Since they were first introduced, analytics have primarily been used to help healthcare organizations understand past events. In other words, they’ve been informational. That’s important, because as George Santayana is famously quoted as saying, “Those who cannot remember the past are condemned to repeat it.” But understanding what happened, or even why it happened, doesn’t necessarily tell you what actions to take to either avoid or improve upon the prior results.
In 2016, analytics will evolve to show us what will occur if we continue down the same path (predictive), as well as the possible outcomes of several different alternatives (prescriptive), helping healthcare organizations make better decisions.
Here are a few ways the evolution of analytics will manifest itself in the coming year.
Increasing consumer involvement. In the modern healthcare era, patients/consumers have primarily been content to be passive bystanders in their own care. Analytics will help change this paradigm. For example, population health analytics can show patients the likelihood of an adverse outcome if they don’t make lifestyle changes. At every level, there will be a greater focus on educating healthcare consumers and integrating them as key stakeholders in improving their own health.
Demand for more precision in analytics. At present, the ability of analytics to stratify risk among patient populations is outpacing healthcare organizations’ ability to dedicate resources to more in-depth patient care. The result is these organizations must make tough decisions on where to focus their limited resources. In 2016, more precise analytics will help answer those questions by breaking down the numbers within those groups to show which patients have the greatest impactability (the ones on whom an intervention will have the greatest effect on their health) and intervenability (those who are willing and able to follow the care plans developed on their behalf). Armed with this information, providers will be able to devote personnel and financial resources to improving the health of the patients they can actually help, while also providing more sensible care to patients where they are unable to make a difference.
Focus on reimbursement strategies. In 2016, more time will be spent looking upstream to determine what can be done in advance of claims to drive greater efficiency. Analytics will help payers understand which providers are consistently delivering services at a higher level of quality with better outcomes. This knowledge will enable payers to increase the level of “gold carding,” which decreases the amount of oversight or review of processes applied to particular providers who are meeting quality, utilization and efficiency goals. The result is reduced administrative burden for payers and accelerated reimbursements for providers.
After years of underinvestment, CIO’s in healthcare may have something to cheer about this year. The biggest trend seems to be the increased focus and investment in IT in healthcare enterprises. With more than $30 billion invested in electronic health record (EHR) systems, and meaningful use (MU) requirements out of the way, we are seeing enterprises turn toward the more strategic aspects of IT in the ongoing transformation of the healthcare sector.
These investments, however, will follow the money. In other words, funding will focus on initiatives that have the biggest impact in terms of revenues, cost avoidance, and transformative potential. A recent survey by technology provider Healthedge suggests that investments among payers will be targeted at selective enhancements to the most critical systems that support business development, and not a wholesale upgrade of IT. Here are a few of the top investment areas across healthcare:
Population Health Management (PHM): Everybody is on board with the concept of PHM as the defining principle in an outcomes-based business model. However, PHM has eluded a consistent definition, other than that its desired impact is to reduce overall costs of patient populations, and improve clinical outcomes. Analytics has been an important aspect of this discussion, however standalone analytics solutions have struggled to demonstrate value, and progress on advanced analytics involving predictive models and cognitive sciences has been slow. This year may change all of that. Many standalone analytics companies are likely to be acquired, and IBM Watson will gain more traction. M & A in healthcare will drive PHM as well.
Information Security: With healthcare data breaches at over 112 million in 2015, including high-profile breaches at Anthem, Premera, and Excellus, IT security is now a CEO level issue. There is no doubt what this means – investments in data security technologies are going to increase. However, there is no guarantee that data breaches will not increase.
Healthcare Consumerism: Changing demographics and unexpected increases in the costs of health insurance are driving the consumerization of healthcare today. Silicon Valley startups, flush with VC money, are coming up with direct-to-consumer approaches that are making traditional healthcare firms sit up and take notice. At the same time, the newly awakened healthcare consumer is also demanding information and price transparency. New York Presbyterian has launched a patient-first marketing strategy aimed at improving engagement with patients through information sharing, and is revamping its website completely. BCBS of NC has already released the cat among the pigeons by publishing price data (and is facing pushback from its provider network). IT investments will now be focused on maximizing the reach and value of the information to empower consumers to make the right choices.
