Feedback in the form of healthcare data analytics is one way to promote better preventative care and motivate physicians who are performing poorly.
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While almost two-thirds of organizations across the healthcare ecosystem have analytics strategies in place, our research shows that only a fifth are driving analytics adoption across the enterprise.
The IBM Institute for Business Value has been listening to what members of the healthcare ecosystem around the world have been saying about their experiences with analytics. We have surveyed 555 executives within the healthcare industry and are about to launch our latest point-of-view, Analytics across the ecosystem: A prescription for optimizing healthcare outcomes. This blog briefly explores just one of the aspects covered in the paper; ‘Importance of enabling organizational strategies with analytics’
The healthcare ecosystem is the convergence of otherwise separate entities, such as life sciences organizations, providers and payers, as well as social and government agencies. Going foreword, gaining and sharing meaningful insights from data across the entire healthcare ecosystem will be a necessity to correlate cost and quality of care. For example, increased interaction among providers, payers, life sciences organizations and patients can help reduce unplanned adverse events. Patients can benefit from more individualized care. Insights from analytics can facilitate continuous learning and promote quality improvement. However, organizations are still struggling with using advanced analytics for gaining such insights. Only 34% of our study’s respondents said they think in terms of analytics that can help gain actionable insight from data.
Enabling organizational strategies using analytics can lead to a significant impact. For example, in a recent IBM Institute for Business Value study about big data, the percentage of respondents in the healthcare and life sciences industries reporting a competitive advantage from analytics rose from 35% in 2010 to 72% in 2012, a 106% increase in two years.
To derive the most value, analytics must become an increasingly important factor in corporate strategy decisions. To position analytics accordingly, organizations must define the enabling analytics strategy, prioritize their roadmaps to address internal requirements and create strategies for future collaborative partnerships across the healthcare ecosystem. A comprehensive plan for governance is a foundational to drive adoption of any analytics strategy. High-level sponsorship of key analytics projects is an important success factor. The most effective analytics initiatives embed small, action-oriented analytics into key decision points of specific business processes that are used widely across the ecosystem. Metrics to measure success should be in place from day one and be tracked. To get the most out of these projects, organizations should focus on early insights that enable refinement of processes over time.
The point-of-view will explore this topic in further detail taking into context the requirements within the organization as well as across the entire ecosystem. Read the paper to learn more and discover the three areas of focus that can have a dramatic impact on your organization and entire ecosystem.
Follow Joseph Conn on Twitter: @MHJConn
e FDA is looking into a new way to regulate drugs and medical devices—by using social media. The agency has drafted social media guidelines that would urge drug companies to use platforms such as Facebook, Twitter, and YouTube, to educate the public about the risks of their prescription drug or medical device.
The draft guidelines, which are currently under review by the agency, propose that companies be required to use the “character space constraints” on social media platforms such as Twitter to tweet the risks, along with the benefits, of a product. The guidelines also recommend that manufacturers include a link that takes readers to more information about the product. In the case of Twitter, that information should all be included in a single tweet.
The document states:
If approved, the guidelines will become the first formal recommendation by the agency regarding manufacturers’ use of social media.Lara can be reached at firstname.lastname@example.org. Follow Lara on Twitter: @BostonLara
Find here the most recent analysis and data by country. A selection of key documents and graphs are shown about topics such as broadband, internet activity and skills, egovernment, e-health, ICT in schools, research and innovation, as well as other main indicators.
Via Philippe Marchal/Pharma Hub
As part of its Health Innovations Award program, twelve projects focusing on population health management, care coordination, interoperability, and financial and clinical analytics will receive up to $110 million in combined funding from the Department of Health and Human Services. At the same time, HHS has made up to $730 million available to states seeking to transform their public and private health insurance structures to meet accountable care goals and encourage innovation across the healthcare delivery system. “As a former governor, I understand the real sense of urgency states and local communities feel to improve the health of their populations while also reducing health care costs, and it’s critical that the many elements of health care in each state – including Medicaid, public health, and workforce training – work together,” outgoing HHS Secretary Kathleen Sebelius said. “To help, HHS will continue to encourage and assist them in their efforts to transform health care.“These efforts will strengthen federal, state, and local partnerships, encourage broad stakeholder engagement, and capitalize on federal resources to ensure greater transformation of delivery of health care services,” added CMS Administrator Marilyn Tavenner.With an average award size of about $9 million, the twelve projects receiving funding in Round Two of the program include academic institutes, professional societies, and healthcare providers across the country. Some of the recipients include:North Shore-LIJ Health System on Long Island, New York, which will use its $2.5 million award to help coordinate the care of patients with late-stage chronic kidney diseases by using patient education, home dialysis, depression screenings, and other population health management techniques to reduce costs and preempt medical errors.Icahn School of Medicine at Mount Sinai, awarded $9.6 million to test its Mobile Acute Care Team (MACT) as a way to integrate the hospital-at-home model to reduce unnecessary admissions. The MACT team will help treat patients for acute needs at home while integrating community care providers and providing appropriate referrals to non-hospital-based services.The Association of American Medical Colleges was granted $7.1 million to test the scalability of electronic consults and referrals across five academic medical centers. Integrated into its Epic EHR systems, the consortium will use standardized referral templates to ensure that patients receive the specialty help they need.Regents of the University of Michigan will use $6.3 million to implement the Michigan Surgical and Health Optimization Program (MSHOP), which allows for real-time risk stratification for patients undergoing abdominal surgery. Over the next three years, the system will be implemented at 40 Michigan hospitals.
