Fighting Overuse with Predictive Analytics

When is the last time you thought to ask your doctor if a screening or procedure he or she ordered was really necessary? If you're like most people, probably not recently. After all, it's a little uncomfortable questioning the recommendations of someone with years and years of training and experience—someone you likely trust. But it might be time to start breaking the ice.

That's because unnecessary tests and procedures account for a significant portion of our country's wasteful medical spending. The U.S. spends more on healthcare than do 13 other high-income countries, according to The Commonwealth Fund's “U.S. Health Care from a Global Perspective” report, and it is estimated that around 20 percent or more of that is spent on waste.

Fortunately, there are more and more consumer-facing tools that help patients engage in shared decision-making with their doctors. Take Pap smears, for example. If a doctor orders a Pap smear to screen for cervical cancer for a woman under the age of 21, the patient can reference both the U.S. Preventive Services Task Force (which gives the screening for women under 21 a letter grade of 'D') and Choosing Wisely to question if the screening is truly beneficial.

These tools are also needed for more invasive, risky, and costly procedures. In fact, a recent New York Times article highlighted how, when facing certain procedures—like surgery for a torn meniscus, where physical therapy often offers the same results—the onus truly is on the patient to ensure the procedure is “worth it.” Predictive analytics can help get these resources into patients' hands before they make an (unintentionally) uneducated decision.

In addition to wanting to avoid harm, patients are also financially motivated to only get the care they need as they begin to pay a greater share of their healthcare expenses. Using predictive analytics to get the right information to those who will benefit at just the right time can help both patients and payers alike.

Would you feel comfortable asking your doctor about one of his or her recommendations? Would it help if you could reference a source like the U.S. Preventive Services Task Force or Choosing Wisely?