Guest post by Mohan Balachandran, co-founder and president, Catalyze.
Mohan Balachandran
As we look back upon 2015, we can reflect, review and based on that and other factors, make some predictions about what next year will bring us. John Halamka had an interesting post that reflect on the bigger challenges, such as ICD-10, the Accountable Care Act and its implications on data analytics, the HIPAA omnibus rule and its impact on cybersecurity and audits and the emergence of the Cloud as a viable option in healthcare. We can expect to see some of these trends continue and grow in 2016. So based on these key learnings from 2015, here are a few predictions for 2016.
Cybersecurity will become even more important
In 2015, insurers and medical device manufacturers got a serious wake up call about the importance and cost of cybersecurity lapses. Healthcare data will increasingly be looked at as strategic data because we can always get a new credit card but since diagnoses cannot change, the possibilities of misuse are significant. Just as the financial industry has settled on PCI as the standard, expect the healthcare industry to get together to define and promote a standard and an associated certification. HITRUST appears to be the leader and recent announcements are likely to further cement it as the healthcare security standard. Given all that, one can safely expect spending on cybersecurity to increase.
IoT will get a dose of reality
The so-called Internet of Things has been undergoing a boom of late. However, the value from it, especially as applied to quantifiable improvement in patient outcomes or improved care has been lacking. Detractors point out that the quantified-self movement while valuable, self selects the healthiest population and doesn’t do much to address the needs of older populations suffering from multiple chronic diseases. Expect to see more targeted IoT solutions such as that offered by those like Propeller Health that focus on specific conditions, have clear value propositions, savings, and offer more than just a device. Expect some moves from Fitbit and others who have raised lots of recent cash in terms of new product announcements and possible acquisitions.
Lightning Bolt invests heavily in research and software development to solve complex problems in the area of medical staff scheduling.
Elevator pitch
Lightning Bolt is the leading provider of automated physician scheduling for hospitals around the world. The company manages more than 3 million physician hours each month, helping to create shift schedules that promote work-life balance, productivity and patient safety.
Product/service description
Lightning Bolt’s cloud-based scheduling platform helps hospitals create dynamic staff schedules with a few clicks, automatically optimizing hundreds of complex scheduling rules. Physicians are able to request time-off and shift changes through the platform, creating transparency and a fair system that balances staff needs. The system also includes HIPAA-compliant messaging and detailed analytics.
Origin story
Working as a staff scientist at the Los Alamos National Laboratory to schedule massively parallel supercomputers in 1998, Lightning Bolt founder Suvas Vajracharya, Ph.D. was approached by a high school friend, a doctor, for help with a big frustration. The doctor noticed that the seemingly simple task of creating call schedules for his group was deceptively complex, time consuming, and often proved an inaccurate science where equitable distribution of staffing resources, or the honoring of individual physician requests, would often conflict or simply could not be met.
Suvas saw that his own technology experience with scheduling supercomputers could provide the foundation for creating an elegant, easy to use solution to solve the inherent complexities in medical staff scheduling. Both supercomputing and medical staff scheduling share fundamental requirements, including the need to distribute tasks equally and efficiently in the presence of complex and often changing rules with varying priorities. Within a few months, Suvas developed a prototype scheduling system to tackle his friend’s challenging problem and Lightning Bolt was born.
Marketing/promotion strategy
The company’s growth has largely been through word-of-mouth between physician executives and hospital operations leaders who have discovered the software and become loyal customers. Lightning Bolt also attends several industry events each year, including HIMSS, MGMA and RSNA.
Market opportunity
The vast majority of physician scheduling is still done manually today at America’s 5,700 hospitals. There are emerging players in the space of automated scheduling but nowhere near as established as Lightning Bolt. The company is part of a growing sector of hospital operations technology, including companies such as Silversheet, Modio Health, HealthLoop and AnalyticsMD.
