•	 Cognizant ReportsAnalytics-Driven Healthcare:Improving Care, Compliance and CostIn the face of skyrocketing costs, the ...
increase by a projected 4% to 6% in 2013,                           mortality rate for acute myocardial infarctionwhich is...
Multidimensional Predictive Models                      short-count pills and fill prescriptions without aPrior to the sig...
advanced analytics to improve after-treatment         among the use cases in which advanced analyt-care by gaining insight...
management and marketing techniques used                  	 In a survey of 263 healthcare professionals,in retail can also...
increased collaboration and sharing of patient         The Way Forward   information among different healthcare           ...
CMS Criteria for Meaningful Use of EHR             Stage 1                                 Stage 2                        ...
Organizations should adhere to the following best          foresights. These insights should be deliver-practices:        ...
7 	Kate Spies, “Physician Compensation in U.S. Among Lowest in Western Nations,” Healthcare  Finance News, May 29, 2012, h...
25     	     “Aetna and Baycare to Introduce Collaborative Care in Tampa,” Aetna News Hub, Dec. 17, 2012,     http://newsh...
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Analytics-Driven Healthcare: Improving Care, Compliance and Cost


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In the face of skyrocketing costs, the healthcare industry is addressing inefficiencies by improving data sharing and collaboration across the industry value chain and applying analytics to improve operations and patient outcomes.

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Analytics-Driven Healthcare: Improving Care, Compliance and Cost

  1. 1. • Cognizant ReportsAnalytics-Driven Healthcare:Improving Care, Compliance and CostIn the face of skyrocketing costs, the healthcare industry is addressinginefficiencies by improving data sharing and collaboration across theindustry value chain and applying analytics to improve operationsand patient outcomes. Executive Summary health conditions and prescriptions, while semi- Ever-increasing costs highlight the inefficiencies structured and unstructured data is available in that currently plague each link in the U.S. health- e-mail, social networking sites, doctors’ notes, care industry’s value chain. If deployed properly, test results, physicians’ commentaries, etc. The advanced analytics can play a significant role integration of all this data is key, and this calls for in reducing these inefficiencies and providing greater collaboration among the IT departments healthcare organizations with insights to manage of healthcare organizations, care practitioners their business more proactively and profitably. and claims processing experts. For example, analysis of electronic health To fully exploit this abundance of data, health- record (EHR) data can lead to improved clinical care organization must create a culture that outcomes and reduced readmissions, both of places a premium on fact-based planning and which can lower costs and inspire patient loyalty. decision-making. Evidence-based insights from This will become particularly important this a variety of sources can be used to provide year, when hospital readmissions — which cost valuable feedback to physicians. Medicare $15 billion in 20121 — will begin to be penalized by the U.S. Centers for Medicare & Furthermore, as data volumes rise, a “pay-per- Medicaid Services (CMS). use” analytics model will help minimize costs for healthcare organizations, large and small. Analytics, moreover, can help predict an individual’s future healthcare needs, which can be Rising Healthcare Costs, valuable for both the payer and provider. Health- Regulatory Pressures care organizations must, therefore, begin to set Healthcare costs in the U.S. are ballooning. up internal systems that gather disparate data The annual spend in 2012 was estimated at in one place. This includes both structured around $3 trillion, or about 20% of the GDP. and unstructured data; for example, EHR pro- This expenditure is twice that of any other vides structured data of a patient’s history of industrialized country. What’s more, costs will cognizant reports | february 2013
