The head of the Texas state agency that funds two major public health-care programs said Tuesday that collecting better data from doctors could save tax dollars.
But Texas Health and Human Services Commissioner Dr. Kyle Janek, a former practicing anesthesiologist and state senator, acknowledged it will be tough to figure out how to keep a fiscal eye on medical spending without interfering in doctors' autonomy to treat patients as they see fit.
"We need to have a frank discussion about the cost of care," Janek said before a Baker Institute panel discussion on technology and health care at Rice University. "It's a painful discussion."
Health and Human Services currently spends $30 billion annually to cover more than 4 million Texans under Medicaid and the Children's Health Insurance Program.
Janek said officials have access only to recipients' medical claims and costs - not diagnoses, the reasons health care providers performed the services for which they charged or whether the treatments were adequate. Insurers and other national, state and local health-care providers also have been looking at ways to make better use of the mountains of data that are collected from patients daily.
"We capture a lot of information on claims," Janek said. "We're not receiving information about care."
Without offering details, he said he envisions technology that could help officials spot trends and identify ways to improve care and reduce costs would cost tens of millions of dollars. The state is in early stages of finding a vendor to develop such a system.
Tuesday's Baker Institute panel discussion also included Dr. Hagop Kantarjian, chairman of the leukemia department at University of Texas M.D. Anderson Cancer Center, and Dr. Lee Newcomer, senior vice president for oncology, genetics and woman's health at UnitedHealthCare.
Dr. Lynda Chin, chairman of M.D. Anderson's genomic medicine department, moderated.
For years, hospitals, doctors and health-care systems have spent billions of dollars to create electronic health records systems to better track patients' medical histories and treatments to create more accurate files, prevent duplication and save money. Large-scale data collection, often referred to as big data, and analysis, plus technology, also could help doctors identify diseases and cures sooner and prolong the lives of patients, no matter where they live, the experts said.
However, the panel agreed doctors still must interact with patients and confirm data they collect before employing it.
"Big data isn't big science," Newcomer said. "It is my biggest nightmare about big data because we constantly see associations in these very big data fields. But association is not a causality. We have to be careful that an association is not a proven fact."
Janek said another challenge is determining who owns the information collected and deciding how it will be interpreted, especially when the collection involves government agencies. He said he fears providers and payers will "bow to the computer," rather than allow doctors to determine the best treatments for their patients.
"These are not obstacles," Janek said. "These are things to be wary of."
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