at home to decide which treatment is best for them.

Invest in supporting carers

For many people with long-term health problems, family members provide the vast majority of the care they receive. Giving these carers the skills to support their loved ones at home is a great investment in quality of life, and in affordable healthcare. A chain of hospitals in India has come up with a great solution – when vulnerable patients are admitted, their main carer can go on a short course at the hospital to learn the skills to look after them at home. They then get to practise these skills on the ward before the patient is discharged.

Groups of patients are a powerful asset

When patients come together they can be a powerful force for improving their own health and that of others. In Uganda a large proportion of HIV/Aids care is delivered by groups of patients working to help their peers understand and manage their condition. We've seen what peer support and education can do in the UK for years through the work of networks like Alcoholics Anonymous and Weight Watchers. What other problems could be tackled by people power in this way?

Listen to what patients have to say

Patient stories have enormous power to challenge and change the status quo. Mothers' perspectives are at the heart of a global initiative called Respectful Maternity Care. Countries including Nigeria and Nepal are inspiring and informing midwives using women's stories to improve the experience of childbirth for thousands. The approach has already been successful in one NHS maternity unit that was struggling to tackle serious failures in care.

We can't directly cut and paste any of these overseas examples into the NHS. Nonetheless, they do help us to think bigger and bolder about making real change happen at long last.

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How Healthcare CIOs View the Data Analytics Landscape

How Healthcare CIOs View the Data Analytics Landscape | Analytics & Social media impact on Healthcare |

Nearly all provider CIO respondents in a recent survey believe data analytics will play a big role in succeeding with accountable care and other value-based healthcare initiatives. But while 42% say they have a flexible and scalable analytics plan, more than three-quarters report only moderate or minimal commitment to integrating analytics into practice.

The April survey from eHealth Initiative and the College of Information Management Executives got responses from 98 provider organizations--35% delivery systems, 27% hospitals, 14% academic medical centers and 9% community health centers/clinics. Only four respondents were not running analytics at the time of the survey.


Seventy-two percent of responding providers extract data from more than 10 platforms or interfaces--some more than 100--with EHR and billing/financial data still by far the most common. But data also comes from patient-generated sources such as portals and health risk assessments (45%), unstructured text (39%), remote monitoring devices (29%), health information exchanges (22%), mobile applications (11%) and genomic data (7%).

Still Young and Learning

Analytics remain in the early stages of maturity. Traditional common uses of analytics continue at high levels. These include quality improvement (93%), revenue cycle management, (91%), resource utilization (81%), and population health management (79%). Respondents use descriptive analytics that mine for historical or retrospective analysis at a 94% rate. Only 68% use predictive analytics to forecast outcomes, trends or performance, and this is mostly done on a monthly or quarterly basis. One-third use prescriptive analytics with sophisticated models to optimize performance and recommend specific actions. On 20% of respondent’s analytics operations regularly integrate and coordinate at an institutional level.

 New Obstacles

Trained staff to collect/process/analyze data, along with interoperability and cost, have been common barriers to implementing an effective analytics program. Survey respondents report new challenges are emerging. These include access to external data beyond proprietary networks; cost-prohibitive work required to clean/validate/integrate external data when available, lack of funding or return on investment, increased regulations on data use and patient privacy. “These trends suggest the critical need for strategic planning in implementing analytics, no matter how large or small,” according to a report of survey results.


Consumer engagement has started to make its mark on data analytics initiatives. Two-thirds of respondents use analytics to support engagement with the primary focus being on patient satisfaction. But few organizations also are applying analytics to consumer strategies such as personalized communication and services, acquisition and retention of consumers, or targeted behavioral change programs.

A report on survey findings, “The Landscape of Data & Analytics in Healthcare” is available here.

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Big data, analytics in healthcare has expanded from business intelligence and revenue-cycle management to clinical care.

Big data, analytics in healthcare has expanded from business intelligence and revenue-cycle management to clinical care. | Analytics & Social media impact on Healthcare |

In this age of big data, analytics in healthcare has expanded frombusiness intelligence and revenue-cycle management to clinical care.

For example, health insurer WellPoint is branching out from simply looking for gaps in coding, thanks to a combination of better data and more advanced algorithms. Now, the company can look for gaps in care as well, Patrick McIntyre, the company's senior vice president for healthcare economics, explained last week at SAS Institute's 11th annual executive conference on health analytics.

About 2.5 million of WellPoint's 37 million enrollees have insurance tied to some sort of value-based reimbursement model, McIntyre said, and the Indianapolis-based payer shares reports with providers whenever there is risk-sharing. "We use analytics and reporting to create economies of scale for all of the provider communities we work with," he said.

Patrick McIntyreWellPoint performs both retrospective analysis of claims – a more traditional form of data mining – as well as proactive analysis of care gaps. This helps the company coach providers on better coding and service delivery.

