Accountable Care Drives Big Data and Analytics
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Accountable Care Drives Big Data and Analytics



Accountable Care Drives Big Data and Analytics - sponsored by HP - IDC Health Insights

Accountable Care Drives Big Data and Analytics - sponsored by HP - IDC Health Insights



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Accountable Care Drives Big Data and Analytics Accountable Care Drives Big Data and Analytics Document Transcript

  • Accountable Care Drives Big Data and Analytics WHITE PAPER Sponsored by: HP C yn th i a B ur gh ar d S ep tem b er 2 01 IDC HEALTH INSIGHTS OPINION Key findings from IDC Health Insights research include: ● Accountable care programs require more accurate, timely, andF.508.988.7881 complete data. ● Current analytic and data warehouse programs use only 20% of data and are retrospective.P.508.935.4445 ● Access to unstructured data in healthcare provides insights that can identify drivers of re-admissions, create "clean" and homogeneous cohorts of patients to improve patient engagement, and identify fraud and abuse prepayment.Global Headquarters: 5 Speen Street Framingham, MA 01701 USA ● The challenges to Big Data and analytics include data complexity, conflicting IT priorities, and lack of understanding of the power of Big Data and analytics. ● HP provides services and software to enable Big Data and analytics. IN THIS WHITE PAPER This white paper is presented by IDC Health Insights and sponsored by HP. The intent of this paper is to provide insights into: ● The relationship between accountable care initiatives and emerging Big Data and analytics technology ● The analytic requirements of accountable care and how Big Data and analytics can address those requirements ● The attributes of Big Data and analytics and healthcare use cases ● The challenges related to Big Data and analytics in healthcare ● The capabilities of HP to address the emerging need for Big Data and analytics in healthcare September 2012, IDC Health Insights #HI236949
  • METHODOLOGYIDC Health Insights analysts used existing primary research, IDCHealth Insights Accountable Care Survey of 40 hospitals and 30health plans (fielded in May 2012), IDCs 2012 Vertical IT andCommunications Survey, and secondary research on accountable careand Big Data and analytics to develop this white paper. Using theresults of these research initiatives and other market intelligence, IDCHealth Insights analysts developed this white paper.SITUATION OVERVIEWWhat Is Accountable Care?When the term accountable care is used, many individuals assume it isin reference to the "Accountable Care Organizations" as defined by thePatient Protection and Affordable Care Act of 2010 (PPACA). Thislegislation created new care delivery and reimbursement models, such asaccountable care organizations (ACOs) and value-based purchasingplans, focused on reimbursing for care coordination, improving quality,and improving patient outcomes. These new models, which reimburseproviders based on quality care measured against evidence-basedmedical guidelines and improved patient outcomes, require healthcareorganizations to transform how care is delivered across the continuumof care. Bundled payments for episodes of care rather than encounter-based or per-procedure reimbursement require better care teamcollaboration and coordination across care settings, which in turnshould improve quality of care and patient outcomes, especially forpatients with multiple chronic conditions.It should be noted that some of the most effective accountable careinitiatives are coming from the private sector. A number of pilotprograms and demonstrations are taking place that include providerstaking on financial risk to coordinate care and improve outcomes.Regardless of whether the initiative is private or public, the fundamentalobjective of accountable care is to meet the objectives of the Institute forHealthcare Improvements (IHIs) Triple Aim, which are:● Better health for the population● Better care for individuals● Lower per capita costTriple Aim is a framework developed by the IHI that describes anapproach to optimizing health system performance. It is IHIs beliefthat new designs must be developed to simultaneously pursue the threedimensions identified ( 2 #HI236949 ©2012 IDC Health Insights
  • Accountable Care and Big Dataand AnalyticsTo successfully engage in accountable care initiatives requirescomplete, timely, and consumable data about consumers, patients,clinical best practices, effectiveness of treatments, and a host of otherdata. Information is emerging as the currency for business and thebasis of competitive differentiation, value creation, and riskmanagement. Traditional information strategies will no longer sufficeto address these emerging demands. Businesses are looking for waysto uncover new business models and agile approaches.Data is the single most valuable asset for healthcare organizations. Todate, healthcare organizations have relied on 20% of data for decisionmaking. The insights that can be gained from the remaining 80% of dataserve as one of the most compelling drivers for Big Data and analytics.Much of the 80% of data is unstructured, and recent research has shownthe tremendous value that can be drawn from unstructured