The health IT revolution is here and 2016 will be the year that actionable data brings it full circle.
Opportunities to achieve meaningful use with electronic health records (EHRs) are available and many healthcare organizations have already realized elevated care coordination with healthcare IT. However, improved care coordination is only a small piece of HIT’s full potential to produce a higher level synthesis of information that delivers actionable data to clinicians. As the healthcare industry transitions to a value-based model in which organizations are compensated not for services performed but for keeping patients and populations well, achieving a higher level of operational efficiency is what patient care requires and what executives expect to receive from their EHR investment.
This approach emphasizes outcomes and value rather than procedures and fees, incentivizing providers to improve efficiency by better managing their populations. Garnering actionable insights for frontline clinicians through an evolved EHR framework is the unified responsibility of EHR providers, IT professionals and care coordination managers – and a task that will monopolize HIT in 2016.
The data void in historical EHR concepts
Traditionally, care has been based on the “inside the four walls” EHR, which means insights are derived from limited data, and next steps are determined by what the patient’s problem is today or what they choose to communicate to their caregiver. If outside information is available from clinical and claims data, it is sparse and often inaccessible to the caregiver. This presents an unavoidable need to make clinical information actionable by readily transforming operational and care data that’s housed in care management tools into usable insights for care delivery and improvement. Likewise, when care management tools are armed with indicators of care gaps, they can do a better job at highlighting those patients during the care process, and feeding care activities to analytics appropriately tagged with metadata or other enhanced information to enrich further analysis.
Filling the gaps to achieve actionable data
To deliver actionable data in a clinical context, HIT platform advancements must integrate and analyze data from across the community—including medical, behavioral and social information—to provide the big picture of patient and population health. Further, the operational information about moving a patient through the care process (e.g., outreach, education, arranging a ride, etc.) is vital to tuning care delivery as a holistic system rather than just optimizing the points of care alone. This innovative approach consolidates diverse and fragmented data in a single comprehensive care plan, with meaningful insights that empowers the full spectrum of care, from clinical providers (e.g., physicians, nurses, behavioral health professionals, staff) to non-clinical providers (e.g., care managers, case managers, social workers), to patients and their caregivers.
From financial services, to technology, to telecommunications, retail and more, big data has made a meaningful impact across industries. In healthcare specifically, big data is being used to create a more efficient, effective and personal approach to providing care.
The statistics speak for themselves: As the $2.8 trillion industry continues to evolve, big data could add as much as $300 million per year.
But big data for healthcare is about more than revenue growth.
As the healthcare industry shifts towards a world of value-based and proactive patient care, big data offers health systems the ability to improve patient quality of life, increase preventable care and enhance patient engagement. Furthermore, big data has the ability to provide actionable insights in hospital settings while saving time, and ultimately costs, by allowing healthcare systems to operate more efficiently and effectively.
Learn more in the infographic below on how big data potential creates improvements in healthcare.
Dean Stephens is the CEO of Healthline, a media group and a health information technology company. Here Stephens discusses healthcare analytics and how it’s important to providers and patients; the ever-increasing importance of harvesting useable and life-changing information from unstructured big data; analytics in population health; the importance of ACOs and the future of Healthline.
Tell me about your background and your role at Healthline. I grew up in a small, blue-collar town in New England and was fortunate enough to attend an Ivy League college, which was a rare thing for this town. After college and graduate school, I got lucky to land a policy analyst position for the Washington State governor, but in no time, got drafted into management consulting at Deloitte. Much of my consulting time was spent in the healthcare industry learning first-hand how “upside down” the industry was. Thus, I joined other entrepreneurs to re-imagine this muddled industry and joined Healthline as CEO in 2001, not knowing then that I would end up building two companies simultaneously.
What does Healthline do and how has the company evolved?
Healthline’s mission is to make the people of the world healthier through the power of information. And we do this through two business units – our media group, which consists of our consumer health website Healthline.com, and our health information technology group, which includes a range of search and data analytics solutions built on our market-leading medical taxonomy. We are currently working with some of healthcare’s largest brands, including AARP, Aetna, Pfizer, Sanofi, UnitedHealth Group, Microsoft, IBM, GE and Elsevier.
