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ADVANCE Perspectives: Healthcare Information Professionals

Is ‘High-Risk’ a Pandora’s Box?

Published November 25, 2015 8:54 AM by ADVANCE Perspectives

By Tamer Abouras


The brave new frontier of health information has largely been reached. Big Data is continually applied, at least in the rote process of storing medical records digitally, and the consequences of that trend are felt on a routine basis.


There are numerous positives and efficiencies created by this progression, but security is also a constant concern. As has been discussed at length, your health information is vital, valuable and (unfortunately) vulnerable.


Whenever there’s an exploration of the upsides in any industry, however — and especially with regard to technological breakthroughs in healthcare — there’s a kind of blind assumption (no doubt enhanced by effective marketing) that the emerging benefits skew toward consumers. The truth, of course, is a bit murkier than that.


The typical process is that a new product, service or technique sees the light of day and it usually is the consumers who reap the immediate benefits. Then, before you know it, businesses — even those in the healthcare business — catch-up.

SEE ALSO: Leveraging Your Good Data

Which all leads to this news item from Triangle Business Journal, reporting on a Durham, North Carolina based startup called Forecast Health which purportedly can “ … bring better predictive analysis to health care organizations.”


That sounds great. How does Forecast Health do that exactly? According to Triangle Business Journal staff writer, Jason deBruyn, “ … the entire United States healthcare system is moving from volume to value in which physicians are incentivized financially to provide better care at lower costs instead of simply performing a lot of procedures on patients. To achieve this goal, providers have turned to big data in an attempt to better predict the high-risk patients and divert more of their attention where they can see the biggest impact.”


None of that sounds particularly off. And as Forecast Health’s founder and CEO Michael Cousins, said himself, “Much of the existing analytical data available to physicians is run on legacy systems. The accuracy is poor relative to what we can do. As they say, we built a better mousetrap.”


So where’s the disquieting part? deBruyn shares it in the next paragraph.


“Forecast Health builds a patient profile from dozens of information sources outside of what doctors have available to them. It pulls personal information from services like Experian and Equifax, but from more than 100 other companies as well, to put together a full profile that could include credit score data — to predict which patients might have a hard time paying for their medicines — or if a patient lives alone, to predict which patients might have difficulty making follow-up doctor appointments. Forecast Health then builds a patient-risk profile to highlight for physicians the different risk factors of a particular patient.”


“The specific information like a credit score is never shared with the physician, it’s just used by Forecast Health to build a risk profile. The physician sees the profile right alongside the patient’s record on an electronic medical record system, which all major health systems now use, so the physician sees it immediately.”


Look, no one is saying it’s not irritating when patients don’t show up for appointments. And there is definitely a better way of allocating precious physician time and resources, with analytics playing a major role in figuring that out.


On the other hand, these “risk factors” seem to be a bit of a breach of ethics. For one thing, thanks to HIPAA, none of these factors are actually directly related to a patient’s health. And what would the implications of using Forecast Health’s profiles as intended be, exactly? Would physicians pay less attention to high-risk patients? Would they charge more or push costs onto allegedly risky patients? The big takeaway is that it probably would not be something you’d want your doctor getting into.


Although the initial reaction from physicians has been reportedly “cool,” Forecast Health already has a partnership with UNC Health Care. Worst case scenario: those patients start being treated like Elaine Benes in Seinfeld’s infamous “chart” episode.


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About this Blog

    ADVANCE Editorial Staff
    Occupation: Editor
    Setting: ADVANCE for Healthcare Information Professionals
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