data.The analytic tools historically available in the market cannot supportthe requirements of these new data sources or the timeliness to supportpoint-of-care decision making. Four fundamental shifts in theapproach to analytics hold great promise:● Context-aware analytics. Integration of transactional data with situational awareness or relevant context● Pattern-based strategy. Looking at the system of factors that are relevant to a business strategy; proactively seeking patterns from conventional and unconventional sources that can positively or negatively impact outcomes● Monetizing information. The ability to derive new economic models based upon the availability of data or analytics● Shared information ecosystems. Blending relevant information that is shared or exchanged across business ecosystems, or how businesses interrelate; information exchange across entities©2012 IDC Health Insights #HI236949 Page 3
  • The capabilities of Big Data and analytics can support accountablecare information requirements. IDC defines Big Data and analyticsusing four attributes:● Volume. Healthcare information will double in the next five years as a result of digitized medical information found in electronic health records, access to unstructured data, data from mobile devices and remote patient monitoring devices, and social media.● Variety. Significant progress in being made in healthcare to access unstructured data from medical records, providing a wealth of insight in areas such as the drivers of hospital re-admissions. Other new data sources, such as remote patient monitoring and the use of social media mature, will emerge as initiatives.● Velocity. Healthcare organizations have historically used retrospective data for analytics, which is too late to affect or prevent fraud and abuse, or to provide clinical decision support. The availability of real-time or near-real-time data will improve the "actionability" of information.● Value. In IDCs 2012 Vertical IT and Communications Survey, 47% of healthcare respondents indicated they did not know how to measure the benefits of analytic investments. There are many examples of measurable results from the use of Big Data and analytics.FUTURE OUTLOOKWhy Big Data and Analytics in Healthcare?As has historically been the case, healthcare industry investment intechnology lags behind that in other industries, but it will begin tocatch up within the next five years.That said, there are many very exciting and successful Big Datainitiatives in the healthcare market. The appetite for access to newstructured and unstructured data is growing as organizations recognizethe value of the insights that can be uncovered to improve clinical andfinancial outcomes, leverage ever-increasing data sources, andoptimize current investments in analytic and information management.Page 4 #HI236949 ©2012 IDC Health Insights
  • Big Data and Analytics Use Casesin HealthcareBig Data technology has a wide range of applications in healthcare todecrease the time from drug discovery to distribution; leveragegenomic data to personalize treatment for rare and deadly diseases;identify fraud, waste, and abuse; and create homogeneous patientcohorts to improve patient compliance in health management programs.The many successes include:● The use of Big Data and analytics to improve patient engagement was built on the creation of very clean and homogeneous patient cohorts. For example, individuals with chronic conditions (such as diabetics) often experience depression, which worsens the chronic condition. It becomes critical to not only identify the diabetic but further "clean" the cohort to account for depression. The impact of stress, whether it is relationship based, financial, or work related, may negatively impact chronic conditions, so it is important to understand stress levels in patients. It is also critical to reach out to patients where and when they can consume the information or take a positive action. Using these kinds of techniques, a number of improvements were documented: ○ Reaching out to patients after discharge from the hospital, reducing hospital re-admissions by 25% ○ Increasing the number of patients who get their recommended diabetes screenings by 76% ○ Quadrupling participation in an online smoking cessation program● To help Kaiser increase participation in its Thrive Healthy Living programs, its patient engagement vendor created different phone calls for different at-risk groups. The at-risk groups were identified based on multiple sources of data and the application of advanced analytics. The smoking call, for example, led with the statement "It doesnt really matter if you smoke, or just know someone else who does, we all know how hard it can be to quit." The result: 28% of the people reached said they smoked or that someone close to them did, greatly exceeding Kaisers previous benchmark of self- reported smoking behavior, while 45% of those respondents wanted information on smoking-cessation tools, and 79% of people who were offered a follow-up mailing said yes.● In Ohio, a group of physicians used utility bills to identify seniors without air conditioners during a significant heat wave in the Midwest. These individuals were at risk of heat-related illness or death. These high-risk patients were notified of the availability of "cooling stations," and as a result, no deaths were reported.©2012 IDC Health Insights #HI236949 Page 5