"Medical practice has begun its inevitable journey toward this transformation when, unless an exam or a procedure is required, most medical questions and answers, as well as virtually all medication refills and renewals, appointment requests, interpretation and discussion of the implications of lab and imaging results will be conducted online rather than in the office.
The reimbursement system in the health care of the future will simply have to take this into account, as we slowly transition to a fee-for-service to a care management."
Via Andrew Spong
Eight practices in West Cornwall will pilot a data sharing scheme using Microtest’s Guru to allow local A&E clinicians and the local out-of-hours GP service with access to patients’ GP records.
Penzance GP Dr Matthew Boulter, who is leading the project on behalf of NHS Kernow Clinical Commissioning Group, said the pilot comes from GPs’ frustrations at their patients being unnecessarily admitted to hospital due to a lack of information sharing.
“A GP puts in place what we thought were pretty detailed plans to avoid admittance, only to find out they’ve been admitted because the admitting physician didn’t know about the plans, and had no way to find out.”
Dr Boulter said allowing doctors and out-of-hours services to view a patient’s GP record can have an enormous benefit, reducing unnecessary admissions and costs to the healthcare system.
“Information is power – the more information you’ve got, the better decisions you can make.”
He said the CCG is aware of concerns about information governance and patient consent, and spent nine months developing an agreement for all the practices to agree to.
Each practice is able to dictate how much information it shares, while access is restricted to those on the local GP performers’ list with no temporary locums allowed to use it.
As part of the safeguards, the Guru system, which can also be used on mobile devices, has a consent screen that pops up when a user tries to access a patient’s records, asking them to confirm whether or not the patient has given their consent for the service.
Dr Boulter said the system includes an override option for access in emergency situations, but doctors who use this are required to fill in a free-text box justifying their access of the records.
Clinicians have read-only access to the records, and practice managers will get a weekly read-out with information about which patients’ records have been accessed by whom to ensure there are no abuses taking place.
Dr Boulter said the pilot is in the middle of going live, with doctors going through training before they receive their log-on details and use the service.
The trial will last for 12 months, with three-monthly audits taking place to consider feedback and make necessary changes so the pilot can continue past the trial’s end if it is a success.
“What we don’t want to do is have the system stop at 12 months while we navel-gaze and analyse the data.”
If the pilot is a success, Boulter said the CCG could look to extend access to ambulance services, Macmillan nurses and others who can benefit from the data sharing.
NHS Lanarkshire has launched a range of analytics applications to give staff easier access to data.
The Scottish health board has developed the dashboards together with MicroStrategy to provide access to systems data about a range of departments across its three hospitals.
Alan Lawrie, the health board’s director of acute services, told EHI the applications interface with the board’s “relatively robust” clinical systems to provide easily viewable data to clinicians.
“With [the applications], we can get it easily rather than having to delve into the deeper, darker parts of the system.
“If you’re a busy doctor or nurse, you can sit in front of your computer and take a look with a couple of clicks.”
Lawrie said one of the applications is a module displaying real-time data from the hospitals’ emergency departments, allowing staff to adjust their focus as necessary.
“You can get a feel for what the heat of the department is and what’s happening on an hour-by-hour basis, right in front of you and in a very visual way.”
The board also has a suite of dashboards with planned care information like inpatient and outpatient bookings to help meet treatment targets, as well as a bed-management dashboard to show in real time how many beds are available in each ward and each hospital.
