Kaiser Permanente saw value of healthcare data early on. An interview with Dr. John Mattison, chief medical information officer, Kaiser Permanente, Southern California, tells why.
“I’ve waited 20 years for today’s zeitgeist to arrive, bringing together deep learning and artificial intelligence to permit personalized medicine,” says Dr John Mattison, chief medical information officer (CMIO) at Kaiser Permanente, Southern California.
It’s a zeitgeist Dr Mattison has been working toward for decades. One of the biggest and most significant trends he sees in healthcare now is the transition away from a focus on population health (that is, the health outcomes of a group of individuals) and toward personalized medicine and community health: treating the individual not simply as one patient in a superset of patients.
Dr John Mattison
Chief Medical Information Officer
Kaiser Permanente, Southern California.
As a non-profit that has to maximize resources, the large hospital/health insurance chain Kaiser Permanente (Oakland, Calif.) has had a team of data analysts long before there was a national health records system. “We started years ago aggregating many terabytes of data in order to personalize our care. Now health record have amplified that, and we have a very sophisticated team that does natural language processing so we can mine not only discrete data but contextual data, and use that for more personalized care.
“We always had a large database, and using the new mining capabilities and new analytic platforms now available, third party studies show we have a very high level of quality outcomes.
“We could not have arrived here by now without this background work over the years. We have no regrets about our health IT investment and infrastructure built up over the years.”
Along with the transition from patient-centric and consumer-centric to person-centric care, there is growing recognition that personalized medicine is a concept, not a deliverable. That means, among other things, an effort must be made away from ‘doctor’s orders’ and instead providing the patients a choice in their therapies: aggressive, moderate, or very little.
Furthermore there is the recognition that people have lives outside of healthcare. That means the doctor needs to take into account other, non-medical pressures the patient may be facing.
Likewise patients need to realize that so many of their daily actions affect their health. For example, take the stairs and skip the elevator whenever possible. It’s amazing how many daily micro-decisions add up over time to significantly affect health.
“We recognize that there is more to a person than just his or her genome, “says Dr Mattison. “The ‘patient’ is a person who has a life outside of healthcare, making daily decision unrelated to medicine, but which greatly affect his or her health. So we are starting to look at the whole person in a social context.
“For instance, we’re starting to ask, ‘What concerns you most right now? What other matters pre-occupy your thoughts?’
“As you know, compliance is a very big issue today. If someone is pre-occupied with some big issue in his life, he’s liable to forget to take prescribed meds or just refuse to take them at all. When a large percent of prescribed medicine is never taken because people forget, or just don’t care, or get tired of the regimen, the efficacy of the drug is hard to measure on a large scale.”
In other words, if people can see how the medication is helping them to deal with day-to-day issues, they are more likely to remain compliant.