Abstract

In our society, artificial intelligence technology has permeated through every aspect of human life. By the end of 2019, more than 60 million Americans will use some kind of smartwatch, whether a Fitbit or an Apple Watch as a part of their daily routine. Further, over 58% of people currently use a healthcare-related mobile application, such as MyFitnessPal or Nike+ Running. Health and fitness application usage increased by over 330% in the last three years. Unsurprisingly, healthcare-related data is one of the fastest growing and financially valuable data pools in the country, if not worldwide. The volume of data generated is predicted to increase to 2,314 exabytes by 2020. Such data is stored in the Big Data pool with universal interface programming, aimed to enhance interoperability with different health provider systems in the medical community. The absence of a legislative directive, guidance, or a systematic approach to organize vast amounts of continuously incoming data on the front end limits its effectiveness through subsequent utilization. It is more prone to being incomplete, dated, erroneous, or incompatible with the analytic systems into which the data is inputted. This problem is especially pertinent in the context of the Value-Based Purchasing (VBP) Program, where the rate of reimbursement of medical services for Medicare patients depends on production of accurate and reliable data. VBP conditions 90% of its payments on the hospitals’ ability to generate data required by the Program. The interconnectedness between VBP’s premise, “enhanced patient quality and lower medical costs,” and production of accurate data highlights the need for legal action to mitigate risks associated with unstructured healthcare data. Such legal action would at a minimum provide a framework or a set of standards for the kinds of data that may be used by the participating VBP hospitals to ensure accurate reporting and the maximization of healthcare analytics. Finally, hospitals nationwide have an independent incentive for acquiring reliable and relevant data to integrate as part of their network to lower actual hospital costs, as Medicare reimbursement was $53.9 billion short in 2017 among the VBP Program providers.

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3rd Place, Virginia State Bar Health Law Writing Competition

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