Lawrie said a ward dashboard with information from the previous month, such as staff sickness levels, complaints and compliments, provides senior charge nurses and ward teams with information about the quality of care.
The applications can be accessed by desktops, laptops and other mobile devices that are linked into the board’s network.
He said the applications have a “modest” cost, with a budget of about £100,000 for the A&E dashboard, while adding value to the existing systems.
“They’re an add-on, rather than duplicating what’s already there.”
Lawrie said the board started work on the emergency dashboard in 2012 before it went live in August 2013, and has received positive feedback from clinicians.
He said the board is planning to make the ward dashboard “a little more real-time” to improve the timeliness of the information.
One of its other major IT projects is its e-casenote electronic patient note project, which Lawrie said is part of the move towards a paperless system over the next 18 months.
Lawrie said the board is starting to back-scan a significant number of historical records and documents to be displayed within its clinical portal, which already includes data from some clinical systems.
The scanning includes basic optical character recognition to allow some search facilities, while the scanned documents will be placed in different sections for test results, correspondence and other categories.
Lawrie said the electronic clinical notes will go live at Hairmyres Hospital at the end of June, with the next phase of the project focused on moving information from GP systems into the portal.
The Framework is designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies. This Framework can help your organization that treat patients as partners instead of just customers.
This article was taken from the May 2014 issue of Wired magazine. Be the first to read Wired's articles in print before they're posted online, and get your hands on loads of additional content by subscribing online.
The healthcare world that most of us experience -- and the one that clinicians are traditionally incentivised to operate in -- has been one of "sick care", in which we focus our time and energies on treating diseases once they have appeared, or reached a point where they can no longer be ignored. The practice of medicine often resorts to a "reactive" state because the information which can be acquired from an individual, whether blood tests, vital signs, electrocardiograms or other measures, is incomplete at best, especially for the majority of us who spend most of our lives away from clinics and hospitals. Further compounding our reactive system is the fact that the ability to understand and make decisions from sporadic and fragmented health data (traditionally stored remotely in paper files) has primarily been left to interpretation by clinicians, doctors and consultants.
This paradigm, however, is on the cusp of change. We're beginning to shift from an era of intermittent, reactive health and medicine to one that is based on information, feedback and analytics. This will become proactive and continuous while engaging and empowering the individual (whether a healthy consumer or a patient), clinician and healthcare system. We are faced with many challenges, such as ageing populations, morbidity from high obesity rates and neurodegenerative disease, compounded in many parts of the world by a shortage of primary care physicians. Many of the digital devices and tools featured on the following pages will give us the opportunity to address many of these challenges for the consumer, patient and practitioner, as well as whoever is footing the bill, particularly as the incentives better align to reward prevention and early detection.
The convergence of faster, smarter, smaller, cheaper and interconnected technologies is accelerating exponentially. Devices are giving us new ways to measure, track, visualise, understand and optimise our bodies, health and wellbeing. The benefits could range from low-cost genetic sequencing to the layering of distributed mobile devices and sensors, wearables and implantables. The network of devices that makes up the internet of things could bring about the internet of the body.
The quantified-self movement began with leveraging basic consumer- and fitness-focused tools such as the Fitbit digital pedometer, but it is expanding to make use of a growing array of devices that can track metrics ranging from sleep patterns to brain waves. We are still in the era of 1.0 wearable sensors, but there are early signs of 2.0-era advances -- such as the Basis Watch (a fitness tracker which measures your movement, heart rate, sleep and perspiration), the Quanttus wristband and low-cost wearable patches (such as those from Vital Connect) which can transmit your electrocardiogram data, vital signs, posture and stress levels anywhere on the planet. This new generation of seamless and integrated devices -- and that's including Apple's long-rumoured iWatch -- will combine with mobile apps and secure APIs to connect your data to the cloud. Your healthcare system will be regularly "prescribed" for improving wellness, diagnosis and therapy.
Devices such as the AliveCor Heart Monitor and low-cost handheld ultrasound technologies put measurements once consigned to an intensive-care unit into the hands of consumers and clinicians. The Qualcomm Tricorder XPRIZE has incentivised and spurred teams from around the world to develop consumer devices for home-based monitoring, connecting mobile diagnostics, artificial intelligence and beyond. One entrant, Scanadu Scout, a sensor designed by Yves Béhar, is due to come to market this year after crowdfunding was used to fund research and initial clinical trials.
