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Every CIO has picked up a copy of Time or Newsweek on an airplane in the last couple of years and "had an epiphany about big data," according to Philip Loftus, CIO of Aurora Health Care. But what do analytics and "big data" really mean, and can they really help healthcare organizations deliver better, safer and lower-cost care?
That was a popular subject for discussion at last week's 12th annual WTN Media Digital Healthcare Conference at the University of Wisconsin-Madison's Fluno Center. So was the feeling that analytics is not so easy to do.
John Byrnes, executive chairman and president of Milwaukee-based private equity firm Mason Wells and a trustee of the Medical College of Wisconsin, showed a Venn diagram involving the future mission of MCW and other, in his words, "high-tech" health systems looking to build a competitive advantage over other providers in their service areas.
The three circles represented clinical care, public health and research in the life sciences; overlaps brought collaborative care in the form of patient-centered medical homes, clinical translational research and healthcare analytics. Driving the center, core competency of the organization will be shared IT infrastructure and a curated research data warehouse, according to Byrnes.
Physician care networks will in many ways, Byrnes believes, move to the virtual world to augment care in between traditional office visits. He said that he foresees private clouds, networks for collaborative care, regional patient and genomic databases, expert systems including artificial intelligence and even emotive avatars because sometimes people are willing to be more open and honest with a computer than with their doctors.
But, alas, that is a long-term vision and not the current reality, though some seem to be on the right path.
According to Alan Eisman, executive director for healthcare at New York-based business intelligence software developer Information Builders, the "nirvana" of analytics is transformation of the organization, with business integrated into overall strategy. "Information and knowledge truly needs to be thought of as an asset," Eisman said.
Philip Loftus, CIO of Aurora Health Care in Milwaukee, said that any health system needs to have a "data foundation" of solid, sound information in place before starting on analytics the old "garbage in, garbage out" philosophy.
"It's not fundamentally about technology," Loftus said. It's about the quality, integrity and believability of the data, since the fundamental goal of healthcare analytics should be is cultural change. "In some ways, getting the data is the easy part of it," he said.
Aurora is focusing its analytics efforts now on population health and on accountable care. Of the health system's 2 million patients, about 95,000, or less than 5 percent, are covered by accountable care organizations or other risk-based payer contracts, Loftus said, but that share should escalate in the next few years as old contracts expire.
He said that health systems should understand what the ACO incentives are, then employ analytics to convince skeptical physicians that they should commit themselves long-term to deliver accountable care.
Christine Bessler, CIO and vice president of information technology at ProHealth Care in Waukesha County, seconded this sentiment. She said that it would be good to know which populations need the most critical care, and that data should be delivered to clinical leaders on a daily basis so they can start to see the value of knowing.
"We have had to turn on a dime to value-based care," Bessler said. "Let's not forget what we are all about, which is improving the lives of our patients." Some providers, of course, have gotten so focused on producing revenue in a fee-for-service world that they have lost sight of the big picture.
Byrnes, whose company's investment portfolio includes IT integrator Paragon Development Systems, suggested that the only way to lower costs in healthcare is to improve quality. "In healthcare, slower is faster," he said during a session on changing business models. "In healthcare, more may actually be less."
Aurora, for one, is applying analytics to help reduce expensive "frequent fliers" to the emergency department, Loftus said. In a handful of cases the health system has paid for post-discharge home care to help "reinforce the behavior change," he said.
On the business side, high-deductible health plans and rising copays mean providers have to collect more money up front than ever before. According to Ashok Singh, senior VP for healthcare engineering at Chicago-based credit-rating agency TransUnion, close to 30 percent of hospital revenue comes directly from patients now.
"Every time they treat someone, they're basically making a small loan to people," Singh said, providing services, then later billing insurers and patients later.
Lately, TransUnion has been combining big data from hospitals as well as from individuals' own credit history, building predictive models on patients' ability to pay. "Now we can look through millions and millions of pieces of data," Singh said. "It's much more accurate than old models of credit scores."