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Welcome to the age of Moneyball Medicine

For several years, the US has grappled with the rising costs of healthcare, while seeing our global rankings, in outcomes like life expectancy and maternal deaths, fall to among the lowest of developed countries. Americans are paying more for healthcare without reaping the benefits. Routinely, newspapers and TV channels report on the newest cancer treatments or technological advances, but there is little discussion about the value of these new drugs or devices or the wide variation in their adoption across providers. For all the data collected on patients and in the industry, little in American healthcare is standardized or optimized, and the value of existing treatments is rarely investigated. And unlike most of our European counterparts, a significant number of Americans are without health insurance, often left on their own to shop for the best quality healthcare at a reasonable cost, but unable to do it. When pricing information can be obtained, there is typically no explanation for the variation seen from doctor to doctor, hospital to hospital.

It’s a lesson in contradictions: the country that arguably has the most advanced technologies in the world, doesn’t use them consistently to fix some of the most basic problems in healthcare. Patients with cancer are generally treated according to where their cancer originates, with little differentiation between patients for treatment, while a few hospitals tout state-of-the-art care based on genetics. Often, it’s only when a drug or device fails to work, that patients start to have their care tailored to their specific disease—a process that delays optimal treatment at a substantial cost system-wide.

Meanwhile, medical centers spend hundreds of millions of dollars to buy electronic health records (EHRs) systems, but patients still can’t easily get copies of their records or share the information between providers. Important information that could impact patient care, such as how active someone is, their environmental exposures to pollutants or carcinogens, even how much food they are eating, is rarely included in their health record—a consequence of a system designed to handle claims and billing, not patient management.

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