By using these technologies and feedback loops, a physician, nutritionist, personal trainer or your social network can help you to be more accountable for your wellbeing. Privacy is critical of course, but leveraging the so-called Hawthorne effect (did you hit your 10,000 steps today?) can be a powerful way to implement behaviour change and adherence to medical regimens. We will all become more empowered, responsible for our own health with useful insights into our everyday wellness, disease prevention and disease management. We also have new ways to interact with our healthcare providers through digital checkups and telemedicine. Our data will also benefit biomedical research and others with similar conditions.
We now have the opportunity to make sense of the terabytes of data which each of us can generate every day. Artificial intelligence and our personal dashboards will lead to an era of predictive analytics.
With so much being tracked by so many devices, we will need to filter and integrate our personal data to the point where we aren't overwhelmed by it. Imagine a GPS system for your health: it knows your habits, your genomics and your goals, and can help you reach a target, whether that be to run a marathon, lose weight, manage hypertension or lower your risks for cancer.
Many challenges remain, not least from the regulatory bodies and insurers, which struggle to understand and leverage these fast-paced technologies. But having the ability to access and share user-generated health data can disrupt our often inefficient and error-prone healthcare systems and bring us to a new era -- one which can help us to reach our full potential as individuals.
Click title to read full article at source
Walgreens (NYSE: WAG) (Nasdaq: WAG) is expanding its relationship with Inovalon Inc. a leading technology company to implement its patient assessment tool and technology platform to support improvements in care quality and risk score accuracy programs across more than 400 Healthcare Clinic at select Walgreens locations.
The convergence of Inovalon’s data-driven patient assessment tool Electronic Patient Assessment Solution Suite (ePASS®) and Healthcare Clinic at select Walgreens creates a unique offering within the health plan and retail clinic industry. With the implementation Inovalon’s analysis of more than 8.3 billion medical events brings analytic insights to Healthcare Clinic programs.
“By integrating data analytics we can gain even deeper insights to help improve patient care and ultimately outcomes” said Heather Helle divisional vice president Healthcare Clinic. “We continue to expand the scope of services capabilities and footprint at Healthcare Clinics. These types of innovative solutions enable our nurse practitioners and physician assistants to play an increasingly important role as part of a patient’s care team.”
Healthcare Clinic at select Walgreens improves members’ choice providing a convenient community-based access point for member assessments versus the traditional in-home model.
The combination of Inovalon’s advanced analytics and Healthcare Clinic’s nurse practitioners and physician assistants as well as its laboratory and immunization resources provides a superior solution to health plans ACOs and integrated care delivery organizations seeking to achieve goals in improving quality outcomes and risk score accuracy.
“Bringing advanced analytics to the point of care in real time is a powerful benefit for patients being seen in today’s highly complex health care environment” said Keith Dunleavy M.D. president and chief executive officer of Inovalon. “We are proud to be working with Walgreens on this industry leading initiative supporting its commitment to improve health care outcomes for Healthcare Clinic partners and patients nationwide.”
Inovalon’s ePASS system delivers a patient assessment tool with individualized predictive analytics to the point of care supporting advanced insight and efficient resolution of gaps in quality care patient assessment documentation and risk score accuracy. The risk score models of Medicare Advantage Commercial Health Insurance Exchange and state managed Medicaid are each supported within the ePASS system. Similarly the industry’s wide array of quality outcomes programs including HEDIS® CMS Stars state Medicaid programs and commercial accreditation requirements of NCQA and URAC are supported within the platform provided at Healthcare Clinic at select Walgreens locations.
As the nation's largest drugstore chain with fiscal 2013 sales of $72 billion Walgreens (www.walgreens.com) vision is to be the first choice in health and daily living for everyone in America and beyond. Each day Walgreens provides more than 6 million customers the most convenient multichannel access to consumer goods and services and trusted cost-effective pharmacy health and wellness services and advice in communities across America. Walgreens scope of pharmacy services includes retail specialty infusion medical facility and mail service along with respiratory services. These services improve health outcomes and lower costs for payers including employers managed care organizations health systems pharmacy benefit managers and the public sector. The company operates 8200 drugstores in all 50 states the District of Columbia Puerto Rico and the U.S. Virgin Islands. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health and wellness centers provider practices and in-store convenient care clinics with more than 750 locations throughout the country.
About Inovalon Inc.