How does your company differentiate itself from the competition
Lightning Bolt is the only platform that considers significant and complex relationships to auto-generate the best possible schedules for large medical organizations. Also, they are the only scheduling system that provides transparency across a healthcare workforce. Since manual scheduling using spreadsheets or paper is the largest competitor, Lightning Bolt’s biggest differentiators tend to be time and efficiency. In one case study, iNDIGO Health Partners generated a $38M ROI over 5 years by switching from manual to automated scheduling with Lightning Bolt.
Guest post by Paul Smith, management consultant, North Highland.
Paul Smith
Information collaboration is not new, but there is an increasingly critical need for effective collaboration to create an efficient healthcare ecosystem. How can healthcare organizations design collaborative frameworks that allow them to successfully manage vast amounts of data and create actionable information from that data?
One of the first, and perhaps most important steps, is to understand why it’s imperative to foster an environment that encourages and promotes information collaboration. The amount of data companies use to track performance can be overwhelming, and many companies are inclined to abandon their quest to connect results across the organization, particularly when redundant data sources conspire across the enterprise to prevent a single source of truth. While it’s easy to understand why it happens, this approach can inhibit an organization’s ability to address the management of its data.
The implementation of an effective, collaborative framework is imperative. Not only does it have short-term impact, like enforcing consistent data quality and use, but it also improves business results. Active collaboration can lower management costs and enhance an organization’s ability to analyze and interpret information over the long haul and:
Improves the user experience for management, physicians, nurses, and patients
Reduces data inaccuracies and redundancies
Offers impact analysis across the organization for change requests
Enhances the organization’s ability to drive insight analysis and action creation based on a balanced information asset environment
Furthermore, if a healthcare organization chooses not to enforce a collaborative information framework, there may be financial consequences. Inconsistency in reporting can lead to noncompliance with provisions of the Affordable Care Act, which require uniform reporting and analytics.
Interoperability Accelerator
What’s really at stake? One example of the potential damage insufficient collaboration can create is evidenced in North Highland’s recent work with a healthcare organization that wanted to improve its management environment. During the onboarding process, new requirements and analytics were captured and documented. The requirements were then coded, tested and deployed prior to completion of the data loads. The missing component was an understanding of the impact that those changes had to legacy analytics in use across the client’s enterprise. As a consequence of no established metadata environment, changes made to the analytical applications impacted numerous analytics and reporting downstream- resulting in massive rework. North Highland worked to remediate data continuity throughout the effected systems and establish a scalable metadata framework to grow analytical capabilities with the future needs of the organization.
This example underscores why it is imperative to implement a model that addresses and improves interoperability, collaboration, and information knowledge, which eliminates a significant amount of risk and creates a highly effective information collaboration governance program.
One successful model that can be followed to address this issue emphasizes a business first approach and requires that there is an overall culture of collaboration both internally and externally. It is based on three fundamental disciplines and supported with metadata foundation that connects and maintains the relationships between the three disciplines. The model’s pillars include:
The Business Information Discipline (BID), which defines the data and information necessary to support the operational goals of each department, business unit or division within the organization. Roles and responsibilities within the BID vary based on the size of the organization, but certain roles are central to the discipline.
The Systems and Network Discipline (SND), which defines the system roles and network analyst roles within the information environment. This is the discipline with the largest concentration of technical resources, each having a degree of stewardship responsibility.
The Information Asset Discipline (IAD), which is responsible for creating, maintaining and delivering information asset management for the organization. IAD outlines governance implementation, stewardship roles and general management of information, enabling impact analysis across the organization.
Organizations must respond to healthcare laws and adapt business models to comply with necessary requirements, all the while continuing to monitor reform-related legislative changes and regulatory guidance. By following the outlined framework, healthcare organizations can create an unbreakable foundation that ensures consistency in data and enhances enterprise agility.