  2. 2. increase by a projected 4% to 6% in 2013, mortality rate for acute myocardial infarctionwhich is more than the estimated 2.3% rate of (AMI) decreases by 7%. Moreover, the EBITDAinflation.2 Despite technology and process improve- per bed increases by 14%, and the percentage ofments, it is widely believed that the U.S. health- individuals who would recommend the hospitalcare industry remains highly inefficient due to a increases by 0.8%.lack of shared insights, collaboration, incentivesfor cost control and quality healthcare research. Excessive compensation for physicians alsoIn fact, it is estimated that around $700 billion of contributes to skyrocketing costs. Physicianthe $2.5 trillion spent on healthcare in 2010 in the salaries in the U.S. account for 8.6% of totalU.S. represents unnecessary expenditures.3 healthcare costs. In absolute dollar terms, U.S. physicians earn more than physicians ofRelief may be on the way. Federal regula- other nations, as the average per capita health-tions mandating better health outcomes are care spend in the U.S. is $2,600 more than thepressuring the industry to become more efficient. next highest spending country.7The Patient Protection and Affordable Care Act(PPACA), for example, addresses the twin goals Deploying Analyticsof reducing healthcare costs and improving In this scenario of runaway healthcare costs — asquality of patient care. It clearly ties reimburse- well as growing regulatory pressure for affordabilityments to the performance of healthcare organi- and improvement in clinical outcomes — analyticszations. A percentage of these reimbursements has emerged as a silver bullet for the healthcarewill take into consideration the efficiency of the industry. Analytics can generate insights thathealthcare organization, as well as patient satis- lower costs, reduce inefficiencies, identify at-riskfaction metrics.4 populations, predict individuals’ future health- care needs and support physicians’ diagnoses.Unnecessary procedures are one cause of the Analytics can enable more efficient use ofcost spike. According to a survey published by resources by ensuring that those who need careArchives of Internal Medicine, 43% of respon- the most receive it.dents said many patients are asked to undergounnecessary tests by physicians.5 In short, analytics can be used to:According to a McKinsey report,6 effective • Build multidimensional predictive models.hospital management strongly correlates with • Reduce costs.high-quality care. When the quality of hospi- • Improve outcomes.tal management improves by one unit on a • Empower patients.scale of 1 (worst) to 5 (best), the report says, theMultidimensional Predictive ModelsToday’s Industry Model Future StateCare Management Identification Care Management Identification Convergence of health and nonhealth insights Medical Health-based Third-party claims data member consumer insights insights Health Health- assessment Multi-dimensional Pharmacy based data Stratification member insights claims data member Predictive and care insights modeling outreach Predictive modeling Wellness Health Outcome Goals screening activity data Stratification • Higher engagement data care • Improved health outreach • Reduced healthcare costsSource: "The Promise of Healthcare Analytics," Healthleaders Media, 2012.Figure 1 cognizant reports 2
  3. 3. Multidimensional Predictive Models short-count pills and fill prescriptions without aPrior to the signing of the PPACA into law refill and then overbill Medicaid.in 2010, payers and providers disagreed onaccountability for controlling healthcare costs. Such fraud can be reduced by using rule-basedToday, both parties agree they must work algorithms.12 For instance, on the payer side of thecollaboratively and share accountability for the healthcare equation, a business rule might asktotal cost of care. Therefore, information about for closer inspection of a claim when it exceedspatient health is increasingly being combined a benchmark dollar amount. Similarly, an alarmwith nonhealth information and third-party could be triggered if multiple medical proce-consumer insights to create multidimensional dure codes are used instead of a single code orpredictive models. These models lead to better if a claimant submits an unusually high numberstratification that, in turn, leads to higher engage- of claims.ment, improved health and reduced healthcarecosts (see Figure 1, previous page). Lack of access to healthcare also contributes to industry inefficiency, as the need for services isReducing Costs sometimes greater than the healthcare resourcesBecause healthcare services come with a price, available. The decision to provide a service shouldorganizations are incentivized to seek volume be driven by the relative merit of the patient’sover value. This model encourages repeat visits need. Surplus resources can then be made avail-to healthcare providers, readmissions and other able to those who really need them. Analyticalinefficiencies that increase costs. Analytics can models can be built on the basis of demographicbe used to implement a payment method based characteristics to inform this decision-makingon performance, where instead of volume, the process, thus increasing access to healthcare toprovider would be paid for value, as determined those most in need.13by outcomes.8 Improving OutcomesThis model can be achieved by structuring the The healthcare industry across the globe ispayment system so that the payer assumes the moving from volume to value. As such, clinical“insurance risk”9 and the provider assumes the outcomes are more impor-“performance risk.”10 Providers can then use tant than ever. Healthcare An