Describe your personal view of analytics and what that means to the rest of us. Why is this important?
Healthcare is the most information-intensive industry on the planet. The number of diseases recognized today and the permutations on the treatment matches to individuals have exploded over the past 20 years. It’s impossible for an individual physician or a large, sophisticated provider or payer institution to deliver effective treatment across all patients without analyzing vast amounts of complicated data. We limped along in the traditional fee-for-service realm. Now as the healthcare market shifts to value-based reimbursement, the value of information and analysis rises dramatically as providers shift from being rewarded for sick care to well care.
Guest post by Anil Jain, MD, FACP, senior vice president and chief medical officer, Explorys, and consulting staff, Department of Internal Medicine, Cleveland Clinic.
Despite advances in medical education, the proliferation of medical journals and the speed of light retrieval of information on the Internet, the lag time between when researchers identify life-saving clinical interventions and when they are put into practice ranges from 10 to 25 years, averaging 17 years. This lag time between the discovery at the “bench” and its practice at the “bedside” is even more startling when you consider the impact of care at the “bedside” to the “bottom-line.” This “bottom-line” has become increasingly important with the formation of accountable care organizations (ACOs) that aim to reward provider organizations and payers that meet the “triple-aim”: high-quality care for the population, high-quality care for the patient, at the most affordable cost. Unfortunately, current practices at the “bedside” reportedly generate approximately $700 billion in care that isn’t necessary and may even be potentially harmful to the “bottom-line.” Moreover, despite healthcare expenditures of 17 percent of our GDP, the U.S. lags behind most industrial nations when looking at composite measures of healthcare quality.
With the increasing use of health information technology and data we should be able to shorten the time between “bench” to “bedside” and improve the “bottom line.”
“Big data” is data that is of high volume, variety and of sufficient velocity that is not amenable to traditional data storage and analysis tools. This “big data” is most typically generated from health systems’ electronic health records (EHRs), laboratory, radiology, financial and billing systems, personal health records, biometrics and smart devices. In addition, patients today are oftentimes utilizing various mobile health and wellness apps and wearable devices which also collect a plethora of data, which only adds to the complexity.
The aggregation of de-identified medical information across millions of health records from varying venues of care facilitating a longitudinal view of a person can be incredibly beneficial for researchers focused on net new knowledge discovery. For data from disparate health systems to be aggregated, it is vital that it is standardized and that subjects across health systems can be matched. This harmonization of disparate data coupled with the appropriate analytics software is critical to identify patterns in the data.
In this setting, the larger the data set, the more likely that a signal can be detected through the noise, even in the rarest of conditions. Fortunately, many hypotheses can be conceived and tested through appropriate analytics within this real-world data set in a much more cost-effective manner than conducting full-scale clinical trials. Furthermore, if a signal is detected or a pattern is found, researchers can then design a more focused explanatory or pragmatic clinical trial to prospectively test the hypotheses. For example, over the past few years within the Explorys network, more than a dozen peer-reviewed abstracts and publications have been generated by leveraging a de-identified data set comprised of nearly 48 million subjects, searchable by a specialized browser-based analysis and query application.
Lance Speck, general manager of Actian cloud and healthcare, speaks here about healthcare big data and how it can be used in healthcare to improve processes from care coordination to coding for ICD-10. In his day job, he is focused on delivering healthcare solutions to help payers and providers address an estimated $450 billion annual opportunity created through data analytics, ranging from fraud analytics to patient re-admission reduction to staff optimization to accountable care reporting and clinical auto-coding. For more than 20 years, Lance has served in a variety of management, sales and product roles in the software industry including a decade focused on SaaS, cloud and healthcare.
How can big data analytics improve patient care?
According to a recent PwC survey, 95 percent of healthcare CEOs are exploring better ways of using and managing big data; however, only 36 percent have made any headway in getting to grips with big data. All agree that big data analytics has the potential to improve the quality and cost of care, but many are still struggling with finding the right ways to infuse analytics into everyday operations. Assuming they realize that they already have access to the data, what do they do with it? What are the areas that will have the biggest impact? Where do they start?
