State of Health Blog from KQED News » Health IT

Turning Health Data Into Information

Eve Harris — Fri, 22 Jun 2012 17:00:16 +0000

Healthcare is not a science problem; it’s an information problem. Thomas Goetz, TEDMED 2010

Todd Park speaks at the Commonwealth Club in SF. (Photo: gobemore.com)

Bank and airline customers rely on sophisticated systems that allow them to personalize and track complex data. But consumers of the services and products that comprise modern health care – the patients — currently are offered much more rudimentary data handling. Faxed prescriptions, paper medical charts and X-rays on film — though not uncommon — are examples of outdated methods of recording and sharing data.

The forces needed to improve patient information systems are gaining momentum, said Todd Park, US Chief Technology Officer (CTO). Speaking June 18 at The Commonwealth Club in San Francisco, Park acknowledged the movement is in its infancy but said the nation’s healthcare information system is “light years ahead of where it was two years ago.”

Park’s trademark enthusiasm was also evident as he talked about the campaign to provide newly-authorized access to government data to software developers and entrepreneurs. The federal Health Data Initiative seeks to provide Health and Human Services (HHS) data to the public, free and with no strings attached, in effort to trigger the creation of health-related applications.

The campaign has precedent in other government bodies. For example, The Weather Channel exists because National Oceanic and Atmospheric Administration (NOAA) data was made public. Location-based services such as real-time driving directions rely on GPS, a system of satellites also owned by the government.

The HHS effort began in 2010 when the agency published its Open Government plan, which says in part that its “vast stores of data” are:

…a remarkable national resource which can be utilized…to increase awareness of health and human services issues, generate insights into how to improve health and well-being, spark public and private sector innovation and action, and provide the basis for new products and services that can benefit the American people.

Two key elements necessary to turn this public data resource into better health and financial reward are 1) a robust private/public partnership and 2) a rethinking of the traditional roles of doctors and patients, who are increasingly taking greater responsibility for making decisions about their care.

Creative and business partnerships are gaining momentum in spurts of work known as “hackathons” and “datapaloozas,” and in business incubators across the country. Software coders and engineers are collaborating with healthcare providers to unlock the information contained in the data.

To create something useful, designers need to ask the right questions: of the data, of healthcare providers and of the public. Although patients couldn’t previously see it, HHS has collected data about patient satisfaction and safety in US hospitals for years, primarily for hospital administrators to use. HHS also knows that 80 percent of adult Internet users now search online for health information and nearly 90 percent of Americans have a cell phone. Under the new initiative, they asked what the data could mean to patients.

Creating a new purpose and meaning for the data – enabling informed patient choice – led to “Hospital Compare.” The site allows users to easily search for hospitals by zip code and to compare patient satisfaction and safety scores using a familiar interface that works like comparison shopping.

But the biggest driver of change is the private sector, which has enthusiastically taken up the “free the data” challenge. Park estimated that 90 percent of the more than 200 groups who competed at the June Datapalooza were startups. Park raved about the results achieved by some of the coders. The teams with the least healthcare experience tackled some of the toughest public health challenges because “they didn’t understand that some healthcare problems are considered intractable,” Park said with a chuckle. Successful healthcare app designers bring consumers user-experience knowledge: they know how to unlock the potential of the data, he said. After all, “we have a deluge of data, but a paucity of information.”

Eve Harris is a Bay Area writer and patient advocate blogging at www.eveharris.com

Forget the Robots: Venture Capitalists Change Their Health Care Investments

Sarah Varney — Fri, 09 Mar 2012 19:24:03 +0000

Venture capitalists are spurning high-tech surgical robots like this for more practical health care investments. (Nick Dawson:Flickr).

It wasn’t that long ago that money flowed steadily to entrepreneurs who dreamt up whiz-bang medical devices. Hospitals souped up their surgical suites with robots or high-tech radiation machines for cancer treatment. Cost wasn’t an issue: They just got passed along to insurance companies, who passed them on to employers and patients.

But after the Great Recession hit and the 2010 health law passed, the financiers behind the medical arms race started to rethink their investment calculus.

“If you come in with [a device] that’s 10 percent better and twice as expensive, it’s hard to get anyone to care,” said Bryan Roberts, a Palo Alto, Calif.-based venture capitalist at Venrock, a Silicon Valley company that invests in firms working on health services, medical devices and drugs.

“The changes in the health system are rocket fuel for entrepreneurs,” says Roberts’ partner Bob Kocher. He is a former Obama health policy adviser who was hired by Venrock in part to capitalize on the expertise he cultivated working on the law in the White House.

The share of venture dollars flowing to seed and early-stage investments in biotechnology and medical devices has plummeted since 2007, when investors pumped $3.6 billion into 332 deals in which a price was disclosed, according to data compiled for Kaiser Health News by FactSet Research Systems. Overall venture investing declined by nearly one-third as the economic recession set in.

Kocher is eyeing businesses that do things like help hospitals keep patients from returning to the hospital with complications soon after treatment — a big-ticket cost that the health law will now tie to new penalties. Like other investors, he also anticipates that many people who gain coverage under the law will face high insurance deductibles. So, Venrock and other firms have funded Castlight Health, a technology company that helps patients choose the cheapest care.

The opportunities within complex health care ecosystems are in things as mundane as billing. “There’s a half a person per hospital bed on average that sits in the hospital doing coding and collections and trying to get paid,” Kocher says.

Their solution? Drop the manual coding and create “a software system that learns as it codes and keeps getting better and better. And all of a sudden you can say to the hospital, Look, we’ll charge you 50 or 70 percent of what you’re paying now. You guys save 30 percent. But by the way, we can make great margins and make a terrific business because our costs are so much lower, because we’ve actually used technology rather than just people to attack the problem,” Roberts gushes.

On the treatment side, the investors in Silicon Valley understand that hospitals don’t want space-age solutions for tomorrow as much as they want cheap, pragmatic products that can solve basic problems. When it comes to controlling urinary infections, for instance, the future is indeed in plastics. Plastic catheters.

Vicki Farrar started a company called Catheter Connections, based in Salt Lake City. She’s almost evangelical about building a better catheter – one that kills the microbes that cause infection – and it’s not hard to understand why. The infections are totally preventable and Medicare won’t pay for them.

“It’s directly impacting the hospital’s bottom line, so they don’t want this out-of-pocket cost. It’s about $50,000 per infection rate,” she says. Meaning, the hospital loses $50,000 for every catheter-related blood stream infection. The DualCap catheter she sells, which looks like a spark plug and smells of rubbing alcohol, costs less than a dollar.

DualCap investor Anne Degheest figured the catheter was a good business to bet on, because it prevents hospital readmissions. She points to another promising investment: In-room televisions that walk a patient through a doctor’s orders – from bed rest to getting prescriptions filled.

“Like while you’re in the hospital, they educate you on the TV so that you cannot see your shows until you’ve gone through the education, and they test you,” she says.

It’s a bit like not getting dessert until you’ve had your vegetables. Maybe this all sounds incredibly simplistic, but venture capitalists say one of the trickiest things about this new world of investing is that their returns, in many cases, hinge on humans changing their behavior. And that’s a lot harder than building a robot.

–Christopher Weaver contributed to this report.

This story is part of a reporting partnership that includes KQED, and Kaiser Health News.