Most people are familiar in some form with Wittgenstein’s Rabbit, a drawing where the image can be seen as both a duck or a rabbit with a shift in perspective.
We may need to start thinking of healthcare in this way because I contend that with the centrality of the EHR within the healthcare system, healthcare is no longer just a service industry, but a data industry.
Now, I believe most physicians still see the job as serving the best interests of the patient, and I even believe that most healthcare administrators would also say (and believe) the same same thing, but in fact, a patient’s digital data set from the moment they walk through the door to the moment they die (and sometimes even after that) is now the fuel which runs the machine.
With the rare exception of a trauma emergency, a patient can’t be seen without first signing up for an EHR and then immediately being represented by digitalized identifiers and an EHR-friendly patient number.
Next, data about the patient will be placed in search-friendly fields—everything from birthdates to highly personal medical histories—all made available for current and future artificial intelligence data mining harvesting and subsequent processing.
And what happens with this data?
Who can say? No one, because since a patient’s EHR data will remain part of the institution forever (or at least as long as the institution or the future acquirers of that institution exist), it may be used for purposes that have yet to even be considered!
(See my post EHR Ethics: It’s Not About HIPPA for more thoughts on this topic)
Now, hopefully, some of it will be directed to help that particular patient, but it will also be presumptively be used as a part of larger data sets—perhaps help future patients, future business models, future institution initiatives, etc.
Data is the coin of the realm of healthcare, and although a patient engaging a healthcare institution is only seen once in the context of “service”, the data from even that one visit—not dissimilar to actual coins— will be used indefinitely for years in the future.
So, let’s be honest. Healthcare is as much a data industry as it is a service industry—it just depends on your perspective.