Start with the basics. Organizations should focus in infusing big data analytics where a big impact can be recognized. They should ask themselves:
Is there enough value in solving the problem?
Can the problem can be predicted?
Can the problem be prevented?
Can the predictive action be delivered accurately, and in a timely fashion to make a difference?
Very early in the process, organizations should address how they plan to incorporate big data into the everyday workflow of clinicians, financial staff and other healthcare stakeholders for organizations to:
Use predictive analytics against historical and external data to anticipate patient occupancy needs to adjust staffing levels to have the right care available at the right time.
Use science to determine with accuracy health trends in specific communities and take action to prevent costly
Determine patients’ risk of readmission before they are discharged to improve patient outcomes and reduce costs and penalties by nearly $70 billion.
Realize that for this insight to be effective, you must put this information into the hands of the clinicians and the patients in the format that fits their daily flow.
How can healthcare providers transition to ICD-10 as simply as possible?
Guest post by Alexandra Sewell, executive director, emerging markets, Comcast Business.
As the healthcare industry moves through 2014 and begins planning for 2015, several trends continue to dominate the healthcare IT landscape. Healthcare organizations are grappling with the explosion of Big Data and implementing strategies to achieve varying stages of meaningful use. The industry is working toward interoperability, mobility and improving data security – all while looking to control costs and provide quality care.
New healthcare technologies hold great promise to improve both access to and quality of care, but they are in varying stages of adoption and federal approvals. This is leaving healthcare organizations and their IT directors searching for flexible solutions that can address current and future technologies.
Unfortunately, the industry’s approach to how technology is sourced, implemented and integrated as a business strategy is fractured. Many vendors offer different approaches to today’s healthcare technology challenges, but very few offer total solutions.
With that said, some technology is taking hold, such as digital hospital rooms, virtual medicine kiosks and mobile e-health devices, which allow physicians and other clinicians to monitor, diagnose and treat patients from remote locations. PACS imaging, electronic health records (EHR) and other data can now be shared within the entire healthcare ecosystem – from patients and clinicians to pharmacists and payers, and this is progress. But it’s been slow to take shape and there are still many questions to be answered.
Security continues to be a major problem in health IT. The coming year will only bring more breaches and problems that must be addressed by those leading their organizations. In 2013 alone, millions of people were affected by breaches.
Breaches can be attributed to something as simple as a stolen device — flash drives and laptops, for example – to unauthorized access or disclosure of information by health system employees. For example, Healthcare IT News recently reported a four-year long breach by a single employee at the five-hospital Riverside Health System in southeast Virginia.
Health IT security issues are only going to get more pervasive, aggressive and encompassing in the years ahead. So, what can we expect as we look ahead? Here are some predictions about health IT security from the industry’s leading minds:
Remaining in compliance with these codes and regulations, like HIPAA, is key from a security point of view for healthcare organizations. Being compliant and ensuring that only the appropriate healthcare staff members and contract workers have access to the information they need to do their jobs ensures that the information remains secure and does not end up in the wrong hands.
Because of the sensitivity of the information accessed on a daily bases within a healthcare organizations and the number of people accessing the information – doctors, nurses, clinical and admin personnel, and contractors – IT security concerns will be slightly different than the highly publicized breaches we read about, like the recent Target breach that originated outside the organization.
Guest post by Daniel Piekarz, vice president of life sciences business development at DataArt.
The life sciences industry will be defined in 2014 by the growing market demand to apply newly developed technology, including big data analysis, to healthcare and medical device practices. While many of the amazing technological advances in the space are driven by a desire to aid humanity, the industry is also caught between increased economic and regulatory pressure that is forcing many to electronically collect heaps of data while looking for custom technology solutions that will allow them to leverage this valuable data and adhere to new industry standards.
Over the next year, trends that reflect newly available technology will start to develop. The adoption of healthcare big data technology will become a major theme in the sector this year, just as it has in several other industries. Many new technology offerings have been created to tie together data from multiple sources that can be accessed by researchers and physicians to allow them to easily exchange information. This also aids in research and development practices by offering another valuable tool to gather and analyze data.
