Sunday, October 28, 2012

Please help Fred

@Fredtrotter, health hacktivist extraordinaire, has posted a fascinating project on MedStartr.  Read it and then, if you are moved, please commit some money.  He explains:

This data set, which we got from a carefully formed FOIA request against the Medicare claims database, shows how hospitals, doctors and other organizations work together.  This conglomeration of data set shows everything — from the connections between doctors who refer their patients to each other to any other data collected by state and national databases. It displays real names and and will eventually show every city.

This data set could be the best source of public information about the quality of doctors ever. More importantly, it should help doctors to encourage other doctors to improve their skills — for example, by seeking board certification. This data set will allow patients and administrators to evaluate the health system on both micro and macro scales and give them the tools to take steps towards addressing inefficiencies.

How could it be used?

It is very difficult to fairly evaluate the quality of doctors in this country. Our State Medical Boards only go after the most outrageous doctors. The doctor review websites are generally popularity contests. Doctors with a good bedside manner do well. Doctors without strong social skills can do poorly, even if they are good doctors. It is difficult to evaluate doctors fairly. Using this data set, it should be possible to build software that evaluates doctors by viewing referrals as “votes” for each other.

Our goal is to empower the patient, make the system transparent and accountable, and release this data to the people who can use it to revitalize our health system.

Why does he need some money?

This data set can be made substantially more valuable by merging it with other “openish” data sources on the performance of doctors and hospitals. We want to turn this into the ultimate source for open doctor and hospital data.

Almost every State Medical Board in the US releases a report about the doctors in that state. This usually includes information on the doctors medical school, information about board certification and information on disciplinary actions against the doctor.

All of these state-level data sources believe that it is a appropriate to charge $50 to $1000 for copies of this data. Frequently, the states release data that is not yet linked to the NPI data. Sometimes some data is only available in PDFs etc etc. In short this data is currently available, but it is either messy, confusing and disconnected… or it is organized but expensive.

As a result it is not possible to get a full profile for a particular doctor, as they potentially move between states, without paying for expensive data aggregation services. These services charge as much as $150 to data on a single doctor. At those kinds of prices, there is simply no way that a data scientist can afford to really do any significant work on doctor data.

This crowd funded project will enable us to purchase all of this data from the various public sources that sell it, and then to perform the conversion required to merge this data with the core NPI database. Our calculations indicate that for $15k we can comfortably get the state medical board data from every state in the union.

3 comments:

Barbara Duck said...

Fred does good work, and go back to the days when only a few of us on message boards at EMRupdate talked about medical records and when I was writing code, and he was beating us over the head with Linux, but his time has come:) This would certainly be a step up from the all flawed data that companies like Healthgrades puts out there for sure.

They don't keep up with board data sometimes and don't like me too much since I found my old doctor who had been dead for 8 years still listed as taking new patients at Healthgrades. I still find errors there as well and found another today on a doctor I know who was mentioned in an article in the New York Times:)

Hat's off to Fred if he can get some accurate information out there for sure. I just wrote up Healthgrades again and most of the other services out there are not much better.

I did an interview with the AMA on the dead doctor topic a couple years ago and these data companies blame it on the state boards for not updating their information:) The state boards are part of the problem.


As long as we rely on boards for accurate information we will always have problems I think sadly. Dr. Oz at one of the free clinics couldn't even participate in one of the free clinics as a practicing doctor and had to "consult" as the California board could not get the paperwork done in time to allow MDs from out of state to participate at the free clinic and thus they were short on doctors to volunteer.

A while back a few doctors and myself did an informal comparison and the Medicare base, even though it was not as complete with information was more accurate than the commercial sites like Healthgrades you see, and it too had a few dead doctors in the mix:)

Fred does good work and I look forward to seeing doctors that aren't dead with good bedside manners . If nothing else a doctor could at least be verified by using the Social Security death index:)

Pat Mastors said...

From Facebook:

Great project from Fred Trotter. Thanks for pointing it out. Just backed it and urge those who seek transparency and accountability from physicians to do the same.

Robert said...

I cannot see how this will possibly have any significant impact on the goals outlined by the proponent. Analysis of suspect data will eventually lead to false and potentially damaging data. Collection of data from secondary sources (for example SEER data) is selective and potentially "dirty" . Until we as a nation, providers and payers commit to structured collection of patient blinded data and transparency in the relationships between physicians, health care systems and payers, plans like this are trying to make silk purses out of sows ears.