Benefits Managers: Big Data is Changing Healthcare

Traditionally a late adopter of “big data,” the health care industry has slowly been taking steps toward utilizing health care intelligence to shape the way care is provided. This shift may be in part due to the change from a fee-for-service payment model to a value-based one, and one where payer/provider relationships are slowly starting to change.

I remember walking into my physician’s office after they had remodeled in the mid-90s.  The main feature behind the reception desk was a wall of carefully organized patient charts, seemingly the focal point of the office. Each was colorfully coded with some variety of fluorescent colored stickers, and the file belonging to me would be pulled from the wall while I was sitting in the waiting room filling out updated medical forms, which would then be added into this very file. Filling out new paperwork each time I went to the doctor got to be a little redundant and, even worse, if I was referred out to a specialist, I found myself filling out the paperwork all over again, because none of my information was held in the same place. There was no central silo for all of my health data. Instead, the specialist would have to request my primary care file be faxed or mailed to their office for review.

Until now, much of any patient’s data–pharmacy, clinical, and financial/demographic data, etc.–has been held in separate silos, where information cannot be analyzed together. And yet today, with the use of an electronic health record (EHR), we’ve eliminated a lot of paper files, but the systems of information still aren’t talking to each other at the patient level. For example, if you’re only ever seen within the same health/hospital system, chances are good that your clinical file is fairly complete. If you’re seen at multiple places, information is still scattered and the complete picture of your health isn’t there. When all of this information is assessed collectively, however, payers benefit from lower costs, and providers benefit by having a more holistic view of a patient’s health, thus allowing them to make better care decisions.

Using big data in health care is referred to as population health management. Some of the specific benefits include:

  • Epidemic prediction
  • Improvement of care
  • Increased patient wellness/fitness
  • Lowered costs

 

The big data used to generate a complete view of a patient’s health, or trends within a group of patients, comes from many sources. One of the most well-known methods is through the use of wearable devices. These are the popular fitness trackers that count how many steps one has taken, heart rate, and even sleeping patterns. Also, the use of at-home medical testing is becoming more advanced, with most devices transmitting results directly to a physician’s office, as in the case of heart or blood pressure monitors, for example. But some of the most powerful and complete sources of data include Electronic Health Records (EHR), a patient record held by a physician. Each patient could have several EHRs based upon the number of physicians and specialists they see.

But, as mentioned previously, most of this information is held in separate silos. When all of this information is brought together, it’s known as data warehousing. The goal is to organize the data in such a way that decision makers can:

  • View clinical and financial data together
  • Create disease registries
  • View predictive analytics
  • Create population risk stratifications
  • View hospital admission and readmission rates

 

The end result of pooling all of this data is the ability to view all plan data at the patient level. Imagine being able to determine pools of high risk employees and providing them with resources to achieve the proper care, thus preventing the onset of a second chronic disease. Or imagine being able to encourage employees to be engaged with their healthcare decisions, which would lead to improved outcomes. What if you could determine that a plan participant wasn’t taking their medications and was possibly experiencing further health complications as a result? All of this, and more, is possible by using big data in the health care space.

Big data truly is paving the way toward lowering health care costs and improving patient outcomes, slowly but surely. Payers, providers, patients, and plan sponsors can all benefit from population health management. Benefits managers and HR personnel can make use of these powerful analytics by partnering with a benefits advisor who acknowledges the benefits of population health management and who actively works with reputable data management vendors to achieve cost savings and better health outcomes for plan participants and sponsors alike.

CBIZ and the Catholic Benefits Trust have worked with many employers to harness the power of big data offered through Conifer Solutions. We’d love the opportunity to further discuss how we can put this technology to use for you and your employee benefits program.

Catholic Benefits Trust
Catholic Benefits Trust