David Caldwell is the vice president of sales and marketing at Transcend Insights, a wholly owned subsidiary of Humana Inc., dedicated to simplifying population health. Transcend Insights helps manage the complexities of population health through community-wide interoperability, real-time healthcare analytics and intuitive care tools. The company’s HealthLogix platform provides healthcare systems, physicians and care teams with valuable clinical insights that enable more informed decisions at the point of care, enhance the patient experience and reduce costs.
Here, Caldwell discusses how the firm serves its clients; the benefits of analytics and its impact on ACOs; population health initiatives; and the future of the company.
Tell us a bit about your product offerings and the role that they play in the health care technology space.
Transcend Insights is a population health management company that provides health care systems, physicians and care teams with advanced community-wide interoperability, real-time health care analytics and intuitive care tools designed to simplify the complexities of population health. The new company represents the merging of three leading health care technology businesses—Certify Data Systems, Anvita Health and nliven systems. We integrated Anvita’s health care analytics into Certify’s HealthLogix™ platform to provide physicians and care teams with the real-time insights necessary to improve health outcomes and reduce costs. In addition, we made these insights accessible at the fingertips of physicians and care teams through a mobile point of care solution, a technology we gained from nliven.
Today, Transcend Insights works with more than 130 health systems, serving at least 600 hospitals and over 20,000 physicians. Through community-wide interoperability, we help large health care systems gain access to both acute care and ambulatory data that reside in various silos across the care continuum.
We analyze 2.3 billion clinical data points on 10.8 million patients every day. Our analytics engine offers more than 33,000 evidence-based clinical rules and last year identified over 36 million opportunities to improve care and helped our clients close 4.3 million gaps in care.
Lastly, we leveraged nliven’s expertise in mobile health technology to develop a mobile point of care solution that allows physicians and care teams to not only visualize data but also gather and assimilate patient data in real-time.
Who are your customers and what level of clinician typically accesses your product on a day-to-day basis?
The vast majority of our customers are multi-hospital, integrated health care delivery networks that have purchased our product to help them move from a fee-for-service to a value-based care delivery model. Our customers utilize the HealthLogix platform to reach both contracted and affiliated physicians, and to piece together disparate electronic health record (EHR) system data across the care continuum.
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.
IDC Health Insights estimates that the combined annual growth rate in the analytics market during the 10 years from 2010 through 2020 will be in the 8 percent to 11 percent range; this places analytics among the top areas of spending growth for hospitals and health systems during this decade. This attractive growth rate has led to numerous new products joining an already-crowded supplier landscape.
The U.S. healthcare provider analytics market has experienced rapid growth and change since the introduction of accountable care with the patient protection and affordable care act (PPACA) of 2010. Analytics are clearly a critical tool that will allow health systems to understand and respond to the business model change and disruption of accountable care, and many types of analytics models and tools will likely be useful to providers. This IDC MarketScape report focuses on analytics platforms that allow providers to examine clinical and financial data together, and to use this data to provide actionable advice for optimizing delivery of care.
Key findings from the report include:
Clinical and financial analytics take many forms. This report examines platforms that allow providers to approach analytics in multiple ways, with agile tools that may include clinical and financial analytics, text and data mining, population health analytics, cost and cost accounting analytics, performance and quality management analytics and dashboards, as well as data exploration tools that can be applied to as-yet-undiscovered questions. This report examines the flexibility of analytics platforms as well as the strength and weaknesses of individual analytics applications available on the platform.
No analytics solution will meet all needs out-of-the-box. Successful analytics programs will develop and nurture platforms that assemble and manage data, offer tools to ensure data quality, and offer applications that allow providers to explore and assemble data on-demand into analytics models that meet business needs, whether they are long-established business needs or spur-of-the-moment questions.
The only valuable analytics are actionable analytics. Analytics are only valuable if they make the right information available, at the right time, at the point of decision making. Solid data and data management approaches are the foundation of analytics platforms, but the rigor of data integrity processes must be balanced.
Lightning Bolt invests heavily in research and software development to solve complex problems in the area of medical staff scheduling.
