Over the past decade, Healthcare Informatics has recognized healthcare leadership teams who have gone above and beyond in their use of information technology solutions with the Innovator Awards. But those innovators could not have achieved such success without dedicated vendor partners. To that end, Healthcare Informatics now brings the Leading Edge Awards, honoring vendors whose combination of expertise and innovation are shaping the future of healthcare systems. The 2015 winner in the category of Cost Savings is Loop360 Healthcare Solutions, an Austin, Texas-based vendor that takes a 360° view of your healthcare needs. Vipul Mankad, M.D., founder, chairman and chief medical officer of Loop360, spoke with Healthcare Informatics about the importance of clinical analytics—and why identifying quality issues before they happen can offer your organization significant cost savings. He also emphasized how predicting adverse, expensive medical events allows the organization to focus care coordination resources and reduce costs.
Vipul Mankad, M.D.
Healthcare Informatics: Tell me more about Loop360’s overall mission.
Vipul Mankad, M.D.: Our mission is to make a positive impact on the quality of healthcare—and the cost of healthcare in our society. To accomplish that mission, we develop technologies that assess evidence-based care and predict those adverse events that result in expensive care. Because, if we can help provide better ambulatory care, we can both improve the quality of patient care and prevent excessive costs, for example, those related to unnecessary hospitalization.
Healthcare Informatics: What are some of the biggest challenges you see healthcare organizations facing when it comes to managing those excessive costs?
Vipul Mankad, M.D.: First, it’s not easy to align the incentives of providers, insurance companies, patients and society. All of those groups need information. But in healthcare, too often, we’re data rich but information poor. There is a lot of data in the physician’s offices, from patients and family members and from insurance companies. But, historically, we haven’t made good use of that data. As a result, the CEO, the doctor, the patient or the patient’s family does not have actionable information.
Healthcare was slower than many other industry to move from paper to information technology systems. And now that there’s been a fundamental change in the way we process information in healthcare, we’ve done a good job of creating electronic records—and we’ve even made many of those records interoperable. We have standards so different systems can talk to each other. But while all those repositories have information, they don’t have state-of-the-art analytics to help us make the best use of information. And actionable, clinical and predictive analyses are required to use all that information so that we can really manage costs.
Healthcare Informatics: How can making sense of all that data help to lower the cost of care?
Vipul Mankad, M.D.: The first thing that any analytics platform needs is to integrate data from disparate sources and make it analyzable. You need to clean and scrub the data so it can be used. And the analytics need to be agnostic of the EMR systems. The platform needs to be able to take data from any system, regardless of what kind of electronic medical record (EMR) system or business system you have. The system must also integrate the insurance company data, often provided in a different format. And all the other data systems, labs or images, that are part of your organization. Once that database is created, you often see data presented in dashboards. A descriptive deployment of common diseases, high-cost patients and locations where higher costs are occurring. And while that’s helpful, it doesn’t give you the whole picture. It is like driving a car while looking at the rear view mirror. It does not tell you where future costs or quality problems are.
That’s where Loop360 distinguishes itself. Because we offer advanced analytics that can analyze the performance of providers to see if what their practice is consistent with nationally accepted clinical guidelines. Why is this important? Because we know that patients in the U.S. only get about 50 percent of the recommended care—and often they are receiving excessive care not recommended in the guidelines. So our analysis places an emphasis on unnecessary care, that which is not consistent with guidelines. We call it “Don’t Do” guidelines. Our analysis allows you to catch those instances, have a dialogue with providers, and then reduce that unnecessary care and unnecessary costs.
Healthcare Informatics: Many healthcare organizations are moving to accountable care organizations (ACOs). How can Loop360’s analytics help them manage the changes that come with such a move?
Vipul Mankad, M.D.: ACOs have three objectives: One, to measure and improve quality. Two, to reduce the growth of healthcare expenditures. And three, to improve the health of the population that is being served by the organization. Quality improvement requires a continuous measurement —so you can identify opportunities to optimize quality performance while the care is provided, well before the annual quality reporting deadline. Loop360 has analytical tools in place to identify excessive care, so that you can reduce it in a timely manner. And that improves overall health and patient experience because patients don’t want all that unnecessary care that adds to their inconvenience and expense, and may even have side effects.
