The Future of Health Information Technology

Big data is a broad term for data sets so large or complex that traditional data processing applications are inadequate. Big data is building systems with billions of data points and the analytic tools to use its repository to improve health. In health care, Microsoft’s HealthVault and the data repository for Qualcomm Life are examples of sources and uses of big data. More recently, the Patient-Centered Outcomes Research Institute (PCORI) proposed an ambitious plan for medical use of big data.1 Currently, big data projects are patient-centric without reporting across the entire population. The larger systems have structured data, such as vital signs and lab values. They can also use unstructured data, such as a progress note. Using natural language processing, applications can read texts and extract information without discrete fields. Big data requires high-powered computing to make sense out of data with background interference. An example is performing a post-marketing surveillance of medications used by millions of people to discover side effects that smaller data sets do not have the power to detect.

As we focus on population management, new tools are needed to provide an overall view of a patient’s care throughout his or her life. New products and approaches have been created that integrate clinical and billing data to provide a holistic picture of the services a patient has received. The ability to see lab reports, admissions data, and procedures from health care professionals outside of a patient's immediate health system is possible when billing data are used. When integrated with clinical data from an electronic health record, a picture emerges that allows health care practices to identify which patients are healthy, at risk, and ill, as well as to identify, with increasing accuracy, which patients still need to receive preventive services, such as mammograms and colonoscopies. Finally, patients who are high-frequency users of health care services can be identified and more proactively case-managed in an effort to improve outcomes and reduce cost.