evidence-available patient data to deliver better solutions industry-related data is based approachthat are focused more on outcomes and value increasing at a rate of 35%than on volume of patient care. per year due to increased to collecting use of EHR capabilities and and analyzingAdditionally, the Health Insurance Portability other forms of unstructured information fromand Accountability Act’s (HIPAA) privacy rules data generated by socialpermit the disclosure of protected health infor- Web site and mobile device various sourcesmation (PHI) for research without the authori- usage. Advanced analytics can be employed tozation of the individual.11 Data-driven models are can help organizations more enable appropriatebeing used to identify disease risk factors. By effectively mine this data tousing these models to identify at-risk populations, improve health outcomes.14 intervention for theproviders can initiate treatment earlier, thus Additionally, an evidence- physician at thereducing costs. In fact, early diagnoses often lead based approach to collecting point of care.to treatments that use less expensive medicines and analyzing informationor no medicine at all. from various sources can be employed — including practitioner research papers, technical reports,Fraud committed by healthcare provider person- clinical trial studies, expert views, patient charac-nel is another cause of growing costs. Such fraud teristics, etc. — to enable appropriate interventioncan take the form of duplicate scripts or filling for the physician at the point of care.multiple prescriptions for the same drug. Theseactivities increase revenue for the provider and Minimizing Readmissionsunintentionally create incentives for employ- Nearly one in five Medicare patients in theees to commit fraud. For example, employees U.S. is readmitted within 30 days of hospitaliza-can substitute generic drugs for brand names, tion.15 Healthcare providers are increasingly using cognizant reports 3
  4. 4. advanced analytics to improve after-treatment among the use cases in which advanced analyt-care by gaining insights into treatment trends ics can drive thoughtful and effective preventiveand causes for readmission and designing inter- care strategies.ventions. A leading U.S. healthcare provider has In an increasinglyreduced readmissions by 22% through the use of Educating patients aboutanalytics.16 their health conditions and competitive taking precautionary mea- world, whereBeginning in 2013, CMS will begin penalizing sures will also help health- reimbursementsproviders for readmissions beyond a stated care providers establishcut-off for some conditions.17 Total penalties preventive care initiatives. are declining andfor 2013 are estimated to reach $280 million.18 Effectively disseminat- proof of betterHospitals that fail to show readmission rate ing information through care is requiredimprovements will be penalized up to 2% of patients’ preferred chan-Medicare reimbursements in 2014 and 3% in nels is vital to encouraging to improve2015.19 Moreover, more chronic conditions will them to access requisite clinical outcomes,be included on the readmission penalty list in information about their organizations needthe future, including cardiac bypass surgery conditions and share pre-and chronic obstructive pulmonary disease. ventive measures. With to analyze all theAnalytics can be used on the EHR data of patients increasing use of smart- data they can getwith chronic conditions, as well as other discharge phones, mobile applications their hands on.procedures, to identify the target population and can be used to educateenhance patient monitoring with appropriate patients and for outreach. These applications canpost-discharge plans that reduce readmissions. help access physician guidelines and share health information, such as sugar levels and bloodIt is, therefore, imperative for healthcareorgani- pressure levels. The key here is providingzations to prepare and understand their readmis- accessibility to portals through smartphones.sion metrics, calculate their readmission ratesby condition and physical performance and com- Health information wellness calculators shouldpare outcomes with benchmark rates. This is a also be accessible on-the-go.20 These wellnesshighly data-intensive analytical process that will calculators can help determine average walkingbenefit healthcare providers by reducing penal- speed, stride length, calories burned by activity,ties or, better yet, avoiding them. Providers can resting metabolism and also body fat percentagealso use patients’ demographic data to conduct (see sidebar, next page). Once these details area risk assessment, identify at-risk patients and obtained, an individual can decide whether it’sprioritize their treatment. necessary to contact a physician. Moreover, this unstructured data is ripe for predictive analysisPreventive Care that can help improve patient outcomes and lead toHistorically, healthcare has been considered better management