Computerization In Health Care Demands High Data Standards

Thomas C. Redman and Donald Nielsen | Harvard Business Review | February 25, 2013

Recent reports bookend the promise and peril of computerization and the electronic medical record in health care. On the truly positive side, the Mayo Clinic and UnitedHealth Group have teamed up to form Optum Labs, a research group aimed at mining (initially) claims records for over 100 million people and 5 million clinical records. The lab underscores the hope and promise that focused data analytics can help improve day-to-day care, better estimate true costs, and contribute to the next generation of research. To illustrate, a study found a previously unsuspected interaction between Paxil and Pravastin, causing elevated blood sugar levels and the incumbent risks of hyperglycemia, particularly for diabetics. Researchers were able to combine Stanford, Vanderbilt, and Harvard databases to find 130 patients taking both drugs — enough to confirm the interaction. Part of the promise of computerization involves thousands of such discoveries.

But the other bookend is the peril, particularly as it relates to the electronic medical record. So far, the effort has yielded mixed results. A recent study shows little evidence that any of the projected $81B annual savings has resulted. Indeed, it appears that electronic records have made it easier to bill for more services, increasing costs for insurers and patients alike.

While we wholeheartedly believe in the promise, results to date do not surprise us. Automating poorly performing processes, in any industry, never yields good results. To paraphrase the great Dr. W. Edwards Deming, "automating a process that produces junk just allows you to produce more junk faster."...