New York State Commissioner of Health Nirav Shah is the Billy Beane of health care.

Let me explain. 

Billy Beane—the general manager and minority owner of the Oakland Athletics—and made famous in the book Moneyball: The Art of Winning an Unfair Game by Michael Lewis, was made even more famous when Brad Pitt portrayed him in the movie adaptation. (Generally speaking, having Brad Pitt portray you is a good way to get famous.)

For those who aren’t familiar, Moneyball is about how, under Beane’s unconventional leadership, “the Oakland Athletics achieved an amazing winning streak while having the smallest player payroll in Major League Baseball. (Short answer: creative use of data.)” (Thank you, New York Times.)

“Today, Geisinger Health System, one of the nation’s premier health systems, is taking an important step to expand OpenNotes. We hope other systems follow Geisinger’s lead to share doctors’ notes with patients, giving them information they can use to participate more meaningfully in their care." – Steve Downs

This excerpted post by Geisinger CEO Glenn Steele, MD, first appeared in October 2012, when results from the OpenNotes pilot were released. Geisinger was one of three health systems that participated in the study.

…As a health system CEO who also is a doctor, I believe it is an ethical imperative that our patients at Geisinger know everything that we know about them. And, I think it’s a logical imperative that if we can open up our medical visit notes to our patients, we’ll find out what they understand and what they don’t, so we can answer questions and work as partners to chart a path to better health.

Sometimes the best ideas come from unexpected sources – beyond technology, beyond research, beyond clinical trials. Sometimes, the future of health and health care lies somewhere else: in the people who will bring it about.

And sometimes, those people are children.

Originally posted on The Health Care Blog.

A few years ago, Tom Delbanco and Jan Walker pitched us with a simple idea: Patients should routinely be able to see the notes that physicians write about them.  Now it’s true that we all have the legal right to see these notes, but obtaining them is anything but routine. The process involves phone calls, faxes (sic), duplicating fees and all sorts of other demoralizing steps. The net result is that reviewing your doctor’s notes about you is a rare experience.

Tom and Jan said that the physicians with whom they had spoken about this idea were split. Some were interested, some were resigned: They recognized that transparency was an increasingly powerful wave and that the world seemed to be heading this way, and the others thought they were crazy—notes were for documentation and communication among doctors and were never intended for patients.  The arguments were of a religious quality—they were about belief and values.  The obvious solution was to test the idea and let data help sort it out.  Today, with the publication of the study results in the Annals of Internal Medicine, that debate is now illuminated.

On Tuesday I had the privilege and the pleasure of serving as a judge on the health panel at the South by Southwest Accelerator. It's a great gig, getting to hear pitches from three startup companies that had been winnowed down from a field of dozens. And the companies were terrific—each is tackling an important challenge with imaginative solutions and great technology.

First up was Simplee. Simplee is positioning itself as the Mint.com of health care expenses. They've developed a service that reads through your insurance company accounts and displays your medical expenses in dashboard form—how much each family member has spent toward their annual deductible, for example.  They also explain the unexplainable—the "explanation" of benefits (EOB) statements we always get from our insurance companies, showing you what insurance covers, what you have to pay out of pocket, and why.  I'm on record (at last year’s Heath 2.0 conference) as saying that if Simplee can pull this off, co-founder Tomer Shomal should get a Nobel prize. While maybe not getting to that level of hyperbole, anyone who has regularly waded through these EOBs can relate to what I'm saying. They're starting with this basic problem of tracking and explaining expenses, but have the potential to go much further—facilitating bill payments, offering context-sensitive preventive reminders, and, as they get enough data, enabling comparison shopping for medical procedures. Best of all, you can try it today—Simplee.com.

Ginger.io then came on. As I've written before, I believe that the data we can capture about our day-to-day lives (observations of daily living) can greatly inform the care we receive and, as researchers start to mine it, it will become the source of new knowledge about what makes us healthy or sick. (Pioneer's Project HealthDesign has been focusing on this opportunity for the last couple of years and will soon have some research results to share.) Ginger.io focuses on a particular slice of this data—the data stored on our smartphones. They can capture social activity (calls, texts), geographic movement (GPS) and physical movement through accelerometers. Their twist is that they're really smart about processing the data and finding meaning in it. They're able to establish a behavioral signature and then identify any deviations from it, which can be important feedback for the user but also potentially for a clinician trying to improve a patient's health. Ginger.io is a spinoff from Sandy Pentland's lab at MIT (see his Pioneer- funded paper on reality mining) and by focusing on the smartphone data, they're avoiding the challenge of getting people to record anything—it's all passively collected. Currently, they're working through researchers and early adopter physicians.

The third and final presenter was Medify, which is working to bridge the gap between very high health information resources like WebMD and the medical literature. They have a robust natural language processing operation that is "reading" (crawling?) all the medical literature and coding it (i.e. intervention, disease, study population, conclusions and other attributes). The user can then get a summary along the lines of 15 studies on a total of 3,000 subjects, five of the studies showed that the intervention was safe and four showed that it was effective. You can then drill down and look at more detail and other dimensions like freshness of the research. I'm not doing it justice with this summary— you need to see it for yourself to get a feel for it. The key is that it takes the complexity of the literature on any given condition and/or treatment and starts to tame that complexity, which, as anyone who has gone Googling in search of deeper medical knowledge can attest, is a big deal. Like Simplee, you can use Medify today at medify.com.

Three exciting companies—each with the potential to bring great value to important challenges in health and health care in very different ways. In the end, the winner was... Ginger.io. Congrats to Anmol and Karan for the win, but also to the teams at Simplee and Medify for their creativity, ingenuity and terrific progress so far. These companies, along with seven other excellent candidates, are cause for optimism.