of the healthcare ecosystem.a local service, and comparing it with relatedgeographic markets was considered unnecessary. Significant data is available on the payer side,It was not price sensitive or driven by market as well. Predicting patients’ future healthcareneeds, so operational analysis was considered needs would greatly benefit at-risk patients.a waste of resources. Even if it were important, For one leading payer, 4% of customers accounthealthcare institutions either lacked appropriate for 50% of its cost. If the insurer could identifytechnology or were saddled with outdated IT sys- and engage that small customer segment totems that in many cases did not offer data analysis better manage their health, it could improve not onlycapabilities. cost control but its healthcare outcomes, as well.However, in an increasingly competitive world, Empowering Patientswhere reimbursements are declining and proof Consumers can and should become more respon-of better care is required to improve clinical sible for their own health if they are provided withoutcomes, organizations need to analyze all the more relevant and timely data-driven insights.data they can get their hands on. Stratifying the They can, for instance, select the best providerpopulation, identifying patients at risk, analyzing in their vicinity by examining a report card ongaps in care and elevating pre-care planning are various institutions. Customer relationship cognizant reports 4
  5. 5. management and marketing techniques used In a survey of 263 healthcare professionals,in retail can also be emulated to understand 71% of respondents cited data integrationappropriate communication channels for patients from multiple sources as a main goal, whileto disseminate the right message at the right 56% indicated data standardization was a toptime. For instance, a monitoring system is avail- priority. More than 8 in 10 (86%) said theseable that monitors a medication prescribed for goals were difficult to achieve.21 The standard-diabetes patients at prescribed intervals and ization problem is clearly visible in physiciansends text messages or makes phone calls as a notes,22 as their descriptive narratives can betherapeutic reminder. difficult to analyze. Techniques such as natural language processing (NLP) can help mine criti-Data Standardization, Integration and cal details from such unstructured data.Collaboration ChallengesWhile there are many possible benefits to be • Lack of collaboration across the health-obtained using analytics, challenges remain, care value chain: Most organizations con-including the following: sider the data they generate to be proprietary and sacrosanct and are, therefore, unwilling• Lack of data integration and poor standard- to share that data with other stakeholders. ization: Historically, healthcare organizations EHR vendors have built data warehouses have lamented the insufficient funds available and are beginning to share masked patient for IT investment. Now, the issue is a lack of stan- data with their clients. For the accountable dardization and nonexistent data integration. care organization model to be successful, Quick TakeMobilizing Via M-HealthHelping consumers and patients fill an active role in healthcare is an essential component of the newhealthcare business model. The explosion of mobile devices and apps dovetails with this requirement.Mobile health, or “m-health,” fulfills two key needs: enabling consumers to manage their health servicerelationships more easily and giving individuals powerful portable tools for managing chronic conditionsand staying well.One application we have developed at our clients’ request will allow consumers to easily manage theirhealth plans from a variety of computing platforms, including smartphones and tablets. The app enablesthem to search for providers, receive immediate explanation of benefits notices, get messages aboutcoverage changes, obtain a secure ID card for use at physician offices and emergency departments, anduse a variety of ease-of-use features, such as click-to-call. Another app offers personalized wellnessmanagement via smartphone or tablet. This app enables patients and members to easily enter or auto-matically download health information, such as blood pressure, blood sugar, cholesterol levels, weight,body measurements, etc. Then, in easy-to-read charts, the app shows them how their current resultsrelate to their goals and offers a variety of tips and information to help them achieve those goals.Authorized physicians may access data from the app to monitor patient progress more frequently, with-out the time or expense of office visits. Plans and physicians may also customize the app to be alerted tochanges in a patient’s condition that require intervention. Employers may even use the app in wellnesscampaigns, with games and graphics encouraging participation. The objective of these features is toprevent minor conditions from escalating to more serious problems that cost more to treat and manage.Apps like these will put health management tools literally at the fingertips of consumers and patients,giving them the more active role in their health choices they are demanding – and that will help reshapehealthcare.This article originally appeared in Cognizanti Journal, Volume 5, Issue 1, 2012. cognizant reports 5
