MMS Ethics Forum: Big Data Offers Big Promise, But Big Concerns As Well

By Richard P. Gulla

It’s called Big Data. Its creation has spawned new companies and new professions, and it’s rapidly enveloping the health care industry.

The basic idea of Big Data is simple: amassing huge amounts of all kinds of information, analyzing it, and then applying that analysis to achieve the goal of improving health care systems and health care for patients.

Still in its infancy, Big Data’s promise looms large. Yet it arrives not without major ethical concerns.  And those concerns provided the focus for the MMS Ethics Forum, presented by the Committee on Ethics, Grievances, and Professional Standards as part of the Society’s Interim Meeting of its House of Delegates.

While Big Data offers promise, it’s also filled with what the experts call “ethical tensions:” how to use the data; the obstacles that limit the data gathering (such as HIPAA); ownership of the data; privacy laws; consent of its use; and the misuse of data, through discriminatory actions or denials of insurance coverages.

The Forum featured three prominent experts in the field.  Joe Kimura, M.D., M.P.H., Deputy Chief Medical Officer for Atrius Health; Ameet Sarpatwari, J.D., Ph.D., Instructor in Medicine at Harvard Medical School and an Associate Epidemiologist at Brigham and Women’s Hospital; and Kyu Rhee, M.D., M.P.P., Chief Health Officer for IBM.

Each of the expert’s presentations was wide ranging, but here are some highlights:

Ameet Sarpatwari: Big Data is characterized by the ‘five V’s:  Variety, used for disparate purposes; Volume, enormous amounts of information that’s gathered; Velocity, data accumulated at near real-time; and Veracity, determining the validity of the information.

The raw ingredients of Big Data in healthcare are several: insurance claims, electronic health records, wearable sensors, social media, and biological registries. Its uses include systems improvement in care, precision medicine (the new movement to personalized medicine), comparative effectiveness (which drugs, procedures, treatments work better than others), and medication adherence by patients.

Joe Kimura: Big Data at Atrius entails finding the answers to many questions.  What is appropriate or not appropriate in the search for data? How does a physician practice use information to do better? How does the data help us learn? How do we measure things that matter to use?  Above all, the goal is to use the information to make more timely decisions to help patients.

Kyu Rhee: The essence of Big Data at this time is IBM’s Watson, now being used more and more in health care applications.  It is humanly impossible to know all the data you need to know, and the goal of IBM Watson Health is to translate Big Data into Big Insights and Big Solutions.  In compiling data, Watson can read 800 million pages a second, which means the potential of cutting the time from research to practice in medicine is enormous.  But in using such data, physicians must be part of the conversation, and be “at the table” in the decision-making process – vital for the profession and the care of patients.

While the each of the experts shared his unique perspective of Big Data, they all agreed on one principle: that physicians and patients must be at the forefront of Big Data and the goals it can achieve.

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