This is what we all dislike about healthcare today, the constant changes as we no sooner adjust to one change and there’s 10 waiting for us. The pace of what is happening in the world of health insurance is becoming more than most can fathom at times. Health insurance companies are fine tuning all their profit lines and that means shifting, changing doctors, changing hospitals. The pace has picked up so much with analytics and subsequent contracts, people are now having problems finding a doctor and a hospital in the same policy at times. I’ve written about that issue a couple of times. A few months ago, I somewhat blatantly stated that Obamacare is a bunch of broken or killer algorithms as they don’t work together.
We have all known what open enrollment is and that puts you in place with an insurance plan that is supposed to cover your for a year, but it’s not working that way with all the constant changes that are happening today. The Affordable Care Model when it was designed has indeed come with a lot of surprises and it depends on IT Infrastructures of health insurance companies to work with the government and we have all read tons of stories where that is not the case and that is what we hate. Anybody in Health IT knows the website will be giving back glitches for some time to come with the way the launch was handled, by novices making the decisions to open it up before it was ready. At this point that is spilled milk to talk about; however the subsequent data issues are not and new glitches will arise every time an algorithm that functions on the site is modified or a new one is added.
Health insurers are now more than every hiring more Quants for analytics, just look at the classifieds sometimes. In addition they have a bit of a data addiction going on with collecting everything and anything they can that gives information about us, for fear they might miss something. I said they are going off a cliff with non relevant data and when we reach the point to where all of this data, cost to process, etc. reaches the point to where there’s no ROI or it costs more to process than the value, perhaps some of this will chill off a little bit.
In addition, we all pretty much know by now about the data selling epidemic that is happening in the US and that supplements the cost of processing data, yes selling our personal data. It’s a monster out there and is adding to accelerated loss of dignity for consumers as well as not allowing for enough privacy. Consumers at some point will totally revolt when the banks and corporations over step their bounds and when their algorithms really become more of a menace than a utility and I think in some area we are there now. I used to be a developer and it’s not hard at all to follow the money and the code and figure out what’s going one as once you’ve been a query monster yourself you know how the addictive process works to try and find some value. The problem is today is that a lot of this is driven beyond the real cost of running a business. Software and analytics is the easiest thing in the world to sell and make a case to the buyer.
It’s only later the buyer see’s what they bought and a lot of it has no ROI. Furthermore this becomes even more exaggerated to somehow look and see if they can find value with use in another fashion or context and then the fun starts with quantitated justifications for things that are not true. More at the link below on that juicy topic and scroll down and watch video #1 in the footer “Context is Everything” and you’ll have a better idea of the madness. Right now with big data everyone thinks they are missing some big pot of gold, and after money, time and expense of working with the data, sure there might be some revelations but it’s the pot of gold or the algorithmic fairies they thought they bought at all.
Below is a really good interview with Quant Cathy O’Neill and if you don’t know what a Quant does, tune in. Keep in mind she goes back to her time at a hedge fund but the same mentality is working at health insurance companies, they forget there are humans attached to those numbers and we are seeing it now in healthcare with this constant shifting, constant variables that we can hardly live with. Some quants have left hedge funds and now work for insurers. Again the big thing to listen to here is the mind set of how they function and think. So next time when all the disruptions come down the tubes from your insurance company, keep in mind this is the mind set of the quants that work there and the models they design. It’s almost a game she says at some point and why shouldn’t we take advantage as we are smarter than you are and the talent is the brain and math power. She’s also writing a new book called “Weapons of Math Destruction” and I don’t know when it will be out but keep that thought.
Again the mindset of people who create these models are almost bliss to the fact that there’s people that have to work and adjust to what they create and sometimes the models are broken and they are pushed on consumers anyway as they mean shareholder profits. She left the business as she felt it was wrong using math models in such a fashion that messes with and depletes retirement funds. We all know what that’s about today too as it’s getting worse with risk. You’ll hear her say they didn’t even want her risk models and went ahead with risky investments anyway.
Another great article from a journalist who sees this as well. Felix Salmon can’t make it any clearer with this quote from his article…so there you go, models that encourage cheating…anyone ever going to ask about the models and code? Probably not, there’s too much verbiage to look at to think about this side that executes everything (grin). He’s telling you the same thing so again this is what’s directing all the action at health insurers today and again they don’t know when to stop.
