Moving To The Open Health-Care Graph

Fred Trotter | O'Reilly Strata | June 4, 2013

A network graph approach to modeling the health-care system.

To achieve the the triple aim in healthcare (better, cheaper, and safer), we are going to need intensive monitoring and measurement of specific doctors, hospitals, labs and countless other clinical professionals and clinical organizations. We need specific data and specific doctors.

In 1979 a Federal judge in Florida sided with the AMA to prevent these kinds of provider-specific data sets violated doctor privacy. Last Friday, a different Florida judge reversed the 1979 injunction, allowing provider identified data to be released from CMS under FOIA requests. Even without this tremendous victory for the Wall Street Journal, there was already a shift away from aggregation studies in healthcare towards using Big Data methods on specific doctors to improve healthcare. This critical shift will allow us to determine which doctors are doing the best job, and which are doing the worst. We can target struggling doctors to help improve care, and we can also target the best doctors, so that we can learn new best practices in healthcare.

Evidence-based medicine must be targeted to handle specific clinical contexts. The only really open questions to decide are “how much data should we relese” and “should this be done in secret or in the open.” I submit that the targeting should be done at the individual and team level, and that this must be an open process. [...]