  6. 6. increased collaboration and sharing of patient The Way Forward information among different healthcare Funding from the government for EHRs will be providers should become a wider practice. made available only to organizations that meet the proposed CMS criteria for the meaningful Other players see analytics as a com- use of EHR (see Figure 3, next page). Healthcare mercial opportunity. Organizations with providers were mandated by CMS to begin analytics expertise offer their services to capturing and sharing data in 2011-12. Provid- health information exchanges23 to improve the ers need to use advanced care processes with quality of information and outcome of care. decision support in 2014 and show improved Pharmaceuticals companies and the research outcomes by 2016. If these criteria are not met, arms of insurers have aligned to explore their reimbursements from Medicare will be ways to improve the health of the elderly and reduced.26 individuals with chronic conditions. Payers have rich sources of information on claims The resulting decision support systems will be with disease codes from patients admitted based on analytics that take health information to different clinics and other administrative from the established EHR and other health IT information. If this data could be combined systems and apply statistical/artificial intelligence with the patient information generated by techniques to identify various risk factors, strat- providers, it could provide a wealth of action- ify patients based on health conditions, provide able insights. actionable information to physicians at the point of care and measure progress on health outcomes. Kaiser, an integrated provider and payer, for example, was able to reduce 30-day readmis- Given that healthcare organizations can reap sion rates at one of its medical centers from multiple benefits from using analytics, it is 13.6% to 9% in six months by using a collab- imperative that they create an environment orative payer/provider approach.24 Aetna, one conducive to nurturing this capability. They must of the largest private insurers, partnered with create a knowledge- and analytics-driven culture BayCare health system to improve manage- that pervades the entire organization. In fact, ment of patients with chronic conditions such all clinical information stored in standard data as diabetes and heart failure, as well as reduce formats such as EHRs must be captured and trans- readmission costs.25 formed into actionable data on which analytics can be applied. The following principles should beOther challenges include limited access to skills considered when building a framework for dataand resources, the lack of a clear vision on the use across the healthcare industry:benefits of analytics, and limited funding andmanagement support for analytics (see Figure 2).Challenges of Analytics Use60 Poor data quality: Diverse data sources makes it 52.2% difficult to create a single source of the truth 48.3% Limited access to skills and resources50 43.5% Information is not available in a timely manner, 39.7% so decisions are made without being data driven40 39.2% Limited analytics champion/sponsorship Lack of a clear vision on how the organization 27.3% can benefit from analytics30 26.8% Poor data: Too many manual systems deployed, resulting in insufficient electronic data20 16.3% Poor data: Transactional systems exist, but data cannot be unlocked easily 10 6.7% Culture not ready to become a data-driven organization 0 OtherSource: "Business Intelligence/Analytics Survey," Healthcare IT News, February 2012.Figure 2 cognizant reports 6
  7. 7. CMS Criteria for Meaningful Use of EHR Stage 1 Stage 2 Stage 3 2011-2012 2014 2016 Data capture and sharing Advanced clinical processes Improved outcomes Electronically capturing health More rigorous health information Improving quality, safety and efficiency, information in a standardized exchange leading to improved health outcomes format Using that information to track Increased requirements for Decision support for national key clinical conditions e-prescribing and incorporating high-priority conditions lab results Communicating that information Electronic transmission of Patient access to self-management tools for care coordination processes patient care summaries across multiple settings Initiating the reporting of clinical More patient-controlled data Access to comprehensive patient data quality measures and public through patient-centered HIE health information Using information to engage Improving population health patients and their families in their careSource: HealthIT.govFigure 3• Data use should focus on patients’ protected • The need for training and skill development health information for research, but their in health IT and clinical informatics should privacy should be protected in compliance be addressed. with HIPAA.