With the rollout of the pay-for-performance model in U.S. healthcare, healthcare leaders are now realizing that having data at their fingertips to make decisions of all kind will be necessary. From both a business and clinical standpoint, big data is a tremendous asset; specifically at the point of care, when patient care organizations apply analytics, it can offer invaluable insights to improve chronic disease management and track at-risk patient populations.
Undoubtedly, the billions of dollars that are being spent on the adoption and implementation of health IT tools means that the amount of data in the healthcare landscape will only grow. However, it should come as no surprise that healthcare is still behind most other industries when it comes to really using big data and analytics. According to Munzoor Shaikh, a senior manager in the consulting firm West Monroe Partner’s healthcare practice, although some of the leading patient care organizations are using big data at the point of care, the industry has a ways to go. Shaikh recently spoke with Healthcare Informatics about the potential of big data to help in the clinical setting—including in the wake of the recent hospital readmissions news—and how a change in culture could end up paying dividends.
Are you seeing healthcare organizations using big data at the point of care?
I don’t think most places are doing it very well. A few are starting to, and most of that has been in hospital settings around reducing readmissions. But that is such low-hanging fruit to me and so overdue, I’d hardly call that a victory from an industry standpoint.
Taking a step back, I think about analytics as a value chain; there’s a value chain to the data that exists, and I like to break it down into four “As.” The first A is access—you need to have access to data, and this isn’t trivial. Hospitals have lots of data, but sometimes there is only access to one type—sometimes they don’t have claims data, sometimes they don’t have demographics data. I was talking to a wellness company recently that did 35 different biometric markers. Hospitals hardly have that data, so access is a critical thing. You need to know what you have access to, and thereby what type of value might be derived from it.
The second A is aggregation, and this is where most of industry’s efforts are going, though few know how to aggregate data in a meaningful way. Those that do are getting the benefit of meaningful analytics from it. Aggregation is a big deal now, and a lot of the health plans suffer from this because they can aggregate their claims data, but can’t take lab data, claims data and clinical data, and aggregate it together very well.
Analytics, the third A, only makes sense when you have done the first two. In healthcare, things are moving so slowly in the big data and analytics world. Hospital readmissions are a cutting edge thing, but this is something big data should have solved a long time ago. And the fourth A is application, which involves the educational and engagement processes that are built around behavioral change. These four “As” help build the value and help build on each other. That’s the narrow perspective—from the broader perspective, very little is being done at the point of care, however.
What needs to happen for that to change?
Well it’s all just happening very slowly, since this industry moves in slow motion in terms of data and analytics. Hopefully in the next five years readmissions will be solved, and other meaningful things will have emerged. For instance, what about chronic disease? Why should the “point of care” be the hospital? Why isn’t the point of care when I come to my office and go to the clinic? Why isn’t when I wake up in morning and track something on my Fitbit? We need to redefine the point of care and think about it as a “point of living.”
What you’re talking about would require a pretty big cultural change, right?
We have this problem in our healthcare system where we wait until we get sick and need care, and then at the point of care we need to do something. At that point, many things have gone wrong. What about all the other points of living? That’s what the big data vision really is, and you see wellness companies going in that direction. To me, that has a quicker future, but not necessarily as a high as a return as readmissions, which people are paying more attention to because they’re so expensive.
Another point of view is what I call a positive deviance perspective. We always talk about using analytics to figure out preventing when you’re going to be sick, but we never think about using analytics to say “you are going to be healthy.” I would like to take whatever it is you do to stay healthy—you may be a positive deviant in our system, meaning you’re not likely to go to hospital or get a chronic disease—and replicate your lifestyle to the rest of my population. Other countries do this well, but in the U.S. we are more focused on the sick than the healthy, and we want to learn from the sick rather than learn from the healthy.
Is patient-generated health data (PGHD) a step in that direction?