A recent article in the New York Times discussed the work of a young entrepreneur in the development of a consolidated Medicaid database based in the cloud (see: Medicaid’s Data Gets an Internet-Era Makeover). It reminded me of how much work needs to be done in the development of such critical healthcare databases including those at the hospital level (see: More Hospitals Buy Clinical Data Warehousing Apps). Below is an excerpt from the article:
Jini Kim, a Nuna founder,...working with the federal government, has built a cloud-computing database of the nation’s 74 million Medicaid patients and their treatment. Medicaid, which provides health care to low-income people, is administered state by state. Extracting, cleaning and curating the information from so many disparate and dated computer systems was an extraordinary achievement, health and technology specialists say. This new collection of data could inform the coming debate on Medicaid spending. Andrew M. Slavitt, acting director of the Centers for Medicare and Medicaid Services, described the cloud database as “near historic.” Largely because Medicaid information resides in so many state-level computing silos, Mr. Slavitt explained, “we’ve never had a systemwide view across the program....The data set will be stripped of identifying information before it is released to researchers.
Here's some interesting information about why Medicaid data is so important (see: The Power of Medicaid Data):
In 2014, Medicaid covered ~80 m low-income Americans
Largest insurer in USA (by beneficiaries)
~2.8% of GDP
~50% of all births
~50% of total expenditures on long-term care
~16% of total healthcare spending
It's interesting to me that it took a young entrepreneur, Jini Kim, to hatch and execute the idea to aggregate all of the state-based Medicaid databases. Why had this idea not thought about previously by perhaps someone in the federal government? Kim was a former Google employee and perhaps this project required someone well versed in cloud and database technology. As the NYT article noted, " ...the new cloud-based technology, using internet-era software, is flexible and interactive. It opens the door to real-time monitoring of [Medicaid data such as] emerging disease clusters, billing patterns and program effects. For example, did the percentage of low birth-weight babies decline after a Medicaid program was put in place?"