Have you heard of the term “Big Data”? My guess is that for many orthodontists the term is likely a bit like the term “The Cloud.” They may have a general idea of the concept, but are not entirely sure how it is or will be important to them. In fact, there is a strong relationship between the two terms that I will discuss later in this article. First, however let’s look at “Big Data” by itself. According to Wikipedia “Big data is a blanket term for any collection of data sets so large and complex that it becomes difficult to process using on-hand data management tools or traditional data processing applications.”
In 2009 the United States Congress passed the American Recovery and Reinvestment Act (ARRA) which included the Health Information and Technology for Economic and Clinical Health Act (HITECH). [For a detailed summary of this legislation please see Kirt Simmons blog posting from July 9, 2012 “The Electronic Patient Record: How it Affects the Private Practitioner”]. One of the requirements of HITECH is that full implementation of electronic health records (EHRs) for all patients is required by 2016. The requirements of this act specifically pertain to healthcare providers who participate in the Medicare and Medicaid programs. That means that currently few dentists are covered by this mandate. However, this does not mean that we are not being affected. Since 2009 doctors and hospitals across the country have spent billions of dollars, with the help of government subsidies, converting paper based systems to electronic digitally based health records. These new digital systems are now collecting vast amounts of valuable data related to patient care. Much of this information was collected before the legislation, but in a paper non-standardized format that was not easily aggregated and retrievable for meaningful analysis. The value of all of this collected digital data is only beginning to be fully understood. Big Data from all healthcare providers is being aggregated and programs to analyze the data are being used to improve the quality, safety, and efficiency patient care. Hospitals are examining treatment protocols and doctors are making better informed treatment decisions based on the previous care of thousands of similar patients.
As I stated earlier, the EHR requirement of HITECH does not specifically pertain to most orthodontists so why is this important to us? Many orthodontists have or are now also in the process of converting their practices to paperless systems (without the assistance of the government money). Several of the orthodontic specific software vendors offer cloud based systems and here is where “Big Data” and “The Cloud” come together. The aggregation of data from hundreds or thousands of individual private orthodontic practices into cloud servers is beginning to open the door for data analysis (mining). Just think about how valuable that information can be to our patients and practices. Most of the research studies published in our journals today involve treatment samples of less than one hundred. The biannual Journal of Clinical Orthodontics Practice Study generally relies on the input for a few hundred survey responders (out of a possible pool of more than 8,000). Wouldn’t it be helpful for us to know the most efficient type of Class II corrector based on the actual metrics collected from the previous care of thousands of patients treated in practices all across the country or the globe? Wouldn’t the knowledge that your treatment times/appointments vary significantly from the national or regional averages be useful? There is little question that access to “Big Data” analytics will offer our profession the opportunity to improve treatment quality, safety and efficiency for our patients just as it is beginning to do for the other fields of healthcare.