Insurer-Funded Study Suggests Diabetes Management May Be Overly Aggressive

For health management companies, diabetic patients represent their primary customer base. These companies aim to improve patients' health outcomes by providing better care environments and meticulous management. However, the latest big data research project conducted by insurance companies suggests that diabetes management may be overly aggressive.

OptumLabs was the first to announce this conclusion. The laboratory was established through a collaboration among Mayo Clinic, UnitedHealth Group, and Optum. Over the past three years, OptumLabs has expanded to include nearly 20 research institutes and has attracted a large number of new members.

Competition for mining healthcare data is intensifying. To better understand what is feasible and what is not within the healthcare industry, IBM established its health data analytics division, Watson Health, in April, joining companies such as Aetna in the race to secure big data resources. IBM aims to leverage data insights to formulate strategies and develop new services and products.

Other members of OptumLabs, including the American Medical Association and the Mayo Clinic, have begun applying early findings from laboratory research. Officials at the lab stated that real-world application is the goal of all OptumLabs projects. Members of OptumLabs are also considering which research initiatives can aid clinical decision-making.

Dr. John Cuddeback, Chief Medical Officer of the American Medical Association, stated, “We have been considering translation from the outset.” Researchers obtained extensive data from more than one million patients with type 2 diabetes and ultimately found that patients’ blood glucose levels can be controlled. However, approximately 8.1 million people with diabetes in the United States, or about one-quarter of those with the condition, remain undiagnosed.

Meanwhile, 40 working groups of the Medical Association leveraged Mayo Clinic research to examine changes in physicians’ management of diabetes. Findings from OptumLabs helped identify that some patients with diabetes may be overtreated. Dr. Cuddeback stated, “We should test those who have not yet been tested or whose condition is out of control.”

These studies benefited from the rich and detailed data of OptumLabs, which includes records for 150 million de-identified patients over a ten-year period. UnitedHealth Group and Mayo Clinic made substantial contributions to the initial data, such as clinical visits, prescriptions, laboratory results, and diagnostic tests. The American Medical Association also contributed accordingly, including patient medical records from physicians’ charts.

Furthermore, data resources can also enhance cognitive computing, also known as artificial intelligence. Dr. Paul Bleicher, CEO of Optum Labs, stated that cognitive computing is a powerful tool that, when applied to complex healthcare challenges, can help develop better tools and uncover new medical data. IBM’s Watson Health has already launched cognitive computing services.

OptumLabs may also co-establish an incubator for developing quality assessments with the National Quality Forum. Currently, the National Quality Forum is using simulation technology to test this concept.

Silverman, COO of the Quality Forum, stated that this incubator connects data and funding with researchers and clinicians. She added, “To date, the development of quality assessment has lagged behind clinical needs.”

OptumLabs’ database will further accelerate specification testing for quality assessment. In practice, the standard procedure involves development followed by testing; after testing, further development and retesting are required. However, Silverman noted, “This process takes two to three years and is costly.” Conducting development and testing concurrently would expedite this process.

In terms of quality measurement, OptumLabs’ data analytics are largely similar to the fixed-performance analyses conducted by AMGA medical group members. However, while AMGA medical group members have considerable discretion in how they treat patients with diabetes, there is very limited evidence demonstrating that these chosen approaches incur the lowest costs.

Currently, OptumLabs’ partners include consumer groups, higher education institutions, and life sciences companies. A few months after OptumLabs was established, the American Association of Retired Persons (AARP) joined the consortium. Pfizer, two healthcare systems, and three universities followed suit. By 2014, two additional universities, the non-profit Pharmaceutical Research Institute, Merck & Co., and medical device manufacturer Boston Scientific had also become partners. Furthermore, since January of this year, six prominent academic figures and corporations have joined, including the Massachusetts Institute of Technology (MIT) and Novartis. The addition of these new key players has brought fresh research agendas, data, and funding.

According to Dr. John, CEO of Mayo Clinic, when OptumLabs was first established, its primary research objective was to compare the effectiveness of treatment regimens. However, as the number of partners increased, the scope of research projects continued to expand. For instance, OptumLabs’ extensive data resources may prove beneficial for disease prediction. Currently, OptumLabs has expanded to 70 research projects and established two well-developed focus areas: heart disease and Alzheimer’s disease.

In its initial years, OptumLabs published nearly 20 articles. These studies included clinical observations assessing the risk of gastrointestinal bleeding among patients of different age groups using newly marketed blood thinners rather than traditional anticoagulants. A study published in The BMJ found that patients under 65 years of age prescribed the new anticoagulants had a lower risk of bleeding; however, for patients over 75, the bleeding risk was significantly unstable. This study also raised concerns among the elderly regarding medication use.

OptumLabs boasts rich data that can be analyzed by age groups. In contrast, early studies exploring the risk of gastrointestinal bleeding could only rely on clinical trial data. However, Dr. Jayant Talwalkar, Medical Director at OptumLabs, stated that data from clinical trials do not meet the regulatory standards set by the U.S. Food and Drug Administration (FDA), and the reliability of testing medication safety in patients stratified by age or other characteristics is relatively low.

Members of OptumLabs expect to incorporate more data, including patient experience and satisfaction data. Dr. Talwalkar stated that incorporating information from more patients would enhance the value of the database.

Researchers analyzing detailed clinical data from physicians’ notes and prescriptions in the OptumLabs database found that the most expensive diabetes medications may be more effective, or vice versa. Annual per-patient spending on diabetes care can vary by as much as $3,000.

As of the end of last year, Optum generated $47.7 billion in revenue and achieved a net profit of $3.3 billion. However, it declined to disclose whether Optum Labs had developed any new patented products for it.

Optum disclosed the operational budget for a specific division of OptumLabs but declined to reveal the overall project budget. The company emphasized that research funding is intended to sustain laboratory operations, and larger-scale research projects may require additional financial resources.

An Optum spokesperson stated that they are leveraging OptumLabs to create a new environment where health system stakeholders can collaborate and innovate to improve patient care and achieve profitability through an innovative research platform.

Compiled by Liu Jianqiu

Editor: Huang Jia