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Tag: healthcare costs

The Luxury of Less

by: Katherine S Rowell author of “The Best Boring Book Ever of Select Healthcare Classification Systems and Databases” available now!

Originally posted here

I often find myself torn between wanting to get as much useful information as possible onto a single page of the reports and dashboards we design and build, and my love of white space, or “The Luxury of Less.” In a page lay-out, white space (also called “negative space”) is the portion of a page deliberately left unmarked. When well chosen and placed, it is a key contributor to attractive, effective design. Done poorly, it can make a page appear incomplete or even pretentiously minimal.

Consider the following example of the potential power of white space, illustrated by Edward Tufte’s redesign of a table of cancer survival statistics.

Original Table:

Source: Hermann Brenner, "Long-term survival rates of cancer patient[s] achieved by the end of the 20th century; a period analysis," The Lancet, 360 (October 12, 2002), 1131-1135.

Tufte First Iteration Table Redesign:

Source: Edward Tufte

Second Table-Graph Iteration:

Source: Edward Tufte

The original table, which is similar to the ones we are accustomed to seeing in scientific publications, is ordered by body system and is perfectly adequate for the look-up and comparison of values, including details about the Standard Error (SE) of each value-that is, it serves its purpose. But could it be improved?

Tufte’s first redesign highlights a particular (and newly featured) aspect of the data: five-year survival rates by type of cancer. Notice how each row in this re-done table has a bit more white space: heavy black lines framing the titles and column-headings, and parentheses around the standard errors, have been removed, giving some visual respite and making the figures more legible. The re-categorization of the data also makes a trend it illustrates somewhat easier to spot (take a minute to look at the information in the first column and follow it across; you’ll see it). The entire table looks and feels cleaner, and especially for research publications that require reporting and display of all relevant statistics, this table redesign works very well.

The third table-graphic-a hybrid of the two forms-provides yet another view, and a different data-visualization lesson. It presents the viewer with a clear picture of survival time gradients, illustrating the slope of survival rates for each type of cancer. In this last table-graphic, there is an even greater use of white space, and every visual element contributes directly to understanding-simply, elegantly, clearly. The use of space coupled with a line to show the slope of change leaves no doubt about the story in the data.

Although I see no compelling reason why a view like this couldn’t be used in a research publication (adding back in the standard errors), this is of course wishful thinking on my part: it simply won’t happen any time soon. What isn’t wishful thinking, however, is that we have immediate opportunities to use these techniques to build the tables and other displays we create for our clients, supervisors, and colleagues. We can most certainly use them to simplify and clarify information for patients and the general public, too.

Bottom line? Tufte reminds us yet again of the power of simplicity, and that showing less often reveals so much more.

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How Predictive Analytics Can Improve Healthcare

The below is the winning essay for a Brandeis GPS’ contest written by Health and Medical Informatics student, Davis Graham. Join Brandeis GPS is a free webinar 7/17 at 7pm: Long Term CareThe Last EMRFrontier

 

“My specific interest in predictive analytics is the ability to merge the once vacant silos of health information into a model which engages a person into the maintenance of a healthier lifestyle.[1]  Genomics and health information technology has the potential to help predict disease before it becomes chronic.  Predictive analytics will allow us to change from a treatment oriented to a preventive oriented healthcare system contributing to the efficiency of healthcare.

Predictive analytics gives the foundation for an individual to step onto a healthier path in life when substantial knowledge supports the first step.  There is a survival instinct which takes place in every individual when faced with the loss of health or life, giving them a fearlessness to assume responsibility to preserve their health and life.

The key element of a healthier population is engagement and implementation of a program which improves health.  For example, if a person has knowledge from predictive analytics showing they would have a 98% probability of being a candidate for colorectal cancer, then the barriers of fear currently existing in our current health care system would program-hero-strategic-analyticsinspire the patient to seek preventive care.  No one should die of colorectal cancer in this country or in the world.  Getting the patient to have a CT Colonography (CTC) would decrease the mortality rate for colorectal cancer substantially.  The cost of a CTC due to just the volume would decrease into the $250 range.  The current cost at our facility is $495; it costs us $200 to have the CTC read through teleradiology by a radiologist who reads these studies frequently.  Predictive analytics could change the whole landscape of CTC cost by pure volume.  Radiologists who are not reading CT Colonography (CTC) now would learn how to read them and would become experienced because of the increase in volume.

It is my hope that predictive analytics is steering healthcare back to the “doctor-patient relationship” of a patient driven healthcare.[2]  It is my belief that patient driven healthcare is the most efficient and effective way of providing health to a population.  With the aid of predictive analytics, the robust information gained from predictive analytics data will enable a society to engage in healthcare, which would educate the population with Stethoscopeknowledge as to how to predict their health outcomes.  Thus, the future patient population would embrace preventive health.  With patients engaged in their health, predictive analytics could reverse the current wasteful trend of 80% of healthcare expenditures being spent on 20% of the population, to one that is healthier for the economics of a country and a population.[3]  I could see in the future where 70% of the healthcare dollars is spent on 100% of the population with the remaining 30% going to research and development in healthcare and predictive analytics.

Predictive analytics would reverse the 20 to 30% of profits now going to health insurance companies into increased health dollars invested into healthcare.  A great example is William McGuire from United Health Care who earned $1.2 billion in one year.  This should be a light to the world that the $1.2 billion which William McGuire made did not go back into the healthcare system;[4]  it went into his pocket to spend and donate where his personal interests lay.  To put it in perspective, $1.2 billion could open 925 doctors’ offices each being 7,000 square foot for a cost of $1,297,400 each[5] or 4.8 million CTCs reimbursed at $250 each.

A key component to predictive analytics is the unbridled sharing of information. With quantum cryptography and the recent efforts of quantum computer (such as D-Wave), we are on the edge for sharing and processing healthcare’s “big data.” Predictive analytics in how-predictive-analytics-can-make-money-for-social-networks-46ce73d0c0the United States will be a new frontier for all health information which is electronically collected around the world. With predictive analytics, a combination of pharmaceuticals used to cure a chronic disease in one area of the world will enable population health to take steps in preventive care in advance of the chronic disease in other parts of the world.

In essence, we are embarking on a voyage into a new land of opportunity to process big data to predict solutions into the future. Healthcare is a team effort and aligns with Ernest Shackleton and his eclectic team, all of whom survived the harshest environment of being beset in the Antarctica.  Our healthcare system needs such a team to drive through the storms of economic pressure and the current healthcare system into one which perseveres.  Predictive analytics is the system which will not only benefit the United States, but predictive analytics in healthcare also has the potential to benefit the health of the world in a way healthcare has yet to be seen.”

About the Author: 

photoDavis Graham is currently earning his M.S. in Health and Medical Informatics with Brandeis University, Graduate Professional Studies. Davis is the Executive Director & CFO at the Manatee Diagnostic Center in Florida.  This essay won a contest for free entry into Eric Siegel’s Predictive Analytics World Conference.

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