How Much Data is Too Much?

I dare say that U.S. health care has possibly reached a tipping point where the obsession with data points, measurements, and outcomes is pushing physicians over the edge. At the very least, we haven’t yet seen the promised payback on all the investment we have made in electronic data collection. At worst, we have believed we can achieve health care nirvana by sending all our patients’ data up to the giant health information vacuum in the sky.
 
The proposition is that we might win the population health war by doing all this. In the meantime what we know is that any community health advancements have come at the expense of the soldiers of medicine who are bearing the multi-varied cost of collecting data on the frontline: emotionally, mentally and physically. Those who are financially secure enough or close enough to retirement and who don’t want to be conscripted are refusing to play the electronic health record game or taking an early career exit. Those who can't are just plain beat.

The problem with believing in the miracle of data is that it is not convincing enough to motivate change for all of the patients we serve. Fitbits measuring steps or sleep and nutritional statements on soda cans and fast food menus have not been effective in producing a long-lasting and significant change in activity. Pure factual, rationality simply does not motivate most people; we have to stop pretending that it does (or that even more of it will.)
 
Dr. Paul Offit, a Philadelphia pediatrician specializing in immunology, spoke at St. Luke's Grand Rounds this past month on "Communicating Science to the Public," using the autism-vaccine ‘medical controversy’ to illustrate. "I think what works the best is at some level to be emotional," said Offit, when the rational, scientific argument can't overcome the "Oprah Winfrey-fed" reservations. "Frame your argument emotionally, passionately and compassionately. You can tell them, 'Let me love your child. Don't make me send your child out into the world where it's more dangerous. Don't put me in that position.'" 

Unfortunately, as physicians, you know that your actual interaction with patients over the past five years has gone in the toilet. Along with it is much of the joy and effectiveness of connecting with people emotionally while performing your scientific work. Even if you have the best analytics finally coming back through information portals, you are still going to have to have heart-to-heart talks with the people you care for. 

In saying this, I admit that I am neither a doctor nor a scientist and you can assess the value of my perspective accordingly. But I have also learned that doctors want to know “what the literature says.” So here is my challenge: assess the literature of YOUR professional lives and your colleagues. I suspect what you will read is the pendulum has swung too far in the direction of data collection. Now the question remains how will you be a part of pushing back into balance?