Big data in healthcare

Big Data in Healthcare August 2013 BLOG POST

Overview Big data solutions attempt to cost-effectively address challenges of large data volumes and realize their potential analytical value, resulting in increased profits and customer satisfaction. Big data is influencing the way business decisions are being made toady – especially in industries such as retail and banking that have abundant stakeholder information. Traditionally, the healthcare industry has lagged other industries in the adoption and use of big data, but it is now steadily catching up with others. All key healthcare stakeholders – payors, providers, members and governments – will be impacted by big data, which can predict how these players are likely to behave in changing market conditions and provide insights into mechanisms to encourage profitable behavior and maximize efficiencies.

Several drivers are stimulating demand for big data in healthcare, including increasing costs, shift in reimbursement trends, and changes in the clinical landscape.

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Lately, risk-sharing models between payors and providers have started to replace fee-for-service reimbursement plans to curb expenses. Under this arrangement, physicians are compensated based on patient treatment outcomes or cost control Additionally, payors are collaborating with pharmaceuticals and providing insurance reimbursement for only those drugs that produce measurable improvements in treatments In the clinical space, stakeholders are warming up to the concept of evidence-based medicine, a system in which treatment decisions for patients are based on scientific evidence

All this requires collection, aggregation, and analysis of large data sets across healthcare demographics.

As payors and providers continue to focus on cost-effective costs, currently neither payors nor providers consistently review outcome data that shows how patients respond to treatments.

Supply and Availability of Relevant Data1: Today, there is a greater and better supply of information to satisfy demand. Two-thirds (69%) of the US primary care physicians reported using electronic health records (EHRs) in 2012, compared to 46% in 2009. States like Wisconsin are leading the way, with more than 71% of Wisconsin's office-based doctors used basic EMRs in 2012. Apart from this, stakeholders have access to claims and cost information including the types of services provided. Pharmaceutical companies also hold vast amount of data as a result of their R&D and clinical trials. Additionally, emergence of information companies such as Acxiom and Accurint, who aggregate customer spending behavior and other characteristics, is a boon for payors looking for reliable sources.

Industry organizations such as Premier Group, a group-purchasing organization and aggregator of information, provide subscription-based data service to all participating providers. Large payors are also operating their own analytics division such as OptumInsight for United Health and Healthcore for WellPoint.

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Data: Clinical

Data: R&D

Owners: Providers

Owners: Pharmaceuticals and academia

Source: Electronic health records, medical images

Source: Clinical trials, medical device input capture

Data: Claims & cost

Data: Patient behavior

Owners: Payors and providers

Owners: Consumers and nonhealthcare companies

Source: Utilization of care, reimbursement claims

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Source: Customer preferences, retail purchases, wellness activities

Success Stories Several stakeholders are stepping forward to take advantage of big data and generate operational efficiencies.

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In 2012, Blue Shield of California and Nant Health entered into a partnership to improve care delivery and outcomes by developing an integrated technology system. The system will provide doctors, providers, and health plans with a comprehensive view of all information related to a patient’s care to proactively identify opportunities for intervention before problems occur, provide real-time wireless monitoring of patients with chronic conditions, deliver the latest updates on medical best practices, and continuously monitor clinical outcomes.

Kaiser Permanente’s HealthConnect system is a health information exchange (HIE) that provides data to all its medical facilities and incorporates electronic health records into clinical practice.

The HIE helped reduce office visits by 25%2.

Challenges Even as information becomes a valuable source for stakeholders to reduce costs and improve treatments, several key challenges exist when it comes to reporting and aggregating valuable data.

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Accuracy: Capturing right data at the right time, especially at the point of contact, is very critical.

Patient contact in a physician’s office or during admission in hospital is when stakeholders will be best able to initiate the data capture process. A right mix of technology and communication will help capture the data accurately.

Privacy concerns: Patients are usually reluctant to provide information about themselves because of privacy and other concerns. Effective mechanisms and assurances should be put in

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place to ensure the privacy of the data that patients submit, including the option of deidentification before aggregating the data.

Consistency: Data, technology and compliance standards need to be defined and implemented to promote consistency in reported data across the healthcare ecosystem to eliminate discrepancies and increase the usefulness of data.

Outlook The era of big data is upon the healthcare industry. Success stories of early-moving stakeholders have proved the transformative power of the data and how it can actually help manage efficiencies. Although the industry is still in the early phases of data management; IT systems, business intelligence, and analytics tools built upon big data can help healthcare organizations realize their common goal of effectiveness, efficiency, integration and safety.

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