Inovalon is a leading technology company that combines advanced data analytics with highly targeted interventions to achieve meaningful impact in clinical and quality outcomes utilization and financial performance across the healthcare landscape. Inovalon’s unique achievement of value is delivered through the effective progression of Turning Data into Insight and Insight into Action®. Large proprietary datasets advanced integration technologies sophisticated predictive analytics and deep subject matter expertise deliver a seamless end-to-end platform of technology and nationwide operations that bring the benefits of big data and large-scale analytics to the point of care. Driven by data Inovalon uniquely identifies gaps in care quality data integrity and financial performance – while also bringing to bear the unique capabilities to resolve them. Touching more than 540000 physicians 220000 clinical facilities and more than 140 million Americans this differentiating combination provides a powerful solution suite that drives high-value impact improving quality and economics for health plans ACOs hospitals physicians patients and researchers. For more information visit www.inovalon.com.
Pharmaceutical companies are slow to board the social media bus, but the rest of the healthcare industry isn’t waiting around.
Online health information is readily available, and consumers have no reservations about tapping the Internet and social environments to find it.
Via Andrew Spong
Big data offers breakthrough possibilities for new research and discoveries, better patient care, and greater efficiency in health and health care, as detailed in the July issue of Health Affairs. As with any new tool or technique, there is a learning curve.
It’s important to aim for initial pilots with wide applicability, a clear understanding of where one’s data comes from, and an approach that starts with a problem, not a solution. Perhaps the hardest task is finding the right balance.
Digitally Sick are back and have taken the opportunity to look at the three big hitters for digital health in 2014: Social. HCP communications and big data (with the exception of mobile health which needs a pod of it's own).
Social media is now almost passé but over the last decade has revolutionised all aspects of pharma communications from patient support to clinical trials. In 2014 we are still struggling with how we should communicate with HCP's and finally big data, or data, is now the most exciting frontier in healthcare, what are the issues and how can this be leveraged by pharma?
Via Alex Butler
Every year around the time of the health and government data extravaganza in Washington, Health DataPalooza, it’s reason to do an accounting of how far we’ve come in terms of accessing health data and using it as a foundation for value-based medicine. NPR says we have reached our “Awkward adolescence” (echoing Susannah Fox) with health data—lots of amazing things happening, but not a lot of impact.
Of course there’s plenty more work to do to make health data more accessible, more liquid and more private, but the progress since Health DataPalooza started less than 5 years ago is amazing, and we should take note, then come back to the paths forward.
This year, the big news was the FDA announced “OpenFDA”, available via an open API, with information on adverse drug events. Time will tell what the release will mean in terms of delivering health, but with over a thousand datasets now release by HHS alone, we are seeing a wave of new capability, even if data stories take time to tell.
Meanwhile, 80% of healthcare is now digitized, more than doubling from just a few years ago.
Samsung and Apple see the potential for accessing and harvesting health data and are moving into the fray to create personal health tracking hubs. There are many more examples showing that health data has, indeed, reached the limelight. Big health data, is now often called “the new oil”, and it’s already serving as a key resource in driving economics and powering countless new companies.
But that’s not what this post is about.
All this data is great, but it doesn’t take big data or rocket science to figure out what’s killing us, and how it might be prevented.
If you’d like to see what is killing us, check out this (small) data tool: http://vizhub.healthdata.org/gbd-cause-patterns/
Stop the presses: It’s us.
You take smoking, diabetes, obesity, cardiovascular disease and alcohol out of the mix, and the vast majority of those in the developed world would live to 90+. For data to really have an impact on health, it’ll have to have an impact on us. Many of these disease are diseases of behavior. We can debate how difficult it is to change behavior, or what biochemistry, genetics or other factors drive behavior, but most of our health problems could be prevented by making different choices. Consumers are going to need to care about it and use it.
There are bright spots that this is possible. Engagement rates reach 70% among institutions who do it well, but it takes leadership.
The reorganization of the ONC without a consumer office doesn’t show a lot of confidence that they are going to lead the way.
How do we fix this?
We’re nearing the point where we’ll be able to capture someone’s vital signs every minute of every day via Samsung, Apple, and many others. Will all this measurement save us from ourselves? Can we truly get prevention, or do will we just get better at heading off problems at the last minute? While preventing heart attacks is great, as a new iWatch is rumored to do, it would be even better if we could fix the unhealthy state that makes them possible before a last-minute intervention is necessary.
With that in mind, here are my wishes and a few predictions for the next phase of health care and health technology (now forever linked) and the road to solving health care with health data:
1. We need to create tools that can actually measure and impact behavior on what goes into us, not just stats on where we are and how we’re moving.