Health insurers, of course, historically have been met with mistrust and suspicion when they reach out to members and providers. With their vast data collections, that is changing. "There isn't a magic bullet, but it's really bound in trust," McIntyre said.

"We need to provide the right care to the right patient at the right time," he added. "I think analytics is going to be the differentiator."

Making sense of the unstructured
Mark Pitts, VP for enterprise informatics data and analytics at Highmark Health, the new, Pittsburgh-based parent company of Allegheny Health Network and health insurer Highmark, offered similar sentiments. As someone with years of experience at payers, a "primary challenge" for Pitts has been how to influence individual behavior to promote better health and save money.

Today, with the advent of "text analytics," organizations like Highmark can make sense of vast stores of unstructured data, not just information entered in a discrete format. (Pitts called this the "bag of words" method.)

According to Pitts, computers now can look for "term concurrence" across multiple documents to search out patterns, such as evidence of patient dissatisfaction, according to Pitts, so people don't have to flip through hundreds of pages in hopes of stumbling across something meaningful. "Have machines find things," he said.

Allegheny is getting ready to bring this technology to the provider side. For example, Pitts said, the length of a nurse's progress note often correlates with illness severity. By paying attention to patients with particularly detailed notes, the health system might be able to prevent medication errors, escalation of acuity and even hospital readmissions, he suggested.

Farzad Mostashari, MDNext wave for Kaiser data

Like Highmark, Kaiser Permanente is both healthcare system and health plan. That massive organization's EHR contains something in the neighborhood of 10 petabytes of data, according to Terhilda Garrido, VP for health IT transformation and analytics, making it ripe for big data technologies.

Garrido wants to gather "patient-reported outcomes" after each encounter, including what patients say on social media, data pulled from medical devices and patient satisfaction ratings. "That, for us, represents the next wave of the continuum," she said.

Physicians can order questionnaires through KP's My Health Manager patient portal. "It's a little clunky," Garrido said, but noted that it is the first stage of what probably will be a long effort. Later, there may be auto-collection of data from mobile and home-based devices, adding another way to track and measure outcomes.

Mostashari on gauging outcomes
If Kaiser is successful, former national health IT coordinator Farzad Mostashari, MD, would be pretty happy.
Graham Hughes, MD"Most of which determines our outcomes isn't what happens in our office," Mostashari, visiting fellow of the Engelberg Center for Health Care Reform at the Brookings Institution in Washington, said during the opening keynote of the SAS event.

"One of the things that drove me crazy in medicine is that I never got any feedback," Mostashari said. According to the former national coordinator, "99.999 percent of the time, we have no idea what we get" for all the money spent on healthcare.

SAS Chief Medical Officer Graham Hughes, MD, echoed some of these sentiments. "Ninety-nine percent of patient care takes place outside of traditional care settings," he said, emphasizing the importance of collecting and analyzing data from patients' everyday lives to close gaps in care and personalize treatments.

"Maybe we start to think of every disease as a rare disease?" Hughes wondered aloud as he discussed the potential of Big Data to help individuals make healthy lifestyle choices outside the sterile, controlled environment of a hospital or clinic.

"We're starting to get past the PowerPoint page and into some real situations," Hughes said.


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#Healthcare Reforms That Work, an interesting example

#Healthcare Reforms That Work, an interesting example | Analytics & Social media impact on Healthcare |

Diseases like diabetes, heart disease, cancer, chronic kidney disease, and stroke are on the rise in both the developed and the developing world, and they have a few things in common.

First, they are responsible for contributing a large chunk of patients into the health care system, especially in developed countries like the US. In fact such diseases are the cause of death in more than 4 out of 5 cases in the US. Second, these diseases are non-communicable, and are caused by poor diet, lack of exercise, and unhealthy lifestyle rather than bacteria, viruses and other micro-organisms.

Third and most importantly, unlike communicable diseases where the incidence rates and overall costs are on the decline, these conditions are posing a heavier burden on health care systems every year. All of our new policies and efforts to provide affordable health care could pale in comparison to the exponentially rising costs associated with these diseases and their demographics. In light of this increasing burden, what can we do?

One area where we’ve begun to make some inroads is with chronic kidney disease (or CKD for short).  CKD is a condition that affects 1 in 10 Americans over 20 and costs the US health care system almost $100 Billion a year. In the US, a little over 1 % of Medicare patients have advanced renal impairment, and yet nearly 8 % of the total Medicare budget is spent on treating them. Today nearly 2 million people in the world are kept alive by dialysis. CKD is closely linked with other conditions such as hypertension, diabetes and heart disease. It disproportionately affects the poor, and is expected to worsen in developing countries at an alarming rate—though the incidence and prevalence of CKD is increasing at an alarming rate in every part of the world. This disease is poorly understood and very few people take measures to prevent it, though CKD is preventable and its progression can be slowed by simple strategies and lifestyle changes.

