BIG DATA AND THE HEALTHCARE REVOLUTION

FORD+SSPG 2014

2020 Decision Context Canada and US last in public sector data

analytics Healthcare costs increasing, but not performance Changing demographics Changes to healthcare in U.S. and Canada Privacy concerns Technology is improving and advancing

How can big data improve quality, cost effectiveness, and equity in healthcare delivery?

Option 1: Mobile Health Initiatives

Utilize new mobile devices, apps, and technology to significantly increase information on individual choices and behaviors, permitting more effective, cost-efficient and equitable healthcare services.

Projected Outcome: More individual-level data available at low-cost to create healthier neighborhoods and communities, with wide-reaching social welfare benefits.

Key Considerations: Lowest cost option (it’s an app!) Puts responsibility and accountability on individuals Incentives, such as tax credits, to increase use of devices Ensuring quality data that can be utilized to understand users’ health to

increase preventative care and information on chronic illness (diabetes, etc.), thereby reducing number and length of costly visits

Individuals choose with whom to share information (HMO, doctors, etc.), addressing privacy concerns

Ensure privacy via biometric data and tech Short, medium, and long-term benefits

Option 2: Capacity Development

Increase government, industry and citizen capacity and awareness of existing big data initiatives in order to improve healthcare equality, cost effectiveness and equity.

Projected Outcomes: development of infrastructure, increased government knowledge of data analytics and opportunities, engaged and informed citizenry

Key Considerations: Long-term planning; lack of an immediate response (5-year

rollout) Ongoing evaluation to ensure flexibility Allows sufficient time for information gathering, consultation and

planning Coordinating and aligning contrasting stakeholder interests Intergovernmental oversight, responsibility and accountability Mid-level cost option

Option 3: Horizontal Integration

Leverage Electronic Health Records to inform clinical decisions and service delivery.

Projected Outcome: More targeted interventions; improved health outcomes and lower costs.

Key Considerations: Competitively-chosen private contractors with federal agency

oversight to build and maintain infrastructure for big data analytics

Strong government oversight over privacy, management and control

Investment in data management needed Data is anonymized and aggregated; patients must give consent

for data to be used Machine learning and large datasets can help recommend

treatments based on individual or social characteristics, and change service delivery

Complete overhaul of databases and a review every 5 years Most costly of all the options

Horizontal Integration Risk Assessment

Risk- Privacy

- Insufficient technology to sustain big data collection and analysis

- High cost and resource intensive

- Lack of consensus regarding data-gathering priorities

- Lack of compliance on behalf of health care institutions and providers

- Insufficient resources to analyze data

Mitigation Strategy Development of a long-term data privacy

strategy, compliance with existing privacy laws, strong government oversight and control.

Partnerships with private sector to incentivize innovation in health care data collection and analytics

Build on existing data collection systems and health networks, leverage existing knowledge base

Extensive consultation with health providers, health institutions, advocacy groups and citizens

Enforcement through legislation and incentives

Intergovernmental partnerships to leverage resources and identify key research priorities (and M.P.P.s!)

Next Steps

Phased Adoption: build capacity toward horizontal integration (#3)

Assess existing initiatives and best practices (including foreign government provisions)

Launch pilot programs Begin citizen engagement and awareness

campaigns The impact of these policy recommendations

will increase international competitiveness and reduce economic inequality in the long-term