exposures. But where is the consumer
in this change? Are we not supposed to
“drive” better, more efficient healthcare
for us?
Today, that drive is limited to asking
for provider cost transparencies or insurance plan shopping. Apart from the
quantified selfers, most of us are happy
with our annual physical check ups that
cost our health system $8 billion a year
according to a 2012 study analysis [4],
but that does nothing to address serious and expensive illnesses or premature mortality. Few, if any, individuals
use analytic insights to proactively know
what our current or future risk exposure
is or what behavior we should abandon
to prevent higher downstream medical
costs. Needless to say, we are not sophisticated enough to analyze our now
forbidden (by FDA) 23andMe genetic
test report to know our genetic predisposition toward future medical expenses.
A FUTURE OF EMPOWERED
CONSUMER PATIENTS
For the latter, we are yet to have
predictive analytics, which can take our
individual physiological measures and
a myriad of other factors and inform
us what we need to do to avoid out-ofpocket medical costs three to five years
downstream that won’t be covered by
our insurance plan. This brings up an
A NA L Y T I C S
interesting idea of fusing our health insurance information with our physiological data and genetics – not under the
watchful eyes of insurance providers but
for us and only for us. Think of it as our
personal financial risk dashboard using
the powers of predictive analytics! It will
be even better if we are able to tweak
our behavior data and then see the impact in our risk dashboard. That will be
real empowerment for us as consumers.
Rajib Ghosh ([email protected]) is an
independent consultant and business advisor
with 20 years of technology experience in various
industry verticals where he had senior level
management roles in software engineering,
program management, product management
and business and strategy development. Ghosh
spent a decade in the U.S. healthcare industry
as part of a global ecosystem of medical device
manufacturers, medical software companies and
telehealth and telemedicine solution providers.
He’s held senior positions at Hill-Rom, Solta
Medical and Bosch Healthcare. His recent work
interest includes public health and the field of
IT-enabled sustainable healthcare delivery in the
United States as well as emerging nations. Follow
Ghosh on twitter @ghosh_r.
NOTES & REFERENCES
1. Avik Roy, 2010, “Obama Officials In 2010: 93
Million Americans Will Be Unable To Keep Their
Health Plans Under Obamacare,” Forbes.
2. “Income, Poverty and Health Insurance
Coverage in the United States,” 2011,
government publication.
3. Thomas Fisher, 2012