Sunday, November 11, 2012

The US Election - Some Interesting Aspects Related To E-Health and Big Data.

As most readers will now be aware President Barack Obama has found himself with a second four year term that starts January 20, 2013.
First a couple of reports on what the re-election is thought to have on Health IT in the US. First we have:

How Health IT Benefits From Obama's Re-election

The fed's health IT incentive program will continue, along with related programs, but one prominent analyst suggests the biggest threat to the EHR incentive program now is the 'fiscal cliff.'
By Ken Terry,  InformationWeek
November 08, 2012
The day after President Obama was re-elected and Democrats held onto control of the U.S. Senate, the future looked bright to folks in the health IT field.
The election outcome suggested that attacks on the government's electronic health record incentive program by Congressional Republicans may lose steam or disappear altogether. Coincidentally, the Health IT Policy Committee met on Oct. 7 to discuss a draft of its Meaningful Use Stage 3 recommendations. AdTech Ad
Robin Raiford, research director for the Meaningful Use practice of the Advisory Board Co., a healthcare consulting firm, listened in on the committee meeting, which was chaired by Farzad Mostashari, national coordinator of health IT. The tenor of the discussion, she told Information Week Healthcare, was that the committee would "move forward and finish the work that's been started."
Raiford was elated. "Like many other people working in this space, I hoped that the momentum would not stop. So it was a great relief to know it would continue on."
Even before the election, she said, she hadn't expected abrupt changes in federal support for health IT, no matter who won. One reason for this stability, she noted, is that the HITECH Act authorizing the EHR incentive program -- part of the American Recovery and Reinvestment Act -- can't be changed or repealed by executive order.
For the same reason, Congressional critics of the incentive program, which to date has disbursed about $7.7 billion, can't force the Department of Health and Human Services to suspend the payments unless they can muster enough political support to repeal the law. That could have happened only if there had been a Republican sweep of Congress and the White House.
Second we have the following from the Head of the Office of the National Co-ordinator for Health IT.

Mostashari: Obama re-election points to critical role of data

By Mary Mosquera
Farzad Mostashari, MD, the national health IT coordinator, said that data and analytics played a critical role in the campaign and re-election of President Barack Obama – mirroring the growing importance of data in healthcare.  
Data and analytics have transformed marketing, campaigning, and even baseball. “How is it possible for us to imagine a world where that power of data is not brought to bear on life and death, clinical care, on population health, and affirming the path that we are on with health IT and bringing data to life?” Mostashari said in comments about his thoughts the morning after the election at the Nov. 7 meeting of the federal advisory Health IT Policy Committee.
During the campaign, the analysis of surveys, polls and computer models drew considerable discussion about whether they were going to bear out their findings and be accurate, or not.
 “It was something of a relief that data matters, that science matters, that predictions can be based on evidence,” he said, adding that there was also “relief in seeing a truce in data.”
“We sometimes see this in our corner of the world, where the preponderance of the evidence, the 92 percent of studies, can be positive and show benefits, but if there is uncertainty and differences,” others can play up a narrative of opposing realities, Mostashari said.
 Lots more here:
So broadly we will see four more years of investments, incentives and innovation in health IT and we will see the US Meaningful Use of Health IT program continue to drive adoption and use of EHRs.
The other point that was made by Dr Mostashari regarding the importance of data is also very interesting.
It is now emerging that the Obama team used an amazing amount of technology - most especially data mining - to create a database of potential voters by demographic and then used this database in the same way as marketing companies and Google use the information to serve each demographic with information they wanted to hear. Car workers were told how the car industry had been saved, young women were told about Obama’s view on abortion and gay marriage etc. etc.
In the end the election was not even really close with the electoral college being won (which is what matters) by a good 60+ out of a total of 538 votes (332/206).
In essence ‘big data’ techniques allowed the Obama team to work out where their strengths were (from polling data etc.), message them and then get them out to vote. In this way they better exploited each of the minorities (blacks, Hispanics, Asians, young women etc.) and interestingly while polls missed it most modellers and betting markets saw Obama as a winner long before the day.
You can be the Australian political parties will all be planning to use their citizen data-bases - which are exempt from the Privacy Act - to try and replicate what Obama achieved.
Last technology point is that the Republican’s ORCA system - designed to help get the vote out - had not been properly tested and failed on election day! There is a lesson there I reckon.
Bottom line is all this is that these ‘big data’ tools can really work and can really make a difference. We have only seen the beginning of the use of this technology in Health I suspect.

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