Big Data and the Healthcare Revolution

1. Big Data and the Healthcare Revolution FORD+SSPG 2014

2. 2020 Decision Context • Canada and US last in public sector data analytics • Healthcare costs increasing, but not performance • Changing demographics • Changes to healthcare in U.S. and Canada • Privacy concerns • Technology is improving and advancing How can big data improve quality, cost effectiveness, and equity in healthcare delivery?

3. Option 1: Mobile Health Initiatives Utilize new mobile devices, apps, and technology to significantly increase information on individual choices and behaviors, permitting more effective, cost-efficient and equitable healthcare services. Projected Outcome: More individual-level data available at low-cost to create healthier neighborhoods and communities, with wide-reaching social welfare benefits. Key Considerations: • Lowest cost option (it’s an app!) • Puts responsibility and accountability on individuals • Incentives, such as tax credits, to increase use of devices • Ensuring quality data that can be utilized to understand users’ health to increase preventative care and information on chronic illness (diabetes, etc.), thereby reducing number and length of costly visits • Individuals choose with whom to share information (HMO, doctors, etc.), addressing privacy concerns • Ensure privacy via biometric data and tech • Short, medium, and long-term benefits

4. Option 2: Capacity Development Increase government, industry and citizen capacity and awareness of existing big data initiatives in order to improve healthcare equality, cost effectiveness and equity. Projected Outcomes: development of infrastructure, increased government knowledge of data analytics and opportunities, engaged and informed citizenry Key Considerations: • Long-term planning; lack of an immediate response (5-year rollout) • Ongoing evaluation to ensure flexibility • Allows sufficient time for information gathering, consultation and planning • Coordinating and aligning contrasting stakeholder interests • Intergovernmental oversight, responsibility and accountability • Mid-level cost option

5. Option 3: Horizontal Integration Leverage Electronic Health Records to inform clinical decisions and service delivery. Projected Outcome: More targeted interventions; improved health outcomes and lower costs. Key Considerations: • Competitively-chosen private contractors with federal agency oversight to build and maintain infrastructure for big data analytics • Strong government oversight over privacy, management and control • Investment in data management needed • Data is anonymized and aggregated; patients must give consent for data to be used • Machine learning and large datasets can help recommend treatments based on individual or social characteristics, and change service delivery • Complete overhaul of databases and a review every 5 years • Most costly of all the options

6. Horizontal Integration Risk Assessment Risk • Privacy • Insufficient technology to sustain big data collection and analysis • High cost and resource intensive • Lack of consensus regarding data-gathering priorities • Lack of compliance on behalf of health care institutions and providers • Insufficient resources to analyze data • Mitigation Strategy • Development of a long-term data privacy strategy, compliance with existing privacy laws, strong government oversight and control. • Partnerships with private sector to incentivize innovation in health care data collection and analytics • Build on existing data collection systems and health networks, leverage existing knowledge base • Extensive consultation with health providers, health institutions, advocacy groups and citizens • Enforcement through legislation and incentives • Intergovernmental partnerships to leverage resources and identify key research priorities (and M.P.P.s!)

7. Next Steps Phased Adoption: build capacity toward horizontal integration (#3) • Assess existing initiatives and best practices (including foreign government provisions) • Launch pilot programs • Begin citizen engagement and awareness campaigns • The impact of these policy recommendations will increase international competitiveness and reduce economic inequality in the long-term