At the end of the day, we’re going to need to measure and provide feedback on input on intake as much as output. We’ll need to not only sense motion and vital signs but also what we’re putting into our bodies in terms of food, drink and chemicals, and start to change it. There has been work on tooth sensors to measure intake and Apple and others appear to be working on hydration sensors. It’ll be exciting to see developments in these areas in the coming years.
2. We need to better understand what drives metabolic disease. Metabolism-related killers are becoming our primary killers, but many normal weight people, in addition to obese people, die of metabolic disease. There’s still a lot we don’t understand about prevention and the disease. Yet metabolic disorders such as diabetes are taking an ever-greater toll and half the country will be at risk for diabetes by 2020. That’s a lot of suffering, a lot of death, and an enormous cost.
3. We need to prepare for the fight of a generation. Metabolic diseases are killing us in ever-larger numbers. The more we measure what’s driving costs, as we collect more and more Health Data, we’re going to run straight into a very big wall of conclusion: sugar is killing us.
With the release of FedUp, the idea of sugar as a culprit for our health care woes is starting to hit the mainstream. If the fight against control of tobacco was tough (and by no means won), the fight against sugar will be 10x harder.
4. We need to correlate outcomes and environment. That means we need to understand what networks behavior of the health care system. We’ll learn a lot from the 125,000 people who die per year from not adhering to their medications. Why aren’t they taking them on time? What’s preventing people from treating themselves?
For that we need to understand things at a systems level and better correlate with the social determinants of health. As Atul Gawande pointed out, yet again, at health DataPalooza, the overall vulnerability of a population is what’s drives our biggest health costs. The intersection of socio-economic/social determinants and network behavior will help us solve major hotspots, major sources of cost and suffering.
5. This one might be obvious, but we need to be better at predicting with data. EHRs like their name implies, are records, focused on the past. We need electronic health systems that are predictive. Apple and Samsung or others will do it, and they appear to be correctly focused on a new kind of technology for the new business model of health care, focused on risk spread among all players (and value place on prediction).
Dave Chase, CEO of Avado, now part of WebMD, issued a stern warning to healthcare providers and their approach to healthIT on Susannah Fox’s blog:
“Just as it was easy to dismiss Google, craiglist, ebay, groupon, foursquare, facebook, etc. so too are the Iora Healths, Caremores, HealthCare Partners, Edison Health, One Medical, Surgery Center OK, Paladina Health, etc. ,but their value proposition is compelling. All of those players are deploying health IT in a radically different way than incumbents. Those orgs and their supporting technology take it for granted that patients are a core member of the care team, have access to their data and generally are using IT for competitive advantage.”
6. We need better rules on ownership and rights around health data, we could start with a Health Data Bill of Rights. In the consumer space, the rise of Snapchat and Whatsapp are indicative of a rise in the awareness and need for privacy. In health care, it will take time, but as health data gets “consumerized” with Apple and Samsung entering the fray, I predict the needs will become more and more apparent.
We need to work on rules and awareness to make health data more private and at the same time more easily exchanged. I don’t know exactly what that will look like but I, like many others, get the sense the answer may come through the blockchain. Fred Wilson at Union Square Ventures sees it as driving the next big investment cycle, after social and now mobile. He says, “our 2014 fund will be built during the blockchain cycle”. More on that in an upcoming post.
What do you think? What do we need to solve health care with health data?
Mark is a clinician, management consultant and patient advocate, www.twitter.com/MarkDuman
We can't directly cut and paste any of these overseas examples into the NHS. Nonetheless, they do help us to think bigger and bolder about making real change happen at long last.
The April survey from eHealth Initiative and the College of Information Management Executives got responses from 98 provider organizations--35% delivery systems, 27% hospitals, 14% academic medical centers and 9% community health centers/clinics. Only four respondents were not running analytics at the time of the survey.
Seventy-two percent of responding providers extract data from more than 10 platforms or interfaces--some more than 100--with EHR and billing/financial data still by far the most common. But data also comes from patient-generated sources such as portals and health risk assessments (45%), unstructured text (39%), remote monitoring devices (29%), health information exchanges (22%), mobile applications (11%) and genomic data (7%).
Still Young and Learning
Analytics remain in the early stages of maturity. Traditional common uses of analytics continue at high levels. These include quality improvement (93%), revenue cycle management, (91%), resource utilization (81%), and population health management (79%). Respondents use descriptive analytics that mine for historical or retrospective analysis at a 94% rate. Only 68% use predictive analytics to forecast outcomes, trends or performance, and this is mostly done on a monthly or quarterly basis. One-third use prescriptive analytics with sophisticated models to optimize performance and recommend specific actions. On 20% of respondent’s analytics operations regularly integrate and coordinate at an institutional level.