  • See Figure 1 for other use cases for Big Data and analytics in healthcare.Big Data and analytics are coming of age in healthcare. Organizationsthat are engaged in proof-of-concept initiatives are realizing the valueof having access to 100% of their data and are recognizing the risk ofcontinuing to make financial and clinical decisions without the mostaccurate and clean data available, regardless of the source or thestructure (or lack of it). Investments in Big Data and analytics canleapfrog the industry to improve the accuracy of decision making atthe point of care and to provide additional insights for clinical andoperational research.FIGURE 1Healthcare Use Case Examples Adverse Medical Clinical Outcomes Chronic Disease Events  EXAMPLE 1: Determine  EXAMPLE 1: Leverage  EXAMPLE 1: Identify drivers of re-admissions genomic data to psychological and for Medicare patients personalize treatments social drivers of patient for complex cancer compliance to chronic  BENEFITS: Avoid care paths patients unnecessary  BENEFITS: Improve re-admissions and  BENEFITS: Improve life overall health and avoid financial penalties expectancy and quality disease progression of life and reduce costs  EXAMPLE 2: Provide  EXAMPLE 2: Track patient discharge  EXAMPLE 2: Accelerate and intervene in patient instructions to care medical research compliance to chronic managers to ensure on the impact of the paths patient compliance environment on select  BENEFITS: Avoid diseases disease progression  BENEFITS: Avoid and complications costly complications  BENEFITS: Reduce the and re-admissions incidence of disease and improve quality of lifeSource: IDC Health Insights, 2012 1Challenges of Big Data and Analytics● Complexity. Healthcare data is among the most complex of any industry. The structured data comes from multiple sources that may define data values differently. For example, lab systems calibrate the results of a complete blood count differently. As a result, data has to be normalized or semantically harmonized. Many healthcare organizations have multiple systems that perform the same function; data must be rationalized and normalized.Page 6 #HI236949 ©2012 IDC Health Insights
  • As healthcare organizations begin to access new data sources, they will have to determine the relevancy of the new data and make decisions about what to include and what to exclude.● Conflicting IT priorities. Healthcare organizations are under a barrage of conflicting priorities including demonstrating meaningful use, preparing for ICD 10, and establishing health insurance exchanges. It is a challenge to take on yet another mission-critical initiative that is not a mandate or a regulatory requirement.● Lack of understanding of the power of Big Data and analytics. Healthcare organizations have been frustrated by historical investments in analytics as determining the value of the investments has been difficult. IDCs 2012 Global Technology and Industry Research Organization IT Survey indicated that 30% of payers and 63% of providers were not even aware of Big Data or how it is defined.HP Capabilities in Big Data and AnalyticsHP offers a wide range of information management and analytics(IM&A) capabilities drawn from its enterprise services, softwareproducts, and cloud and security platforms to address Big Datachallenges and opportunities in the healthcare industry.HP IM&A services include information strategy and organization,information management and architecture, business analytics andinformation delivery, and social intelligence. HP provides theseconsulting services around its own Big Data software assets,Autonomy and Vertica, and third-party software assets, in particularSAP HANA and Microsoft SharePoint/BI platform. HP supports thiswith a variety of software and solution delivery models including on-premise installation, hosted, software as a service (SaaS), cloudcomputing, and multitenant SaaS (cloud deployment).HP focuses its capabilities to enable healthcare providers, health plans,and life science companies to proactively manage information-relatedbusiness risk, enhance customer experiences, and optimize businessperformance to create competitive advantage.HPs Autonomy software asset helps healthcare providers, healthplans, and life science companies develop connected intelligence fromstructured and unstructured data for actionable decisions that improvebusiness performance.HPs Vertica analytics database delivers scalable performance on BigData queries enabling real-time decision making to be embedded inhealthcare processes in order to optimize business performance.©2012 IDC Health Insights #HI236949 Page 7
