A million trials in 5 minutes: How Monte Carlo simulations could revolutionize healthcare

Dr. David Friend, Chief Transformation Officer, The BDO Center for Healthcare Excellence & Innovation and Joshua Lefcowitz, Managing Director, BDO Valuation & Business Analytics Practice - Print  | 

When it comes to using data to personalize medicine, Google and a UK hospital group's partnership to build a personalized healthcare app – using 1.6 million health records – is really just the tip of the iceberg.

Big data analytics in healthcare presents endless possibilities.

Using multi-variate statistical analysis and appropriate modeling, healthcare organizations can go beyond binary analysis to show all the possible outcomes of clinical treatment, insurance premium pricing, business valuations and even personalized medicine in near-real time.

Analyze 250,000 clinical trials in 30 minutes. Evaluate a patient's possible reaction to precision medicine almost instantaneously. Input a patient's symptoms and health history, and receive a recommended course of action at the bedside. If modeled and interpreted correctly, healthcare organizations can use data to overcome personal biases that encourage adherence to outdated, costly screening standards or biases toward certain treatment methods.

Use of these Monte Carlo simulations will change how businesses along the healthcare supply chain and care continuum research, deliver and pay for care and will require less reliance on trial-and-error techniques.

Pricing Premiums
For insurance providers looking to take on additional groups and new populations, Monte Carlo simulation provides faster clarity on risk and on pricing premium strategy. Simulations allow insurers to incorporate literally hundreds of variables – the likelihood of health developments like pregnancy or cancer, income levels, geography, etc. – and apply them to test populations to better understand how a broader population might behave, how much it would therefore cost to care for the individuals within it, and thus how to price premiums competitively yet profitably.

Monte Carlo simulations can also provide insights into opportunities to gain market share – and flag when an organization's risk might suggest a strategic shift in approach.

Valuing Businesses and Research
On the valuation side, organizations can run Monte Carlo simulations from a business case study or market penetration point of view.

One BDO client invented a new piece of hospital equipment, but existing equipment was already serving a need. BDO created a simulation that showed what would be needed to penetrate the market and generate revenue, modeling the company's potential market share over the next five, seven and 10 years based on a variety of factors.

Healthcare organizations can also use Monte Carlo to decide whether to pursue certain business opportunities such as real estate acquisition, partnerships or research – and perhaps more importantly, when to abandon them because the risks outweigh the reward.

Optimizing Clinical Care
Perhaps most controversial, and yet simultaneously the most compelling: data analytics can identify more effective treatments.

Data eliminates personal biases inherent in people, eliminating tendencies toward current standards that may be inefficient or ineffective. For example, some countries in Scandinavia have stopped paying for routine mammograms after data studies found that they were hurting people more than they were helping – giving people inaccurate results and causing them undue stress and sometimes unnecessary surgery.

Data can combat these clinical biases and pinpoint the best course of action in medical treatment.

As the application of Monte Carlo clinical data analysis evolves, healthcare providers – should privacy restrictions allow – will be able to not just prevent waste, but to actually drive improved outcomes with treatments personalized to every individual.

Using cancer treatment as an example, a doctor could plug in a patient's characteristics, like past medical history, genetics and stage of illness, and run thousands of different scenarios to see every possible outcome with all variations of treatment.

Costs to using big data
Integrating big data into healthcare faces several obstacles, access to data being one of the first – but also one with considerable momentum. Current privacy restrictions broadly prevent the use of much healthcare data, but this is likely to change as people come around to the idea of personalized – and more effective – medicine. Already, long-sealed research doors are beginning to crack open, such as the tissue bank collaborations popping up among providers, or the call made earlier this year by 14 health journals for researchers to share their clinical experiment data.

More at issue are the biases, the ethics and the training required to make multi-variable analysis truly functional. If U.S. insurers were to stop paying for mammograms, for example, open rebellion would likely ensue – data can overcome some biases, but not all, and certainly not all at once.

Further, eliminating some of human components of treatment can lead down the slippery ethical path of placing a monetary value on a person's life. If data simulation indicates a costly drug would prolong a patient's life by a couple of days, who gets to decide what those days are worth?

And finally, accurate data modeling demands training of physicians and other medical professionals in data analytics who can correctly interpret results and spot shoddy data. A new program at the NYU School of Medicine is training new physicians in these skills, but those already in the field will also need to update their skills. As with all industry changes, when Monte Carlo simulation becomes the standard in healthcare, it will take some time – and ironically, trial and error – to figure out how to best leverage the technology while remaining sensitive to the human element.

Nevertheless, the end result could mean better cost savings, and, most importantly, more effective treatment.

Dr. David Friend, Chief Transformation Officer, The BDO Center for Healthcare Excellence & Innovation has more than 35 years of global healthcare experience serving as a C-Suite Operating Executive, Board Director and Advisor to Academic Medical Centers, Employers, Payors, Hospitals, Physician Groups, REITS, Law Firms, and Post-Acute Care Organizations. He provides advice on mergers and acquisitions, strategy, clinical integration, physician engagement, and enhancing shareholder value.

Joshua Lefcowitz, Managing Director, BDO Valuation & Business Analytics Practice has nearly 15 years of public accounting experience providing dispute advisory, forensic accounting, and valuation services. is notably one of only 15 Accredited Senior Appraisers to complete the American Society of Appraiser's Inaugural Multidisciplinary Advanced Education in Healthcare Valuation Program.

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