It's coming from all directions and I had a pharmacist who felt it was important that this knowledge get out there for people who fill prescriptions..well and that would be just about all of us, right?
I keep doing my best to inform consumers of what kind of analytics and scoring processes run behind the scenes that you "don't" see, can't talk to and thus it's harder to understand. Anymore please don't think what you don't see won't hurt you and don't be fooled and say "I have nothing to hide". You may not have anything to hide, but you sure have a lot of data for sale.
Technology does some wonderful things but all of technology is not always good for us. The other day I read about USC and their "virtual human" and the fact that they were proud of themselves creating this as they did some whacked out study that said people share more about their healthcare with this bot robot than with people..but what they didn't say is how much more comfortable people feel lying to a robot or bot...there's the other side. We still need to talk to each other as humans and suggesting that this robot could be an aid to doctors, well to me it's nonsense and you're better off talking to your doctor.
News is rigged today with Journobots as well, as 60% of what you read is written by a bot. The news articles that are most noticeable are the data news stories. The bots can can a data base as they are programmed just like stock trading software to use an example and they write a story based on the parameters one enters.
I really try to pick and choose what I read as I like news from a human and not a bot and besides that, I'm tired of the "Stat Rat" mentality of the government that thinks "numbers are everything". It's bad enough when we have to hear the "fake" job reports that are flawed. It's the biggest joke on the internet with people commenting; however who uses these numbers? The bots that trade stocks so in essence humans have become somewhat of a second priority with the news. You can read more here and see a great video on how the "fake grass root" campaigns get mixed in with the real ones and you can't tell them apart sometimes as the marketing today is created to just that.
News Rigging Has Arrived..
So now let's talk about what's going on at your local pharmacy and what occurs when you fill a prescription. I'm going to do a bit of copy and paste here from my article I wrote on this. Indeed it was sent to the FTC and a few members of Congress. Guess what, they get "scored" too and that may be enough for someone to open their eyes here. I would dare any member of Congress to see if they could get their "secret medication adherence score".
I call it Excess Scoring in America and a lot of this takes place so companies can make money selling analytics software, which by the way is probably one of the easiest sells out there. I used to do it and write software, I know. The reason it is so easy is that the software will do what it's supposed to do minus a few bugs along the way today, but does it create a return on investment, that's the question. You can collect and analyze data all day and look at the results. This is where a lot of the prescription data has gone, to where it makes profits for corporations and the double benefit for the consumer is shrinking. It's not like it used to be.
Now when you fill your prescriptions, the war on cash is over here too, as you are an Outlier, in other words you're not like everyone else. You have to be fixed and you get a score that shows you as "non compliant" as a default. This also serves to drive up the perception that medication compliance is worse than it is. It's a problem no doubt and there are ways to help, but not by accusing consumers of being "Outliers" if they can't find enough data to "score" you with. Again do look at how this is happening. Here's a prior post I made before the pharmacist contacted me about the "Outliers" segmenation efforts. This is not up for debate on whether or not it occurs, it is, as described by the pharmacist and their job description.
The Secret Medication Aherence Scores You Can't See
From the Original Post...
I had a conversation with a pharmacist who took some time to cue me in to what’s going on in the world of “Medication Compliance Predictions” and the impact it has on the life and job of a pharmacist. To tell you the truth, I was absolutely floored at how much software and algorithms have gone into this process. If you read my recent post about Express Scripts, you’ll understand. The metrics that are being used today are over the top and there’s a lot of money being made “scoring” and selling those scores to anyone who has the money and wants the data.
That’s right, if you pay cash you are now considered an “Outlier” by the software firms that collect and sell data on prescriptions. Pharmacists are now seeing patients being given “5 star ratings” on their compliance. Where does this data come from? There are many sources available. First off they can buy your credit card data from MasterCard and any other charge card company and some of these transaction have more than 100-200 fields of data about you available. We all know about the “reward” programs and how those are gate keepers to mine data and sell it, but it appears now that credit card transactions are also in the picture.
Here’s paragraph from an article that’s more about the pharmacist worrying about their 5 Star rating given to them as employees who are dealing with the 5 Star ratings of the Outlier patient. One thing to make clear in all of this is the fact that this is not normal monitoring, see if someone has not filled a prescription , etc. this is flawed data that contains metrics that go over the top. Read this, “find those outlier patients that ruin your numbers”…there’s the wrong with the focus. You may be doing fine taking your medication but the metrics are not being hit, again, the data is flawed.
