It’s high time for change — and health care data is paving the way
By Nate Freese, Director of Analytics, Grand Rounds
The story of how I came to Grand Rounds began four years ago, when, at the age of 27, a simple morning run ended in the emergency room after I experienced multiple strokes.
Unable to walk, and faced with the controversial decision over whether to undergo heart surgery at such a young age, I began wading into the health care system morass. The first physician I saw assured me that I should definitely get the surgery; the second recommended, with equal confidence that I should not. The more I researched the question on my own, the more confusing and difficult the decision became.
In this regard, my situation could not have been more commonplace. Medicine rarely yields clear, easy answers, no matter how much we, as patients, tend to crave them.
Where my situation differs from the norm is how I was able to respond to it. Unlike most patients, I was a “medical insider,” having worked for years in health care consulting. Rather than making a gut call and hoping for the best, I sought out the top experts in the country. Drawing on my industry experience, I profiled leading physicians around the country, communicated with several electronically, and ultimately flew to Boston to meet with a team of researchers focused specifically on the question I faced.
I chose to forgo surgery, which may or may not have been the right choice. But I can at least say with confidence that my decision was made with the absolute best knowledge available, which is something that too few patients can say.
The medical community offers physicians with remarkable skills and expertise. What it does not provide is a standard, objective means of guiding patients to the particular physician, whether local or afar, who is best suited to the patient’s situation. This is where open health data can help, and connections like this are what’s being discussed at this year’s Health Datapalooza.
From personal to proactive
Today, I lead the data science team at Grand Rounds, a company that aims to fill this gap by connecting patients with physicians most qualified to address their specific needs. My team is responsible for a matching algorithm that evaluates billions of clinical data points from more than 150 million patients to determine which physician is most appropriate for each individual patient who comes to us.
We have access to far more provider-level data than existed even five years ago, and to work with that data, we’ve built a world-class team of mathematicians and scientific researchers. We’re using health data to connect patients to connect to the right provider.
Given a set of symptoms, we can tell you which physicians in your area are most likely to make the correct diagnosis. We can tell you which ones are most likely to recommend the appropriate treatment, and which ones will provide care in a clear, accessible manner that answers the questions you, as a patient, are likely to have.
Real world application
James* came to the attention of Grand Rounds after being set adrift through the health care system several years before. James started to notice it was difficult for him to stand for long periods at work, over several months, he had increasing numbness in his hands and feet and eventually, was unable to drive due to muscle weakness. Then he suddenly collapsed on Christmas Eve while celebrating with his three daughters. His eldest daughter rushed him to the emergency room where doctors believed he may have experienced a stroke. However, a barrage of tests showed negative results.
Over the course of two years, James saw multiple physicians and tried various treatments to address his gradual loss of muscle and increasing weakness, but nothing was successful. He collapsed again and was rushed to the emergency room for a second time. This time, test results suggested he was experiencing chronic inflammatory demyelinating polyneuropathy (CIPD), a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. His doctors prescribed steroids and an IVIG therapy to be taken every 14 days.
James, like most of us, was unclear on not only the best path, but the ultimate destination best suited to his health care goals. At the time, his employee health navigator service was collaborating with Grand Rounds and together we identified him as someone whose case needed special attention. We worked with him to initiate a case to get a second opinion from an expert.
Grand Rounds then connected James with Dr. Nicholas Silvestri, the director of the adult neurology program at University of Buffalo School of Medicine, a leading expert on the symptoms James had reported. He confirmed James’ condition was indeed CIPD and suggested two alternative medications that could help reduce the frequency of his IVIG treatments and the prednisone he was taking. The new treatment plan, coincidentally, would also mean saving nearly $300,000 in health care costs.
What can we achieve next?
When I joined Grand Rounds, I saw an opportunity to have an impact on lessening the divide that separates the “medical insiders” from the rest of the population. I wanted to help other patients choose their doctors based on the same level of information that I had access to myself.
In a few short years, we’ve achieved countless results just like James’ and have seen life-changing care that previously may not have been possible. But this is just the beginning — every patient deserves to know who the right doctor is for them and to receive the best possible treatment, from the very start of their care journey onward.
The health care landscape is changing rapidly; many innovative opportunities are being discussed right here at this year’s Health Datapalooza. We’ve got a long way to go but it’s exciting to witness our country’s health care leaders and influencers congregating in one place to address one of our most pressing challenges — how to improve our nation’s health care system.
*Names have been changed
