Unsustainable cost growth, inefficient care coordination, and inoperable data systems are just a few of the challenges healthcare leaders face today.
Tim Suther, senior vice president and general manager of data solutions at Change Healthcare, thinks a better healthcare system is achievable through the effective and responsible use of data and analytics. Here, Mr. Suther answers three questions on why he thinks healthcare is in crisis and the role data plays in fixing it.
(Editor's note: Responses have been lightly edited for clarity and length.)
Question: You hold a view that U.S. healthcare is in crisis. Why do you say that?
Tim Suther: We spend $3.5 trillion on healthcare annually, which by most estimates is about a trillion dollars too high. For that investment, we rank 43rd in the world in life expectancy. There are lots of truly tragic implications to this crisis. Medical expenses are the No. 1 reason why Americans file for bankruptcy. Many people forgo care because it's too expensive. The implications go beyond simple cost. For instance, about half the promising therapies in labs today failed to get sufficient enrollees for trials that might positively affect our loved ones. The money we spend is not paying off.
Q: What is the role of data in helping to fix the problem?
TS: Many of the most pressing problems in healthcare are information-related. Take the fact that about 50% of clinical trials fail to get sufficient enrollees. That is fundamentally an information problem. With the appropriate data, we can ensure care is matched to those who need it. We can help consumers compare costs and experience of providers. We can help all constituents benchmark against the best in the industry.
We can also predict and fill care gaps, and ensure networks are adequate. We can assess outcomes and safety of new drugs. All of these solutions are fundamentally dependent on information. At the end of the day, data has the power to provide insights that can transform U.S. healthcare.
Q: What about "data protection?" How can you unearth critical insights without compromising patient privacy?
TS: We live in a time where suspicion is cast on data. In other industries, the amount of care given to protecting our information is a small fraction of what exists in healthcare. We've all read about Facebook and Cambridge Analytica. We watched the YouTube recommendation-engine steer content in various, sensational ways. It's easy to read about those things and think that must be occurring in the healthcare industry. But the reality is, healthcare has something other industries don't: HIPAA.
Change Healthcare takes a very responsible view to the use of information, especially under HIPAA. Our de-identification process is independently certified as HIPAA compliant. I've worked at companies like JPMorgan Chase and Acxiom, and I know the state of the art when it comes to protecting and using information in a responsible way. The work we've done at Change Healthcare is as good as I've ever seen. Our guiding principle is, we want to ensure the use of information is appropriately permissioned and used to drive improved outcomes and efficiency. The bottom line is our data is among the safest, most valuable and most protected in the industry.