“Once quants disrupt an industry, they often don’t know when to stop—and they create systems that encourage cheating.”
“On a managerial level, once the quants come into an industry and disrupt it, they often don’t know when to stop. They tend not to have decades of institutional knowledge about the field in which they have found themselves. And once they’re empowered, quants tend to create systems that favor something pretty close to cheating. As soon as managers pick a numerical metric as a way to measure whether they’re achieving their desired outcome, everybody starts maximizing that metric rather than doing the rest of their job—just as Campbell’s law predicts.”
“Campbell’s law: “The more any quantitative social indicator is used for social decision-making,” he wrote, “the more subject it will be to corruption pressures and the more apt it will be to distort and corrupt the social processes it is intended to monitor.”
So this current system is going to break as we are not going to be able to keep up, no matter how much more complex it gets and the Quants will be there looking for small nooks and crannies to help the shareholders profit. All of the overdone analytics in healthcare (outside of genomics and science as that is their business with big data) has made our health system worse. On top of that we don’t even have HHS writing policy anymore, it’s done by the Center for America’s Progression and you’ll find people like Zeke Emanuel who thinks all should die at 75 over there. He was a big contributor to the ACA and is not much more than a walking/talking commercial for United Healthcare.
This is the real reason all the variables are coming at all of us right and left. If you want to learn more about how this occurs, click here and visit the Killer Algorithms page which is full of videos from people smarter than me that will explain. I chose the videos as they are mostly at the layman level so you won’t be overwhelmed but rather better educated on how what runs on servers 24/7 is running everything and as long as we continue to elect people in office who have no data mechanics logic, the insanity of what we are seeing now with Quants at one end and digital illiterates on the side of the government, it’s only going to get worse. BD
Well if it’s not AARP and United wanting cheap code, or even Verizon, they do it too, here’s another opportunity to knock yourselves out and write some cheap code that will benefit Walgreens. If you don’t win, you don’t get anything here either, but if it’s marginal and the Walgreens code department can use it even if you’re not the official winner, maybe they might throw a few dollars at you, who knows.
Walgreen has some other issues going on over there too as they just lost their CFO over some bad accounting algorithms and he’s now suing them and their VC investment head left as well as their VP of Merchandising too.
Just a little side note, Walgreens is also busy suing CVS over some mobile code too, so no wonder they want to line up some cheap code apps here:) Whatever you do, don’t cheat if you get into this contest and use someone else’s code right now. We know they need some more apps to probably collect some more data, preferably on us older folks because we have more of it.
So there you go, one for “cash for cheap code” contest on the board. They keep doing all of these and I wonder when the novelty is going to wear off and when the younger coders are going to demand some decent pay for this? Also don’t forget that Walgreens now is partnering with WebMD to get some more of your data with rewards points next year. You will have to log on to the WebMD page and upload data from widgets and trackers. That sounds like the kind of stuff insurers want to get a hold of. In some Walgreens stores you might have the pharmacist jump over the counter to sign you up for the YMCA or other Untied Healthcare programs as they get pay for performance money from United to do so. BD
The challenge aims to drive healthy behavior through incentives, making it easier and more affordable for patients to manage their conditions, and for doctors and their preferred Walgreens pharmacy to better engage in a patient’s overall health and recovery.
The contest encourages the integration of Walgreens’ Balance Rewards incentive program's application program interface. This will allow users to earn Balance Rewards points for making healthy lifestyle choices. These rewards can be redeemed at participating Walgreens for merchandise, both in-store and online.
Categories and awards in the contest are as follows:
*Walgreens Best Overall App Integration Award ($7,000)
*Henry Ford Health System Patient Engagement Award ($3,000)
*People’s Choice for Best App Integration Award ($3,000)
Third-party app developers can access contest details and submit an integrated app entry by visiting the challenge page through Nov. 28. Winners will be announced during the Walgreens session at the upcoming mHealth Summit in Washington D.C., Dec. 7-11.
I can relate to the bad algorithms after being in the hospital myself with the pain drip machine falling offline and waking me up a lot. Well that’s just my tiny world there but the hospital staff lives and breathes these things every day. So my experience with the device above is only one tiny device compared to what goes off in a hospital. This is a good study and well worth it to get some data on what’s going on. This is not the first time this topic has been brought up either but I think it’s the first time there’s been “real” data to look at to see how bad it can be.