Tied to the big data trend is the emergence of personal healthcare data aided by physicians’ adoption of EHR technology. By allowing patients to own and access their healthcare data on a healthcare information dashboard, patients can more easily understand risks and preventable care options. Pooling anonymized patient data together can also lead to better analysis, and physicians are already starting to work with vendors to develop big data diagnostic tools. These new technology advancements have started to create a generation of patients more committed to their own healthy future than ever before. Through an intelligent system database, patients and physicians can better understand patterns and symptoms that affect their healthy lifestyles. While this type of big data solution is gaining a foothold, there is still resistance from some doctors due to their concern over critical review of their procedures.
In today’s dynamic healthcare industry, it is important that providers embrace modern information technology and innovations to achieve organizational success. It’s no surprise that the health IT landscape is changing rapidly, driven by the interrelated trends of mobility, cloud, security and big data. This will fundamentally change the way that healthcare organizations communicate and collaborate moving forward. But, these health IT trends are not only driving change, they are also serving as the path to deal with many of the new dynamics created in today’s office environment.
In turn, healthcare organizations will need a “new style of IT” that helps them become more agile and efficient while reducing operational costs. In addition to these megatrends, changes to government regulations are driving an industry-wide shift to improve healthcare IT, which have increased healthcare IT spending projections to $34.5 billion in North America.
There will be an abundance of technology resources available to help healthcare providers facilitate this transition; however, IT decision makers must be able to identify the technologies that will work best for their business. The following three strategies are key consideration points when looking for new technologies to help you manage IT megatrends.
Benefit from Healthcare Big Data
Regulatory changes associated with the Patient Protection and Affordable Care Act (PPACA) will create a surge of newly insured patients. The Congressional Budget Office expects that the PPACA will cover around 14 million of the uninsured in 2014 and 25 million by the end of the decade. There is a significant financial opportunity with these new patients, but it is important to consider that the number of practitioners will not immediately increase to accommodate this influx.
Investing in technology and tools designed to specifically address big data and the vast amounts of patients’ personal information will help healthcare organizations provide more personalized care to these newly insured patients. By selecting tools that help collect, store and search for patient information, healthcare organizations can increase productivity by significantly reducing time spent managing patient records. Converting documents into searchable digital formats is an important part of this process, and educating staff on how to properly scan and organize documents in their digital form will help make patient data more accessible and usable.
Guest post by Michelle Blackmer, director of marketing, Healthcare, Informatica.
The volume of protected health information (PHI) in electronic form is exploding – both from the wholesale move from paper charts to electronic health records for capturing clinical data and with the proliferation of new sources of electronic data from networked medical devices. Additionally, IT staff have been overwhelmed by regulatory mandates, rampant technology changes (e.g., virtualization, BYOD, big data), massive application projects and flat or decreasing budgets.
This increase in electronic PHI combined with the challenges for health systems IT make it even more important for providers and non-providers to find efficient ways to secure their data. However, with malicious activity showing a consistent upward trend, absent a change to an almost maniacal leadership focus on protecting patient data and the deployment of available tools and processes as an organizational imperative, 2014 will bring even more frequent and larger breaches of PHI.
Current data security climate
Even still, many healthcare organizations are not taking the necessary steps to reduce the proliferation of unprotected PHI in non-production test and development environments. Ninety-four percent of respondents to the third annual Ponemon Institute Benchmark Survey on Patient Privacy and Data Security had at least one data breach in the past two years, and 45 percent reported having had more than five total incidents each. Even more surprising is that the leading cause for a breach is a lost or stolen computing device that houses PHI. The survey also found that:
Unrestricted database administrator (DBA) access heightens risk: 73 percent of DBAs can view all data.
Data compromise/theft remains rampant: 50 percent of respondents say data has been compromised or stolen by a malicious insider such as a privileged user.
Organizations are under-coping:68 percent have difficulty restricting user access to sensitive data, 66 percent have difficulty complying with privacy/data protection regulations and 55 percent lack confidence that they would even detect data theft/loss from their own production environments.