“Big Data” generated from electronic medical records holds promises to transform healthcare and benefit patients, but a host of challenges threatens to derail the effort to lower costs, improve quality, and improve health care.
This is according to a report published today by the national health policy institute NEHI.
“Excitement over ‘Big Data’ and Real World Evidence must be tempered,” said Thomas Hubbard, vice president of policy research at NEHI (Network for Excellence in Health Innovation) and principal author of the report.
“Big Data has not eliminated longstanding challenges in standards and methods, nor has it addressed the dilemma of how our health care system can allow for real world demonstration of the value of innovations while controlling costs.
“The promise of Big Data and Real World Evidence is real and exciting, but the excitement needs to be channeled into a very focused effort among all stakeholders – researchers, payers, patient groups and the life sciences industry – to resolve some of these longstanding challenges.”
In Evolving Landscape: Comparative Effectiveness Research, Outcomes Research and Health Care Innovation, NEHI reported that comparative effectiveness research (CER) and patient-centered outcome research (PCOR) – cornerstones of the Affordable Care Act designed to increase quality and reduce costs – hold promise for more effective health care. But, the report notes, there is a daunting list of tasks that stand in the way.
Among those items: data standards and methods for data collection and analysis must be developed, validated, and broadly accepted before they can influence health care decision-making.
“These are not trivial,” Hubbard said. “The great strength of research with patient data is that – when it meets clear and robust standards for analysis – it can yield findings that are especially well targeted to treatment. But routinely collected patient data rarely meets such standards. Making use of existing data will be a huge effort. On top of that, we need new methods of analysis.”
Further, experts agree that “the use of voluminous patient data in creating faster, cheaper, and more precise ways to deliver highly effective care to patients will be extremely limited until we solve these challenges,” Hubbard said.
The NEHI paper serves as a status report on CER, a direct comparison of health care interventions to determine which work best, which was expanded five years ago with an initial $1 billion infusion from Congress. The result of that effort: It’s too early to tell.
“Little if any of the CER research commissioned under the ACA has found its way into clinical findings and practice yet,” Hubbard said. “But this shifting landscape toward patient-centered research creates potential for new, innovative forms of patient care if these challenges can be met.”
NEHI, Thomas Hubbard