Every time an alarm goes off there’s a purpose to it and with 88% of the Arrhythmia Alarms being false positives, you and I and anyone else would tune them out as you know there’s good odds that it’s a fake alarm and it goes down the list of priorities to attend to, and shut it off.
This study was done at USCF a big hospital and they have a lot of automation all over to include alarms. A while back this video appears in the Boston Globe and it’s worth repeating to watch again.
Is that screech enough to get your attention in the video, hold your ears. The “toxic” alarms of course are the ones that require urgent attention and even the video they talk about the false positives. They spend a lot of time chasing alarms and now we have a number to put to it. Interfacing between devices and information systems is about the biggest problem and there’s more such as broken connectors and so on. With more devices entering medical data, I again think the ONC would be miles ahead to be over at the FDA as EMRs and devices, just due to the way technology is rolling are growing together and that way they would have two points of view from safety and the records portions and I would think we would win there. BD
Their study is in the Oct. 22 issue of PLOS ONE and available online.
The issue of alarm fatigue has become so significant that The Joint Commission, a national organization that accredits hospitals, named it a National Patient Safety Goal. This goal requires hospitals to establish alarm safety as a priority, identify the most important alarms and establish policies to manage alarms by January 2016.
“There have been news stories about patient deaths due to hospital staff silencing cardiac monitor alarms and alerts from federal agencies warning about alarm fatigue,” said senior author Barbara Drew, PhD, RN, David Mortara Distinguished Professor in Physiological Nursing in the School of Nursing at UCSF. “However, there have been little data published on the topic to inform clinicians about what to do about the problem. Our study is the first to shed light on cardiac monitor alarm frequency, accuracy, false alarm causes and strategies to solve this important clinical problem.”
During that time period, a staggering 2,558,760 unique alarms were recorded, many caused by a complex interplay of inappropriate user settings, patients’ conditions and computer algorithm deficiencies. This includes a subset of 1,154,201 arrhythmia alarms, of which 88.8 percent were determined to be false positives caused by the algorithm deficiencies.
When it came to Ebola, there was a lot more policy to be written of course other than just getting rid of a larger cup. Folks like this are are a danger and it goes all the way up to the White House, Obama and Biden, and the email bot that comes out of the White House too. Again, I call it “The Grays” to where folks can tell what’s virtual and what’s the real world and further whether or not to use a “virtual” or “real world solution. Well Ebola is the “real” world so nothing virtual was going to work here. I wrote this post a while back on that topic based on what I have been observing in the world today.
The article here goes on to talk about some of the other focuses that Thomas Frieden had while he worked at the New York City Health Department so he took the easy things that work with PR, transfats, smoking and more, so according to this article this is where his best expertise was. He didn’t do too well with the flu and ignored some requested policy in that area.
So long and short of all of this, well maybe we had one more living in “The Grays” for too long and I’ll tag the Big Gulp campaign right to his tail with pushing Big Gulp and Bloomberg too:) They just didn’t know when to stop shoving a broken model down the throats of consumers. Data Scientists and Quants do get that way with their models and someone once in a while if they get off base has to come in and say “no” as they are not Gods.
Seriously we need to either get these folks to spend more time in the “real” world and drop out of their virtual values when the addiction takes over or can them if it’s that bad. Well I guess when we look at where he came from and where he got his basic training, did politics speak louder than the virus? You decide. BD
As City Journal's Steven Malanga reports, CDC chief Frieden has spent the last decade crafting government policies to attack smoking, transfats, and other dubious "lifestyle diseases" instead of, for instance, focusing on bio terror threats like anthrax and Ebola, or crafting policy to treat heart problems and cancers.
In 2001, only months after the Twin Towers fell in New York and during the same time Americans were on guard against anthrax, Frieden interviewed for the position of New York City Health Commissioner.
In that interview he was asked what his priority would be if he got the job. Instead of worrying about terrorism, bio terror, heart conditions, food borne illness from local restaurants, or cancer, Frieden said that his big priority would be to attack the tobacco companies.
Once he took on the NYC health position, Frieden began to initiate polices that offered increasingly "outrageous solutions to health problems based on few facts," Malanga wrote.
These dubious political campaigns were the soul of Frieden's tenure as NYC Health Commissioner and led to other health policies, such as Mayor Bloomberg's ban on large sodas