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Proxies will have to do

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During a recent planning call for a patient disease management program the discussion turned to metrics. Key to any program design is agreement on what outcomes will be measured and what will be deemed success. It makes no sense to launch a program without developing goals about levels of engagement, target clinical results, and ultimately financial payback.

So far so good, right?

Until we moved beyond vague generalities about impact and tried to identify the actual sources of patient data that would validate the program.

  • “We only get about 10% of the patient lab results we request.”
  • “We attempt to get physicians to attest to patient check-ups in writing, and you know how that goes.”
  • “Legal has deep concerns about merging patient data sources.”

So how then do these brands continue to sell expensive patient programs without validated outcomes?

The default technique is to use proxies. How many opt-ins do we have? Do patients regularly engage with the program? Are they active participants for a longer period of time than they were with the last DM program? If the answer is yes, then we will assume they are healthier. Right.

Just when you would think we would be mining terabytes of data on patient behavior to determine comparative effectiveness of disease management interventions, many of the leading brands who have the resources and data to track results are backing away.

It’s not clear whether the problem is too hard, will take too long to solve, or whether the business owners feel it’s over-engineering.

Let’s hope it’s not that they’re afraid to confront the real clinical results.

It’s time for us to figure out together how to crack this data Gordian knot and give our healthcare leaders and our fellow consumers the insight they need to make better health decisions.

In the meantime, proxies will have to do.

 


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