Sabermetrics to Rescue Health Care

In the last few decades, baseball experienced a revolutionary transformation, thanks to a data-driven approach called sabermetrics. This shift allowed teams like the Oakland A’s to win games and division titles at a fraction of the cost of their wealthier competitors. Inspired by this concept, Billy Beane, along with Newt Gingrich and John Kerry, proposed a similar revolution in American healthcare in a 2008 New York Times op-ed. They argued that just as baseball used statistical analysis to improve team performance and reduce costs, the healthcare system in the United States should adopt evidence-based, data-driven methods to improve care quality and reduce costs.

 

The Parallel Between Baseball and Healthcare

At first glance, baseball and healthcare might seem like entirely unrelated fields. However, when you consider the inefficiencies that both industries once (and in some ways still do) grapple with, the connection becomes clearer. In baseball, before sabermetrics, decisions about player drafts, contracts, and game strategies were largely made based on intuition, tradition, or anecdotal evidence. Scouts relied on outdated metrics and subjective judgment, which often led to suboptimal decisions—overpaying for aging stars, ignoring promising young talent, and making costly errors on the field.

Similarly, healthcare, as Beane, Gingrich, and Kerry pointed out, has historically made decisions based on tradition, anecdotes, and the personal observations of individual practitioners rather than solid evidence or data. Doctors and healthcare providers often base treatment choices on what they’ve learned through experience, rather than on rigorously compiled and analyzed data that shows which treatments work best in specific situations.

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Evidence-Based Medicine: The Healthcare Sabermetrics

Much like the introduction of WHIP (walks and hits per inning pitched) and VORP (value over replacement player) transformed baseball, the application of evidence-based medicine could revolutionize healthcare. In the article, the authors emphasize how the United States, despite spending more per capita on healthcare than almost any other industrialized nation, lags in terms of healthcare outcomes. This inefficiency leads to staggering numbers like nearly 100,000 deaths per year due to preventable medical errors.

The proposed solution lies in bringing a “Moneyball” approach to healthcare—using data to determine the best treatments and medical practices based on effectiveness, not tradition or assumption. For example, while some medical procedures may be frequently used, there is often insufficient evidence to prove their efficacy. This means that expensive treatments could be prescribed that either don’t work as well as thought or aren’t necessary in many cases.

Real-World Success: Cochrane Collaboration and Intermountain Healthcare

Two key examples illustrate how a data-driven approach to healthcare has already proven its value.

First, the Cochrane Collaboration is a nonprofit organization that reviews medical research and compiles systematic, evidence-based reviews. A notable success story was its 1992 review, which revealed that many women at risk of premature delivery were not receiving corticosteroids, which improve the lung function of premature babies. As a result of this evidence, the use of corticosteroids tripled, leading to a nearly 10% reduction in deaths of low-birth-weight babies. This success demonstrates the life-saving potential of evidence-based medicine when medical practice is guided by rigorous data.

Second, Intermountain Healthcare, a Utah-based nonprofit healthcare system, provides a compelling example of evidence-based healthcare in action. With 80% of its care based on data collected from electronic medical records, Intermountain delivers higher-quality care at a cost one-third lower than the national average. The key to Intermountain’s success is not that it diminishes the role of the physician but that it equips doctors with robust data to inform their decisions, ensuring they are providing the best possible care based on proven outcomes.

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A National Institute for Evidence-Based Medicine

One of the key proposals made by Beane, Gingrich, and Kerry is the creation of a national institute for evidence-based medicine. This institution would conduct new studies and systematically review existing medical literature to inform medical providers on the most effective treatments. By providing doctors with better data, the healthcare system can avoid costly, ineffective treatments and focus on interventions that improve patient outcomes.

To encourage the adoption of evidence-based practices, the authors suggest that doctors who follow clinical best practices should receive increased Medicare reimbursements and some liability protection. This not only incentivizes the adoption of evidence-based methods but also helps protect doctors who are following the latest and most reliable data.

How Far Have We Come?

Fast forward to today, and while the shift toward evidence-based medicine has made significant strides, there is still a long way to go. Programs like Choosing Wisely, initiated by the American Board of Internal Medicine, encourage physicians and patients to discuss the necessity of certain tests and procedures, emphasizing those backed by strong evidence. Additionally, the use of electronic medical records has improved significantly since 2008, allowing for more robust data collection and analysis.

However, challenges remain. Many healthcare systems still prioritize profit over patient outcomes, and the complexities of insurance and pharmaceutical lobbies often slow down the adoption of more cost-effective, evidence-based care. The Affordable Care Act attempted to address some of these issues by penalizing hospitals for high readmission rates and incentivizing preventive care, but the systemic shift toward data-driven decision-making remains incomplete.

Conclusion: A Data-Driven Future for Healthcare

The revolution that transformed baseball into a more efficient and data-driven industry has the potential to do the same for healthcare. By embracing evidence-based medicine, doctors, hospitals, and policymakers can help drive down the high costs of healthcare while improving patient outcomes. As the examples of Cochrane Collaboration and Intermountain Healthcare show, the shift toward data-driven healthcare can lead to significant improvements in quality and cost-efficiency.

To fully realize this potential, the creation of a national institute for evidence-based medicine, as proposed by Beane, Gingrich, and Kerry, would be a powerful step forward. Much like how sabermetrics reshaped the game of baseball, a data-driven approach in healthcare could ensure that the system is based not on outdated practices or personal observation but on reliable data that saves lives and reduces costs. In a world where healthcare is becoming increasingly complex and expensive, it’s clear that adopting a “Moneyball” mentality is not just an option—it’s a necessity.

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Author: Dennis Coates

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