The good news is that we’ve already begun to transform costs for CKD.  Five innovative reforms have been found to help reduce costs without compromising on the quality of health care services:

Decentralization of responsibilities: Most dialysis centers today are trying to provide drug management, laboratory services, and vascular surgery management in addition to dialysis service under one roof. This bundling of care allows each center to function independently and to provide a one stop solution to all patient needs. In 2010, provision for bundled care was included both in thePatient protection and Affordable Care Act and in the Affordable Health Care for America Act. Bundling services together discourages unnecessary care, and encourages better coordination across providers which can lead to better quality of service at a lower overall cost.

Transparency: In a country like India, the incidence and prevalence of kidney disease is still unknown today. The lack of such data makes it impossible for any country to allocate resources effectively. In other words, cost containment cannot be achieved without cost estimation first. Unlike India, the UK has been devoting significant effort towards the maintenance of the UK Renal Registrywhich discloses all outcome measures including patient survival for kidney disease population. This approach has helped UK become one of the most cost-effective and one of the best providers of kidney care in the developed world today.

Incentives: After a decent level of transparency is established in any system, it becomes relatively easy to evaluate its performance and suggest remedies to improve it or maybe even reward good performance. In some hospitals in Europe, an incentive program is being discussed to encourage good performance. For example, a hospital in Italy has suggested a model which advocates higher use of Peritoneal Dialysis (or PD for short, a form of home dialysis which is cheaper than traditional hospital dialysis). Published literature indicates that PD is at least $ 15,000 to $ 20,000 cheaper than traditional hospital dialysis per year and also offers similar if not better quality of life. If hospitals decide to raise the percentage of patients on PD from 12% (the European average), to an easily achievable 40%, it could lead to a considerable amount of savings without any compromise in quality of care.

Patient participation: Nowadays, patients want to be in control of their own therapy and want to know more about it. They want to be given the choice of how care should be provided and what services they will receive. Taking all this into account, it is of paramount importance that the system gives patients the right to choose. A number of successful evaluations have been carried out in the US and the UK where patients were given their own personal budget to allocate, rather than a standard menu of services. These evaluations have shown that such an approach not only makes the patient feel more satisfied but also overall expenditure falls, since clinicians are less conservative than patients when it comes to spending money on health care.

Another innovation that has contributed to the improvement of patient participation is telemedicine. Today, there are home dialysis patients who are remote monitored by the doctor, and as result the patients spend less time in the hospital, less money on drugs required to treat complications, and most of all enjoy a higher quality of life. These patients are more “in control” of their lives.

A focus on prevention: Chronic kidney disease is actually divided into 5 distinct stages, and the costs associated with each stage are different. A study in 2004 revealed that costs continuously increase as we progress from stage I to stage IV. This is clear proof that a far greater sum of money can be saved by health care systems if they can reach patients at an earlier stage. Currently the US only spends less than 4 cents on preventive measures for every dollar spent on health care. It might help if more resources are allocated in educating the public on how to avoid diseases like chronic kidney disease, like emphasizing how to eat and exercise right.

If we can apply what we’ve learned here to the other big four diseases, we might be able to stem the rising costs even as the incidence of these diseases continues to rise. But we have to keep innovating. In all, the need is for innovative policy, new perspective and a more holistic approach to providing health care. The five reforms arising from CKD management can possibly be a powerful tool in achieving that goal.

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Healthcare data analytics landscape changing rapidly

Healthcare data analytics landscape changing rapidly | Analytics & Social media impact on Healthcare |

Nearly half of healthcare organizations responding to a new survey say they  are experiencing a positive return on investment in data analytics and reporting  technology.

The survey, by TCS Healthcare Technologies in conjunction with the Case  Management Society of America and the American Board of Quality Assurance and  Utilization Review Physicians, found the landscape changing quickly from similar  measures taken in 2008 and 2010.

Forty-six percent reported positive ROI, compared with 14 percent who  reported a negative return, according to an announcement

Thirty percent of respondents reported stratifying healthcare information to  promote population-based screening, or to identify candidates for case  management. Meanwhile, just 25 percent reported using predictive modeling  applications, while 35 percent reported doing so two years ago.

Excel (39 percent), Crystal Reports (20 percent) and Access (17 percent)  remain the most widely used applications.

Users cited the importance of dashboard and visualization capabilities,  naming among their priorities the ability to manipulate reports and data  presented and to view trends for individual patients and for large sets of  data.

Applications for population health management that integrate claims and  clinical data are key to the success of accountable care organizations, an IDC Health  Insights report found recently, saying many organizations have found that  relying on EHR information alone isn't enough.

While tools that help organizations with case management have been  touted for their ability to improve care, as New Jersey-based primary-care  practice Vanguard Medical Group experienced, it's not all about the technology.  A Kaiser Permanente study found readmission-prediction software wasn't accurate enough for  it to replace manual review of cases.


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