Presentation Delivered at Meaningful Use of Complex Medical Data / MUCMD on an alternative read on "Big Data" in healthcare. http://mucmd.org

1. It's Not the Size but
What You Do with It:
‘tiny data" and Business Value in a
‘Perverse’ Market
Meaningful Use of Complex Medical Data Joshua Rosenthal, PhD
Children’s Hospital, Los Angeles - 2012

2. Context
Idea
1 %*
Prototype
1 %*
Funded
1 %*
Exit
1 %*
Exit w/
Good Multiple
*Health Care Start Ups
fail at astounding,
disproportionate rates

3. Alternatives
Better Odds (seriously) Default Noble, but hard & < 10 years left
Better Odds (w/ life insurance) Not an Alternative (infra) See “Default”

4. User Guide
Most ‘Successes’, Aren’t
Note: Payer buying Provider

5. User Guide

6. User Guide (ALT)
Consultants / SaaS-based
Professional Services, data / analytic
Providers platforms

7. Hey, what about
Social / Public Good?
You’re always better off if you create market value
(even if you’re a non-profit) MPH?
With finite budgets, non-profits will compete against each other;
need market reinforcement/acceleration
Can go for-profit w/ public/social good
for broader usage/greater impact*
* KickStarter.com gave more $ to the arts last year than the NEA.
Cf. WarbyParker & eyeglasses for Africa
>

8. Context
High Big Data ‘Tiny’ Data?
Biz Value
Start with Biz
? Problem, figure ?
out data / tech
Figure out how
VC / to create value
Accelerator from tech / data
Most:
? Cool Tech
Complex Data
Low
Biz Value Comp Sci. Interests
Hard Easy

9. Health care has not done so well
In this race vs. other verticals
“Just wait ‘till next year Financial Services & Energy!”

10. Lots of Bodies
Health Care, Where Good Ideas Go to Die

11. Lots of failure (DTC*)
*Direct-to-Consumer Note:
People don’t like to pay
out of pocket for something
they don’t like to do or
don’t want to know about

12. Lots of noise & fluff
Speaking at a major health care conference near you

13. Noise
I have better Hmm, ‘fixing the pipes’
engineering / architecture was not the answer

14. Lots Fluff
I have better Hmm, the pretty colors
design & experience on my social app didn’t stop me

15. Lots of ‘false indicators’
My data is bigger than yours Hmm,
this fixation indicates...
Silly boys

16. Lots of market perversities
*
* Source: Dartmouth Atlas for Unwarranted Variation

17. Review
FAIL
Health Care Start Ups
fail at astounding,
disproportionate rates

18. Old Paradigm – Fee for Service
Payers aggregate –
but have not historically been “health care”
“Actually, I make more money
off of bad drivers.”*
(Read w/ accent)
Note:
Medicare $ > Employer $
Employer populations = tougher outcomes (3-year turn)
Cf. Medicare reimbursement rates

19. Old Paradigm – Fee for Service
Hospitals/Providers may generate revenue
by filling rooms
Keep patients away?!?
I was trying to book you for an extra night!

20. Shift: Demographic –> Market
MBA test:
“To stay ahead of the game, the market I should look at is ____________ .”

21. Market Shift = New Profit Paradigm
P4P to incentivize market (including payers)
WRONG – This isn’t the end, it’s just the beginning!*
* Cf.

22. Government is releasing lots of data*
* Expertly captained by

23. Need market to adopt – use to create value
Cf. Weather & Geo-Location data
Thanks, government!

24. ‘tiny data’
The data of the New Profit Paradigm
NEW PROFIT PARADIGM:
Profit generation (vs. cost savings) zero-sum consolidation
Impact across Growth, Performance & Value
Expanding from Medicare to Medicaid & Commercial
Players are incentived (driving M&A for hospitals, populations, medical management, etc.)
-
‘TINY DATA’:

25. ‘tiny data’
The data of the New Profit Paradigm
NEW PROFIT PARADIGM:
-
‘TINY DATA’:
Not Member, Claim, EH/MR, lab, genetic, etc.
Summarized aggregate, contract around NEW P4P (lots public)
Measured at contract, cohort, geography
Across entire spectrum of health care
(Chronic, Wellness, Quality of Care, Customer Service, Customer Satisfaction)
Connections between entities (docs, hospitals, nursing homes) & Crosswalks to disparate data
Relationships & standardization vs. modeling & exploration
Product vs. research/consulting

26. ‘tiny data’
Pros Cons
Fits on a Lose ‘size
thumb drive bragging
rights’
Scale No lone
through ranging /
platform heroics
Creates May have
market value to work
w/ this guy

27. Context
High
Big Data ‘tiny data’
Biz Value
Low
Biz Value
Hard Easy

28. So?

29. Do Good…
It’s easy to do good...
... but you are probably not profitable
If P < EHC x DWS, then 501c3
P: Profit; EHC: Employee Head Count; DWS: Dog Walker’s Salary; 501c3: Non-profit

30. … and Create Value
It’s easy to make money...
... but you are probably doing bad things
“I’ll bill you.”

31. Big
‘tiny’
or
It’s tough to do good & create value in Health Care
So let’s practice
together