Data and Medicine

Medicine is often accused of being slow to respond to changes in society and technology. While this is not universally true, it is probably fair to say that models of care have not evolved substantially over the last 100 years. Regardless, the environment in which we practice continues to evolve, driven by increasing access to information and data, and changing consumer and payer expectations and behaviour.

The easy accessibility of information and reviews has changed the way we, as consumers, make choices regarding our purchases and how we shop. We can research potential acquisitions prior to purchase, rating them on a multitude of criteria we select based on available information ranging from technical specifications to user reviews and price. We can then choose where to purchase a product ranging from traditional bricks and mortar shops to online outlets.

So how does this look in the world of healthcare?

Patients are able to review medical practitioners on doctor ratings websites, such as Whitecoat and Healthshare, as well as through the review mechanism on Google. The Commonwealth has also proposed the development of a website on medical fees to help patients gauge potential out-of-pocket costs for common services. The move has been followed by Medibank, which recently announced it would be providing specific information about potential out-of-pocket costs doctors charge for common procedures. Its ‘Find a Provider’ website already provides information on how often a specialist charges and out-of-pocket costs by percentage of claims.

We know private health insurers have extensive data available to them. As a general practitioner, my clinical software allows me to not only view the contact details of a referred specialist, but also details such as the number and percentage of patients who have been billed under a no or known gap arrangement with a specific private health insurer. I have patients who have refused to see a particular specialist after looking up his/her review online.

While there can be debate on the validity of available data, it is clear that it is out there, and it is being used. It is also clear that what is currently available may not provide the best basis on which to make decisions. Google reviews are based on anecdotal patient experience. While they may help consumers learn whether the practice has good parking, or the doctor is a good listener – they do little to provide objective evidence about the quality of care being provided by the practitioner.

This is our challenge.

Alongside consumer reviews and demand for transparency around fees, we are increasingly seeing a push for transparency around outcomes.

In general practice, the Quality Improvement payment of the Practice Incentive Program will now require the uploading of deidentified clinical data on a range of measures such as completeness of data, recorded rates of influenza immunisation and patients with diabetes who have had their HbA1c recorded.

The data is out there. But how will it get used and who will control how the information is contextualised and presented to the public?

Data and digital disruption is part of the world we live in. Our challenge as professionals, and as an association, is how we manage this.

If we don’t, other organisations – such as private health insurers – will step in to fill that void. We need to take ownership of this space, with a mature and balanced approach to data and transparency.