Trained staff to collect/process/analyze data, along with interoperability and cost, have been common barriers to implementing an effective analytics program. Survey respondents report new challenges are emerging. These include access to external data beyond proprietary networks; cost-prohibitive work required to clean/validate/integrate external data when available, lack of funding or return on investment, increased regulations on data use and patient privacy. “These trends suggest the critical need for strategic planning in implementing analytics, no matter how large or small,” according to a report of survey results.
Consumer engagement has started to make its mark on data analytics initiatives. Two-thirds of respondents use analytics to support engagement with the primary focus being on patient satisfaction. But few organizations also are applying analytics to consumer strategies such as personalized communication and services, acquisition and retention of consumers, or targeted behavioral change programs.
A report on survey findings, “The Landscape of Data & Analytics in Healthcare” is available here.
In this age of big data, analytics in healthcare has expanded frombusiness intelligence and revenue-cycle management to clinical care.
For example, health insurer WellPoint is branching out from simply looking for gaps in coding, thanks to a combination of better data and more advanced algorithms. Now, the company can look for gaps in care as well, Patrick McIntyre, the company's senior vice president for healthcare economics, explained last week at SAS Institute's 11th annual executive conference on health analytics.
Making sense of the unstructured
Allegheny is getting ready to bring this technology to the provider side. For example, Pitts said, the length of a nurse's progress note often correlates with illness severity. By paying attention to patients with particularly detailed notes, the health system might be able to prevent medication errors, escalation of acuity and even hospital readmissions, he suggested.
Farzad Mostashari, MDNext wave for Kaiser data
Like Highmark, Kaiser Permanente is both healthcare system and health plan. That massive organization's EHR contains something in the neighborhood of 10 petabytes of data, according to Terhilda Garrido, VP for health IT transformation and analytics, making it ripe for big data technologies.
Garrido wants to gather "patient-reported outcomes" after each encounter, including what patients say on social media, data pulled from medical devices and patient satisfaction ratings. "That, for us, represents the next wave of the continuum," she said.
Nearly half of healthcare organizations responding to a new survey say they are experiencing a positive return on investment in data analytics and reporting technology.
The survey, by TCS Healthcare Technologies in conjunction with the Case Management Society of America and the American Board of Quality Assurance and Utilization Review Physicians, found the landscape changing quickly from similar measures taken in 2008 and 2010.
Forty-six percent reported positive ROI, compared with 14 percent who reported a negative return, according to an announcement
Thirty percent of respondents reported stratifying healthcare information to promote population-based screening, or to identify candidates for case management. Meanwhile, just 25 percent reported using predictive modeling applications, while 35 percent reported doing so two years ago.
Excel (39 percent), Crystal Reports (20 percent) and Access (17 percent) remain the most widely used applications.
Users cited the importance of dashboard and visualization capabilities, naming among their priorities the ability to manipulate reports and data presented and to view trends for individual patients and for large sets of data.
Applications for population health management that integrate claims and clinical data are key to the success of accountable care organizations, an IDC Health Insights report found recently, saying many organizations have found that relying on EHR information alone isn't enough.
While tools that help organizations with case management have been touted for their ability to improve care, as New Jersey-based primary-care practice Vanguard Medical Group experienced, it's not all about the technology. A Kaiser Permanente study found readmission-prediction software wasn't accurate enough for it to replace manual review of cases.
With apologies to Internet meme-makers everywhere, analytics experts have a message for healthcare providers trying to get their heads around business and clinical intelligence: "Big data, you're doing it wrong."
But so few have proper goals and strategies for their data, according to Graham Hughes, MD, chief medical officer of business analytics firm SAS, based in Cary, N.C.
"Raw data from claims or from an EMR database are not suitable for analysis. Turning raw data into usable information requires preparation, including normalization and validation. Only then can an organization gain trustworthy insights from the information and put it to use in maximizing patient care, reducing risk and strengthening a business's bottom line,” they add.
A severe shortage of analytics pros makes navigating this landscape all the more difficult, according to Hughes. "It's also a mistake to think you can staff up on this easily," he says.
Near the end of 2013, many in the life sciences industry were looking for clear evidence that the FDA was willing to work with industry to get more needed drugs to patients. Eyes were focused on the “scorecard” of new drugs approved, which for the first eight months of 2013 reached 18."
