Watching from the Wings

 

Do you ever get the feeling that someone is watching you? If not then I applaud you for your ability to compartmentalize, because someone probably is watching you. No, I don’t mean that neighbor that always seems to be outside when you leave to go to work or that white panel van that sits down the street. I am talking about someone watching the digital wake that follows each of us through our lives.

Whether it is by social media posts, online shopping, internet searches or any number of other online activities, we are generating data all the time that is being harvested and analyzed by huge tech firms. The internet giants use this data to provide value to their platforms and ultimately to customize advertising to each individual user in order to make a profit.

Regardless of your stance about internet privacy and the ethics behind mining what is perceived as personal information, there is a bright spot here. This concept of monitoring and using personal data has been pivoted and transformed into something that we can all benefit from. Insurance companies can use the analytic techniques born in the online world to start driving real change in their provider networks. This can help to reduce their overall cost to operate as well as the premiums they charge for their products.

When it comes to your healthcare data all roads lead to your insurance company. Your primary care provider’s office visits, laboratory claims, prescriptions, and durable medical equipment requisitions all pass through your insurance company. These claims send signals to your insurer about the course of treatment your healthcare providers are administering but until very recently those signals were largely recorded but ignored. Traditionally doctors and other providers would often use one of two methods to prescribe treatment. One was to start with a generic treatment and progressively change that treatment until it became targeted and highly effective for each patient. The other method would be to have a patient go through a barrage of tests to see what, if any, indicators of different conditions would come back in order to then design a specific and effective course of treatment. On paper neither of these seems to be very efficient but, in the end, patients got the treatment they need despite the often times burdensome cost.

I want to be clear that there is nothing implicitly wrong with either of these treatment methods as they can both provide effective care in the long run. That does not mean that there isn’t room for improvement. A bicycle can take me to work every day but a bicycle with a motor can get me there faster and with less effort. Enter modern high-performance and cloud computing services, and a completely new way of administering care comes to light. This would not come without some sacrifice on your part. You would have to let your insurance company keep records of your health information, the care you have received, and the outcomes of your treatment. Would you be comfortable with that?

Imagine, however, you are diagnosed with a relatively common condition. It is nothing overtly serious mind you but will require significant treatment to control. Now, what if your insurance provider has information on thousands of people that have similar symptoms, health history, and are undergoing treatment now? What if your providers could leverage that information to tailor a treatment to you that could not only provide the most effective care, but that ended up saving you and your insurer a lot of money? Are you still uncomfortable? What if you knew that building and using systems like this could dramatically increase the overall health of the public and at the same time reduce healthcare costs overall? Is it worth it?

  • Disclaimer: This Blog is for educational purposes only as well as to provide general information and a general understanding of the topics discussed.  The Blog should not be used as a substitute for legal advice and you are advised to seek additional information from your insurance carriers, Medicare and/or Medicaid agencies for additional criteria and regulations regarding these services.

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