  • Vertica and Autonomy deliver a powerful combination for real-timeanalytics and decision making using structured and unstructured dataacross the enterprise.Strengths and ChallengesHP has a comprehensive product and services portfolio that isconsistent with what IDC Health Insights expects from one of themarket-leading enterprise healthcare vendors:● Cloud computing. HP can offer clients a variety of enterprise- grade cloud computing solutions, including public, hybrid, and private. The ability to offer private cloud to healthcare organizations is considered a strength for a number of reasons: healthcare organizations will demand a private cloud and are looking to reduce datacenter costs and make data more accessible.● Security. HP offers clients a security strategy through the HP Security Framework, designed to offer end-to-end information security plans and execution road maps to protect the enterprise information in their information management and analytics solutions. Because of the sensitive nature of healthcare data and the requirements and penalties imposed by the Health Insurance Portability and Accountability Act, security is top of mind for healthcare IT executives.● Information management and analytics. The healthcare industry has begun to recognize the advantages of having access, on a single platform, to new sources of data such as unstructured clinical information as well as data from remote patient monitoring, social media, and mobile devices. Robust data harvesting, cleansing, and integrating will become essential. Strong and deep analytic capability will be required for yet an even larger base of users. HPs capability as demonstrated by Autonomy and Vertica will enable HP to support healthcare organizations requirements.● Mobility. HPs approach to enabling enterprise mobility is suited for organizations that wish to reach their constituents across multiple networks and devices by delivering applications, content, and services in a scalable, secure, and reliable way. This gives healthcare organizations the ability to enable clinical mobility and improve patient engagement, both key to meeting the goals of accountable care.Page 8 #HI236949 ©2012 IDC Health Insights
  • HP faces many of the same market challenges as other enterprisevendors:● Competitive portfolios. HPs competitors are also focused on expanding their solution portfolios — in terms of the breadth and depth of product capabilities and professional services — and offering public cloud computing options.● Channel network management. HPs channel strength is also a weakness. Successful execution of its strategy to broaden its portfolio will require that HP reinforce its position in the enterprise space without alienating the channel that has been so beneficial to the organization.● Focus on security. As more patient information is made available through the electronic health record via a range of devices, including mobile devices, the risk of a privacy breach rises. Under ARRA, privacy breach notification, minimum use, and disclosure reporting requirements become more stringent and total annual penalties for violations can increase to $1.5 million.PARTING THOUGHTSHealthcare organizations looking to improve their capabilities in BigData and analytics should consider the following:● Recognize the value of untapped data assets in supporting fact- based decisions by physicians, case managers, pharmaceuticals, patients, and caregivers.● Recognize the implications of operating without critical information and build use cases to address the challenges. The goals of health reform and accountable care cannot be realized without access to Big Data technologies.● Conduct a gap analysis to determine what new technology and staff investments are required.● Formulate a Big Data strategy that includes evaluation of decision makers requirements, decision processes, existing and new technology, and availability and quality of data.● Consider a shared service model for technology deployment with noncompeting partners. The cost of Big Data technology is outside the financial resources of most healthcare providers, so new business models will need to be developed.©2012 IDC Health Insights #HI236949 Page 9
  • ABOUT IDC HEALTH INSIGHTSIDC Health Insights provides research-based advisory and consultingservices that enable healthcare and life science executives to:● Maximize the business value of their technology investments● Minimize technology risk through accurate planning● Benchmark themselves against industry peers● Adopt industry best practices for business/technology alignment● Make more informed technology decisions and drive technology- enabled business innovationIDC Health Insights provides full coverage of the health industry valuechain and closely follows the payer, provider, and life sciencesegments. Its particular focus is on developing and employingstrategies that leverage IT investments to maximize organizationalperformance. Staffed by senior analysts with significant technologyexperience in the healthcare industry, IDC Health Insights provides aportfolio of offerings that are relevant to both IT and business needs.Copyright NoticeCopyright 2012 IDC Health Insights. Reproduction without writtenpermission is completely forbidden. External Publication of IDCHealth Insights Information and Data: Any IDC Health Insightsinformation that is to be used in advertising, press releases, orpromotional materials requires prior written approval from theappropriate IDC Health Insights Vice President. A draft of theproposed document should accompany any such request. IDC HealthInsights reserves the right to deny approval of external usage for anyreason.This document was reprinted by HP with permission from IDC HealthInsights.Page 10 #HI236949 ©2012 IDC Health Insights