“For example, Michelle Farrell has begun looking at the medication possession ratio data report in her QS/1 system and looking to tie that back to her star ratings. Brent Dunlap looks at the EQuIPP dashboard to gain insight into outlier patients who are causing their numbers to dip and who may have health issues they can help with. And Brian Beach runs a report out of Kelley-Ross’s PioneerRx system when something doesn’t look right in EQuIPP. “We’ll use our ability to drill down into our data to look at an adherence metric like proportion of days covered, for example,” says Beach. “We see which patients we are not hitting our benchmarks with, and then we’ll reach out to the patient or the provider to try to resolve any issues.” For Beach, this is all about providing value by showing that the pharmacy is being proactive in its interventions that benefit patients, and can even help prescribers meet benchmarks, too.”
The pharmacist went on to tell me that people who pay cash all the time get “one star” and they have to go through this process to talk about why they only have one star. This is one more way to work on the war on cash with making patient “outliers” who use cash. So what’s really wrong with this system? Why are patients being called “outliers” until they can prove their innocence? That’s exactly what we having going on here. Again this not normal medication compliance monitoring, it’s all about getting the pharmacists up to a higher score by going after bogus rated “Outliers” that the software creates. It’s the methodologies used and the context. So good luck getting “patient engagement” here with using the data to find “the bad guys” if you will.
All those who pay cash are given the “non compliance” ding which is not fair, only because their imagedata can’t track everything. Again we are not disputing monitoring those with chronic conditions to see if they are filling their prescriptions here as the issue as that’s pretty normal anymore to take a quick look and see but rather the “scoring” of those at a one star level who pay cash.
The sad reality here is that it’s all about “stars” when you review all the material and not about medication compliance as the way the model is written. Most pharmacists I know reach out and help patients with or without stars. I’m sure patients love being scored with one star if they can’t track the payment cycle of their prescription. How do you engage with this? You don’t as it falls into “excess scoring” of both patients and pharmacists, same battle doctors have had for years and only the data sellers get rich. Education is still a much better route without having to make billions selling patient prescription data. These scores, outlier or not, get sold to insurance companies.
In many pharmacies the pharmacists can’t consult with you face to face until they are certified and have taken this Outcomes MTM certification course, which of course costs money. Nope, they are not qualified on their own to talk to you the patient face to face on their own anymore, they need to be certified to do that and this company is making money. CVS is a big user of the Equipp program so you can be assured they have a lot of “Outlier” patients with only one star:) Be ready for the pharmacist push to be more prevalent as the pharmacists “have” to make those numbers. If you paid cash at Walgreens for your last prescription, you’re screwed on this 5 star rating. If they bring you all in house using credit cards, CVS has a lot more data to mine and apps to create to even get more of your data:) So with your future visits to CVS if you pay cash, be aware that you will become one of their “Outliers”.
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So there you have it, and again it's what goes on in the math model and algorithm world today and the current nomination of Andy Slavitt to run Medicare, well, he will make sure this accelerates as he's a former Goldman Sachs banker and that's what his basic training is. He's done it for years at United Healthcare as well and they got sued for some of it with short paying doctors back in 2010 with the big class action suit to where they "lowballed" a data base that all used to calculate out of network charges and licensed it to every other major insurer. So a vote for him (as that sofware was his at Ingenix) will be subjecting consumers to even more "scoring' that is proprietary and nobody can replicate for accuracy. Tell your Senator what's going on here and request that they seriously take a look before giving a positive vote on his nomination.
That's a big problem today in the fact that companies, banks, etc. can say "trust my software and computer code" and I'll give you analytics that will make your smarter and save money. It's no more prevelent than in the way medication adherence "scoring" is done as you are guilty of non compliance until you prove your innocence as you get that one star if there's not enough data around about you. This is a shameful way to roll out yet one more version of what I call "Operation Perception Deception" to the American Public. I have a post on that too if you want to dig in a little further. Just be careful of your perceptions today as marketing and other factors are working to confuse you to where we all start confusing virtual world values with the "real world" and some of that with current business models is coming home to roost.
Operation Perception-Deception Is In Full Swing in the US
I urge you don't spend too much time on flag stories as they are symbols and sure they have some significance but they can't come and attack you like an algorithms like these that secretly score you as an Outlier and with the use of a star system, state you are non compliant as you use cash and don't give everyone a big enough data trail here to mine and to sell as well. Here's one more example from CVS as they announced they will be selling more medicaiton adherence scores too.
CVS to Distribute more Medicaton Aherence Scores...
This is ugly stuff and not a conspiracy theory at all, it's happening and it's ugly and frustrating as you can't see it, talk to it or make sense out of it. We all choose our perceptions today but be aware, and I think most are today with reward programs and such that there's more going on behind the scenes than you think, that is working to deny the freedoms that we have enjoyed in the US for years. Just like any other tool in life, technology can be used to do great things and there are those that lie and cheat with the same tools, sadly. Computer code can be created to cheat and make money with, and it's not all good.
In the meantime if you get a lot of questions from your pharmacist, it just might be you are targeted as one of those "Outliers" who's doing the bad deed of paying cash for your prescriptions.