Doctors in the Carolinas Health System are making patient care a little more personal. The system, which includes more than 900 hospitals, nursing homes, doctors’ offices, and surgical centers in North and South Carolina, have begun using consumer data on 2 million people to identify high-risk patients, and take a proactive approach before they become ill. The data is purchased from companies who trawl public records, store loyalty program transactions, and credit card purchases. If you didn’t renew your gym membership, they know about it. If you’re buying alot of junk food, they know about it.
Consumer spending data can provide a more comprehensive oversight than what is gleaned in the five minutes in the Doctor’s office, Michael Dulin, chief clinical officer for analytics and outcomes research at Carolinas HealthCare, told BusinessWeek. his data is then fed into an algorithm to ascertain a patient’s “risk score”; within two years, they plan on having thse risk scores readily available to Doctors and Nurses. “What we are looking to find are people before they end up in trouble,” says Dulin.
The risk assessments are allowed to shared between Doctors under the contract with the system’s data provider. In future, Dulin aims to give more specific details to the company’s doctors on their patients’ spending habits. “The data is already used to market to people to get them to do things that might not always be in the best interest of the consumer,” he says. “We are looking to apply this for something good.”
There are concerns, however, about the intrusive nature of this data capture. Some worry, for instance, that it will have a negative impact of patient-Doctor relationships. “If the physician already has the information, the relationship changes from an exchange of information to a potential inquisition about behavior,” says Ryan Holmes, assistant director of health care ethics at the Markkula Center for Applied Ethics at Santa Clara University.
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As we’ve previously reported, it’s in US hospital’s best interests to take a proactive approach. Under Obamacare, there’s a stick-and-carrot system in place for readmissions. Curb the readmission rate, gain financial incentives; continue to let it soar, and payment for treatment will be removed. Thus taking a data-driven approach can save money as well as saving lives.
Obamacare also prevents insurers from denying coverage because of preexisting conditions or charging patients based on their health status- meaning this data cannot be used for nefarious purposes by insurers. Robert Booz, a Gartner analyst, explains how this has changed the game: “The traditional rating and underwriting has gone away with health-care reform. What they are trying to do is proactive care management, where we know you are a patient at risk for diabetes, so even before the symptoms show up we are going to try to intervene.”