• Data transparency is a must and should be A data analytics framework (see Figure 4) can be overseen by a reliable steward. used by various stakeholders to not only manage• The initiative should begin by collecting, disease treatment but also improve the quality of piloting and deploying high-use, high-value patient outcomes. However, the security of data subsets of data around specific diseases. is paramount.• Organizational focus should shift from trans- actions to quality and outcomes.Framework for Analytics Health management/ disease management Stakeholders (payers, providers, pharmaceutical companies, etc.) Security of data Data use Quality of outcomes Application of Regulation and technology complianceSource: Cognizant Research CenterFigure 4 cognizant reports 7
  8. 8. Organizations should adhere to the following best foresights. These insights should be deliver-practices: able across the organization and applica- tions. Only then can ana-• Develop a culture that emphasizes fact- lytic tools be applied to Both structured based decision-making. Available data should deliver results. and unstructured be structured and analyzed to provide a guide- • Convert most manual line for the organization to improve on effi- data into electronic data from within ciencies and for quick decision-making. The form. The data from and outside the data should be freely available to stakeholders transactional systems organization who want to use it. A balance must be achieved should be made avail- between data quantity and quality so that phy- able to those who need should be sicians are not overwhelmed; only relevant it or could benefit from integrated to build insights should be made available to them. it. Timely availability of a solid information• Provide feedback where required. Most information is important, clinicians will appreciate a comparative analy- provided information foundation from sis with another clinician. If analytics are used security is given high which to draw and the shortcomings are presented in the priority. both insights and right format, then an overall improvement in • Evaluate and make sec- the outcomes should follow. Clinicians should ondary use of transac- foresights. be told clearly what they need to change, such tional data. For example, healthcare organi- as the drug administration process or the use zations should consider revenue-generating of testing. partnerships with pharmaceutical companies• Ensure integration of data and greater col- to leverage their transactional data ethically laboration between IT and domain experts. and ensure mutual benefits for both industry Both structured and unstructured data from segments. within and outside the organization should be • Use a pay-per-use model, especially as integrated to build a solid information foun- volumes increase. This would help to variabi- dation from which to draw both insights and lize costs and avoid higher fixed investments.Footnotes “Work Environment Affects Hospital Readmission Rates,” NursingTimes.net, Dec. 31, 2012,1 http://www.nursingtimes.net/nursing-practice/clinical-zones/management/work-environment-affects- hospital-readmission-rates/5053171.article.2 John Commins, “Healthcare Reform Unstoppable, Regardless of Court’s PPACA Decision,” HealthLeaders, June 28, 2012, http://www.healthleadersmedia.com/page-2/COM-281759/Healthcare- Reform-Unstoppable-Regardless-of-Courts-PPACA-Decision##.3 “Valuing Healthcare: Improving Productivity and Quality,” Kauffman Task Force on Cost-Effective Healthcare Innovation, April 2012, http://www.kauffman.org/uploadedfiles/valuing_health_care.pdf.4 “Healthcare Reform: Impact on Hospitals,” Health Capital Consultants, Health Capital Topics, Vol. 4, Issue 1, January 2011, http://www.healthcapital.com/hcc/newsletter/1_11/aca.pdf.5 Rachel Fields, “How Will Healthcare Reform Affect Unnecessary Care,” Becker’s ASC Review, May 1, 2012, http://www.beckersasc.com/news-analysis/how-will-healthcare-reform-affect- unnecessary-care.html.6 “Management in Healthcare: Why Good Practice Really Matters,” McKinsey & Co., http://worldmanage- mentsurvey.org/wp-content/images/2010/10/Management_in_Healthcare_Report_2010.pdf. cognizant reports 8