With healthcare spending at about $3 trillion per year and accounting for nearly a fifth of gross domestic product (GDP), managing costs and improving outcomes are top priorities for healthcare providers, insurance companies and consumers alike.
KMWorldinterviewed five experts in the field, who offered insights into how business intelligence solutions can help organizations take on the challenge of a new and sometimes confusing environment.
Those interviewed by Judith Lamont, KMWorld senior writer, include John Carew, assistant VP, advanced analytics for Carolinas HealthCare System; Michael Corcoran, chief marketing officer, Information Builders; Graham Hughes, M.D., chief medical officer, Center for Health Analytics and Insights, SAS; Vi Shaffer, research VP at Gartner; and Alex White, managing director for corporate finance/restructuring, FTI Consulting.
Q Lamont: What are the most significant driving forces in healthcare today?
A Hughes: Multiple forces are putting pressure on the healthcare system, but the biggest change is the unstoppable shift from volume to value. Traditionally, revenue in the healthcare industry has been a function of the number of products and services provided. The Affordable Care Act (ACA) is requiring a focus on outcomes—keeping patients healthy. This means that healthcare has to pivot and make some dramatic changes in its business model.
A Shaffer: Another major factor is the shift in demographics. We are dealing with the diseases of an aging population as the baby boomers hit 65 and above, as well as a range of chronic diseases. It requires a different continuum of care. We are seeing innovative changes in how healthcare is paid for and delivered. Providers have more incentives to keep patients healthy.
A White: The method of care is also shifting, with greater emphasis on outpatient care and the care continuum. These changes represent good opportunities for improving the quality of care because of the continuity across multiple settings, and also for cost savings—for example, by eliminating redundancy in diagnostics and treatment or identifying health risks earlier. That, combined with new technologies such as wireless sensors and mobile devices, means there is a tidal wave of data that people are struggling to capture and analyze from across a host of care settings.
Q Lamont: How are analytics solutions helping to address these issues?
A Hughes: Understanding individual risks as well as the risks within population is a data-driven exercise. Healthcare providers who are being rewarded for value will have to measure whether they are achieving the patient outcomes that are expected of them, and evaluate the extent to which they are proactively managing the risk of the patients they are taking accountability for.
A White: Multiple studies have shown that around a third of the nearly $3 trillion the United States spends on healthcare is wasted. As the paradigm shifts from volume- to value-based reimbursement, that means companies that are well positioned to identify and reduce inefficiencies should, in theory, be at an advantage. The bet that many are making is that analytics can help them do that—whether it's identifying unwarranted use of interventions, reducing fraud and abuse or managing care more effectively.
A Shaffer: Many of the innovations in treatment and reimbursement depend on technology for analytics, use of electronic records and monitoring seriously ill patients outside the hospital. More information is available about the patient, which allows better analysis of what approaches are most effective. Information is a strategic asset, and it must be infused rapidly to drive the clinical process, because there is a lot of downward pressure on costs now.
Q Lamont: From the viewpoint of a healthcare provider, how is your organization responding to these challenges?
A Carew: Carolinas HealthCare System is a non-profit healthcare system with 40 hospitals and 900 provider locations, as well as home healthcare, skilled nursing and hospice care. We are doing extensive analyses to measure quality of care across this continuum, evaluating outcomes and costs. We also need to understand which patients are at risk for developing severe or chronic illnesses, and try to avert those conditions.
Q Lamont: What is an example of an analysis that is being done right now in response to changes in healthcare regulations?
A Carew: We are looking very carefully at hospital readmissions, because that is one of the provisions of the ACA that has already been implemented. If a patient is readmitted within 30 days of a hospital stay, there is an impact on reimbursement. One of the strongest predictors of readmission is past utilization, so we monitor those statistics as well as other factors in ?the patient's environment, such as ?family support.
Q Lamont: What sort of interventions are you conducting in response to this information?
A Carew: When we identify a high-risk patient, we have several approaches. One is a program called TeachBack. This program assists with health literacy, meaning the ability of an individual to understand his or her condition and cope effectively with it. TeachBack explains the disease and how to take medication, and then the patient explains it back to the provider. We use this method because teaching is one of the most effective ways for someone to gain mastery of information.
A Hughes: It is important to address patient engagement head-on as part of multiyear population management strategy. For example, a 14-year-old diabetic does not interact with the healthcare system the same way as an acutely ill 70-year-old. Even though analytics-powered customer engagement approaches are common in other industries, its adoption in today's healthcare system is very immature, and only the pioneers are experimenting with these technologies.