4 ms·

Medicine has a data problem. It is multifaceted and far more difficult to fix than it should be. I've worked on these problems for years and it is immensely fru

by gmarx 12y ago

Medicine has a data problem. It is multifaceted and far more difficult to fix than it should be. I've worked on these problems for years and it is immensely frustrating. Incentives just aren't set properly to solve them. For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it.

jpmattia 12y ago
> For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it. It's worse than that: It would be sued out of existence by those people who rank badly (ie, exactly those bad practitioners that need to have their asses kicked.) In a related example: A friend wrote a book about first-hand experience in dealing with a nursing home for her aging parent. There were many instances of problems, but one in particular was that a doc had prescribed the wrong drug. The publisher loved the book, and made the publication offer contingent on a number of changes. One of those changes: You can't implicate a person or his institution because of the liability. It doesn't matter how good your proof is, the jury system is so broken that the publisher just can't accept the risk. Now just imagine if there were a searchable database of outcomes tied to individual practitioners or institutions.
- VikingCoder 12y ago
  You're not going quite far enough - Medical Practitioners and Medical Institutions should be required by law to document outcomes, provide information about disputed outcomes, and update the information on a periodic basis. And tampering with the information should carry heavy punishment, including jail time for the practitioner and officers of the institution. Actions like the recent cover-ups in the VA hospitals about wait times leading to deaths should be nearly impossible to hide from the public eye.
  - gmarx 12y ago
    You'd need to take account of differences in patients lest you discourage doctors from treating the more unhealthy. You also need to alter the way we define and punish malpractice.
zaroth 12y ago
Did not ACA put incentives in place specifically for outcome tracking? I was just talking with a guy at MIT working on post-stroke outcome tracking and automated scoring simply through the myriad of sensors on a high-end smartphone, and he mentioned ACA now or in the future will pin a significant portion of reimbursement on outcome tracking, forming the basis for his business model.
- gmarx 12y ago
  They are intended to. Even if ACA isn't the ultimate form, most healthcare reform involves paying for performance rather than procedures and this implies outcomes tracking of some kind. You've got some serious chicken/egg problems though

by gmarx 12y ago

jpmattia 12y ago

> For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it. It's worse than that: It would be sued out of existence by those people who rank badly (ie, exactly those bad practitioners that need to have their asses kicked.) In a related example: A friend wrote a book about first-hand experience in dealing with a nursing home for her aging parent. There were many instances of problems, but one in particular was that a doc had prescribed the wrong drug. The publisher loved the book, and made the publication offer contingent on a number of changes. One of those changes: You can't implicate a person or his institution because of the liability. It doesn't matter how good your proof is, the jury system is so broken that the publisher just can't accept the risk. Now just imagine if there were a searchable database of outcomes tied to individual practitioners or institutions.

VikingCoder 12y ago
You're not going quite far enough - Medical Practitioners and Medical Institutions should be required by law to document outcomes, provide information about disputed outcomes, and update the information on a periodic basis. And tampering with the information should carry heavy punishment, including jail time for the practitioner and officers of the institution. Actions like the recent cover-ups in the VA hospitals about wait times leading to deaths should be nearly impossible to hide from the public eye.
- gmarx 12y ago
  You'd need to take account of differences in patients lest you discourage doctors from treating the more unhealthy. You also need to alter the way we define and punish malpractice.

zaroth 12y ago

Did not ACA put incentives in place specifically for outcome tracking? I was just talking with a guy at MIT working on post-stroke outcome tracking and automated scoring simply through the myriad of sensors on a high-end smartphone, and he mentioned ACA now or in the future will pin a significant portion of reimbursement on outcome tracking, forming the basis for his business model.

gmarx 12y ago
They are intended to. Even if ACA isn't the ultimate form, most healthcare reform involves paying for performance rather than procedures and this implies outcomes tracking of some kind. You've got some serious chicken/egg problems though