  9. 9. 7 Kate Spies, “Physician Compensation in U.S. Among Lowest in Western Nations,” Healthcare Finance News, May 29, 2012, http://www.healthcarefinancenews.com/news/physician-compensation- among-lowest-western-nations.8 Robert Gelber, “Fixing Healthcare With Big Data,” Datanami, April 4, 2012, http://www.datanami.com/ datanami/2012-04-04/fixing_healthcare_with_big_data.html.9 The risk of whether a patient will develop a costly health condition.10 The risk of higher costs from delivering unnecessary services, delivering services inefficiently, or committing errors in diagnosis or treatment of a particular condition.11 “HIPAA, The Privacy Rule and its Application to Health Research,” NCBI, http://www.ncbi.nlm.nih.gov/ books/NBK9573/.12 “Combating Healthcare Fraud,” SAS, 2010, http://www.sas.com/resources/whitepaper/wp_15046.pdf.13 “The Value of Analytics in Healthcare,” IBM Global Business Services, 2012, http://public.dhe.ibm.com/ common/ssi/ecm/en/gbe03473usen/GBE03473USEN.PDF.14 “IBM Uses Watson Analytics to Increase Smartphone, EHR Capabilities,” Healthcare IT News, May 26, 2011, http://www.healthcareitnews.com/news/ibm-uses-watson-analytics-increase-smartphone- ehr-capabilities.15 Mike Miliard, “Texas Provider Uses Business Analytics Post Treatment Care,” Healthcare IT News, March 23, 2011, http://www.healthcareitnews.com/news/texas-provider-uses-business-analytics- post-treatment-care.16 Mike Miliard, “Texas Provider Uses Business Analytics Post Treatment Care,” Healthcare IT News, March 23, 2011, http://www.healthcareitnews.com/news/texas-provider-uses-business-analytics-post- treatment-care.17 Neal Gold, “Three Admissions to Reduce Now,” HealthLeaders, March 15, 2011, http://www.healthlead- ersmedia.com/content/COM-263665/3-Readmissions-to-Reduce-Now.html.18 Amy Boutwell, “Time to Get Serious About Hospital Readmissions,” Health Affairs Blog, Oct. 10, 2012, http://healthaffairs.org/blog/2012/10/10/time-to-get-serious-about-hospital-readmissions/.19 Charles Fiegl, “2,200 Hospitals Face Medicare Penalty for Readmissions,” Amednews.com, Aug. 27, 2012,http://www.ama-assn.org/amednews/2012/08/27/gvsb0827.htm.20 ichelle McNickle, “Five Critical Technologies Health Systems Should Require,” Healthcare IT News, M July 30, 2012, http://www.healthcareitnews.com/news/5-critical-technologies-health-systems-should- require.21 “Needles in a Haystack: Seeking Knowledge with Clinical Informatics,” PricewaterhouseCoopers, 2012, http://pwchealth.com/cgi-local/hregister.cgi/reg/needles-in-a-haystack.pdf.22 “Medical Record Documentation for Patient Safety and Physician Defensibility,” MIEC, January 2008, http://www.miec.com/Portals/0/pubs/MedicalRec.pdf.23 The term “health information exchange” (HIE) refers to electronic sharing of health-related information among organizations, with the goal of reducing duplication of services and operational costs for healthcare providers.24 Gabriel Perna, “PwC Report: With Population Health, Payers and Providers Have to Play Nice,” Healthcare IT News, Sept. 28, 2012, http://www.healthcare-informatics.com/article/pwc-report-popula- tion-health-payers-and-providers-have-play-nice. cognizant reports 9
  10. 10. 25 “Aetna and Baycare to Introduce Collaborative Care in Tampa,” Aetna News Hub, Dec. 17, 2012, http://newshub.aetna.com/press-release/health-care-professionals-and-networks/aetna-and-baycare- introduce-collaborative-care-.26 “Ready or Not: On the Road to Meaningful Use of EHRs and Health IT,” PricewaterhouseCoopers, June 2010, http://pwchealth.com/cgi-local/hregister.cgi/reg/Ready-or-not-On-the-road-to-meaning- ful-use-of-EHRs-and-health-IT.pdf.CreditsAuthorsSanjay Fuloria, Ph.D., Senior Researcher, Cognizant Research CenterYuvaraj Velusamy, Researcher, Cognizant Research CenterDesignHarleen Bhatia, Creative DirectorChiranjeevi Manthri, DesignerAbout CognizantCognizant (NASDAQ: CTSH) is a leading provider of information technology, consulting, and business processoutsourcing services, dedicated to helping the world’s leading companies build stronger businesses. Headquarteredin Teaneck, New Jersey (U.S.), Cognizant combines a passion for client satisfaction, technology innovation, deep in-dustry and business process expertise, and a global, collaborative workforce that embodies the future of work. Withover 50 delivery centers worldwide and approximately 150,400 employees as of September 30, 2012, Cognizant is amember of the NASDAQ-100, the S&P 500, the Forbes Global 2000, and the Fortune 500 and is ranked among thetop performing and fastest growing companies in the world.Visit us online at www.cognizant.com for more information. World Headquarters European Headquarters India Operations Headquarters 500 Frank W. Burr Blvd. 1 Kingdom Street #5/535, Old Mahabalipuram Road Teaneck, NJ 07666 USA Paddington Central Okkiyam Pettai, Thoraipakkam Phone: +1 201 801 0233 London W2 6BD Chennai, 600 096 India Fax: +1 201 801 0243 Phone: +44 (0) 207 297 7600 Phone: +91 (0) 44 4209 6000 Toll Free: +1 888 937 3277 Fax: +44 (0) 207 121 0102 Fax: +91 (0) 44 4209 6060 Email: inquiry@cognizant.com Email: infouk@cognizant.com Email: inquiryindia@cognizant.com©­­ Copyright 2013, Cognizant. All rights reserved. No part of this document may be reproduced, stored in a retrieval system, transmitted in any form or by anymeans, electronic, mechanical, photocopying, recording, or otherwise, without the express written permission from Cognizant. The information contained herein issubject to change without notice. All other trademarks mentioned herein are the property of their respective owners.