In addition to detecting unnecessary care, our tools also help you identify the care that is necessary and often missed; that can improve outcomes for a patient. For example, with diabetics, a careful follow-up plan should include a hemoglobin A1c test—as well as a discussion about diet, exercise and medications. Asthma patients should be on appropriate medications to prevent exacerbations. Appropriate care avoids any future complications and expensive hospitalizations.
Good quality assurance program should include monitoring performance on standardized measures, evaluation and improvement. And one of the ways that Loop360 distinguishes itself is that we don’t just report quality once a year, we do it concurrently and continuously. And by doing so, you can find out where you can intervene throughout the year to better coordinate your care, improve your quality and reduce major cost drivers like hospitalizations.
ACOs will always have limited resources. For example, ACOs may only have a certain number of care coordinators. So, with predictive analytics, you can help predict which patients are likely to experience an adverse event that may require hospital care—and with good ambulatory care, you can prevent those potential hospitalizations. Predictive analytics help to focus care coordination on the patients that need it most. That will reduce overall costs, first by reducing staffing costs and then, reducing hospitalization—and it’s also better for the patient so they can live a happy, productive life at home.
Healthcare Informatics: How can the right analytics help organizations get past data fatigue—and use all the information they have to their best advantage?
Vipul Mankad, M.D.: If you need a glass of water to quench your thirst, you would not open the fire hydrant. You don’t want to create thousands of pages of reports. You want to see just the most important information presented at the right time and at the right place so that you can act on. Of course, that data is going to differ based on your role. The ACO manager needs different information than, say, someone in the billing department. The doctor needs a different set of information than, say, the patient or the family.
But meeting the ACO manager’s information needs is a great example of why having the right analytics is so important. The ACO manager needs a 360° view of the entire ACO patient population—and predictive modeling so that the manager can make decisions about resource allocation. The manager can’t assign a handful of care coordinators to care for thousands of patients. You need to have the tools so you can focus care coordinators on a limited number of patients who have preventable problems. On the other hand, physicians need a 3600 view of each individual patient they are treating, not only what they are providing in their office but what the patient is receiving from all providers. Physicians need one kind of data, the patient needs another. The patient, through his or her own secure portal, should be receiving education that is customized to their own situation. When patients are engaged in their own care, the quality improves and costs go down. You don’t want to load anyone with tons of data they don’t really need. You want to make sure you give the data that is applicable so everyone knows what each person can do to improve the quality of health care and ultimately, quality of life.
Healthcare Informatics: How can the right analytics solution help cut costs without sacrificing quality of care?
Vipul Mankad, M.D.: By working with clinicians, Loop360 has put its data mining focus on common quality problems in healthcare that are actionable. We provide the analytics to help identify the patients with high probability of being admitted and those that require more care coordination. If you can prevent a hospital admission for chronic disease, you will see quality improve and costs decline.
Of course, there are different types of quality issues. There may be too much care being given where it isn’t needed. There may also be too little care being given—or inappropriate care being given. Having the right analytics in place can help you detect all of those different quality issues. And taken together, if you can identify those problems and act on them, you will see improved care for your patients and reduced costs.
Healthcare Informatics: What is your vision? Where do you see Loop360 in three to five years?
Vipul Mankad, M.D.: At Loop360, we wish to harness the power of big data and advanced analytics to improve care of individuals, enhance health of the population and reduce costs. Loop360 has already achieved those goals for new breed of healthcare organizations as they were established in their first phase. As we move forward, and the low hanging fruits have already been plucked, Loop360 analytics will become even more important. We cannot simply work harder; we have to be smarter. Combining clinical insights and data mining capabilities, we will bring the right information to the right people at the right time, and contribute to achieving the "triple aim."