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Finding Actionable Insights from Healthcare's Big Data

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This webinar covers how to:
- understand ways to prioritize your business drivers
- analyze your data and align opportunities (cost, reimbursement, risk) to maximize impact
- understand your target hyper-segment down to the member level
- identify higher cost segments and behaviors that would benefit from digital intervention
- learn ways to take action now

Published in: Business
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Finding Actionable Insights from Healthcare's Big Data

  1. 1. Insight. Action. Measure. Finding actionable insights in healthcare’s Big DataAugust 5, 2015 © Medullan, Inc.
  2. 2. 2page© Medullan Inc. Heather Ritchie VP, Product Management Heather leads product strategy and roadmap at zakipoint Health. Her expertise is in defining product strategies and customer experiences for healthcare technology solutions. Your Guides Today Ryan Rossier VP, Product Innovation Ryan leads the product innovation team at Medullan. His expertise includes market research and analysis, program management, agile delivery excellence, and lean start up.
  3. 3. 3page© Medullan Inc. Today’s Discussion What are the possibilities? What are the challenges What’s an insight? What’s an actionable insight? Case studies How we see the world: Insight. Action. Measure. Q&A 1 2 3 4 5 6
  4. 4. 4page© Medullan Inc. BACKGROUND: Healthcare data So, where can data help in healthcare? 160 Exabytes = 1.3B Terabytes Would take Watson 82 years Real-time capture, real- time results Data sources and types are on the rise Can I trust the data?
  5. 5. 5page© Medullan Inc. Where can data help in healthcare? There is massive potential benefit locked in healthcare’s data. Population health management Precision medicine Care optimization R&D productivity
  6. 6. 6page© Medullan Inc. Where can data help in healthcare? There is massive potential benefit locked in healthcare’s data. Today we’ll focus on Population Health. Population health management Precision medicine Care optimization R&D productivity
  7. 7. 7page© Medullan Inc. What are the opportunities in Population Health? Bend the curve of avoidable costs Value comes from the market’s ability to effectively use its data to invoke the right actions. Time Cost Identify at-risk members Validate efficacy and refine Design interventions `!
  8. 8. 8page© Medullan Inc. Data Volume Value The insight value chain
  9. 9. 9page© Medullan Inc. InfoData Volume Value The insight value chain “has context,
  10. 10. 10page© Medullan Inc. InsightInfoData Volume Value The insight value chain “has context, is well understood,
  11. 11. 11page© Medullan Inc. Actionable InsightInsightInfoData Volume Value The insight value chain “has context, is well understood, and delivers value if addressed.”
  12. 12. 12page© Medullan Inc. Actionable InsightInsightInfoData Volume Value The insight value chain Ability to take an action that will have an Impact “has context, is well understood, and delivers value if addressed.”
  13. 13. 13page© Medullan Inc. Key challenges in getting to actionable insights Technology limitation Lack of experience and skill set Unclear measures and metrics The best efforts of today don’t effectively turn data into actionable insights. Data relevance result No clear ROI Cultural shift required Data silos
  14. 14. 14page© Medullan Inc. What makes something insightful? Answers questions specific to a broader problem or need Unearths an issue or opportunity that you were not aware of Can be understood by all stakeholders An insight’s value is not proportionate to the volume, variety, or velocity of its source data. so what pharmacy wellness Health Coach member profile explanation of benefits incentives Plans enrollment claims statements secure messagingphysician finder physician finder personal health record Benefits Helps you predict what might happen if no change is made
  15. 15. 15page© Medullan Inc. What makes something actionable? Has a high potential of being actualized Offers clear benefit if acted upon Benefit can be tracked and measured Specific contributing factors are understood Not all actions return the same benefit or require the same effort. It’s important to prioritize. so what
  16. 16. 16page© Medullan Inc. INSIGHT #1: Spouses Driving Cost Trend The spend trend for spouses was getting worse, but was changing that trend actionable? 0 100 200 300 400 500 600 700 800 2011 2012 2013 2014 Spouses Employees Dependents PMP COSTS
  17. 17. 17page© Medullan Inc. INSIGHT #1: Spouses Driving Cost Trend 0 100 200 300 400 500 600 700 800 2011 2012 2013 2014 Spouses Employees Dependents PMP COSTS ✔ Contributing uncovered using existing analytics solution ✔ Agreement was reached at the employer that this was a priority ✔ Analytics partner determined benefit opportunity and track intervention impact ✔ Current wellness partner could utilize current touch points to augment current program YES.
  18. 18. 18page© Medullan Inc. INSIGHT #2: Gaps in Care Worsening for Diabetics Diabetic costs doubled in 1 year for essentially the same population. Was that insight actionable? $- $3,000 $6,000 $9,000 $12,000 $15,000 Total Health Plan Claims Pharmacy Claims Office Visit Outpatient Inpatient Medical Claims 2014 2013
  19. 19. 19page© Medullan Inc. $- $3,000 $6,000 $9,000 $12,000 $15,000 Total Health Plan Claims Pharmacy Claims Office Visit Outpatient Inpatient Medical Claims 2014 2013 INSIGHT #2: Gaps in Care Worsening for Diabetics ✔ Contributing factor quickly identified - increasing gaps in care contributing to >1600% PMPY inpatient claims increase. If gaps in care continued, the trend likely to continue ✔ Agreement that the benefit opportunity, (short and long term), made this worth pursuing ✔ Existing analytics partner was able to provide data for partner plan review, as well as vendor opportunity assessment if that becomes the right action. YES.
  20. 20. 20page© Medullan Inc. HOW WE SEE THE WORLD: Insight. Action. Measure INSIGHT OUTCOME & LEARNING RIGHT PEOPLE RIGHT INTERVENTION, RIGHT TIME RIGHT REFINEMENTS Identify the right people and get them to act with the right intervention. 1 2 3 ACTION MEASURE
  21. 21. 21page© Medullan Inc. Questions?
  22. 22. 22page© Medullan Inc. Join us for the next in our 3 part series #1 INSIGHT Finding Actionable Insights Aug 5, 2pm #2 ACTION #3 MEASURE Getting Members to Act Aug 19, 2pm Measuring Effectiveness Sep 9, 2pm See info.medullan.com/webinars for more details.
  23. 23. 23page© Medullan Inc. Thank you! Ryan Rossier rrossier@medullan.com Heather Ritchie Heather.ritchie@zakipoint.com
  24. 24. See Clearly | Take Action | Save Money We have one goal. To enable every company, regardless of size, to understand and lower its healthcare costs.
  25. 25. 25page© Medullan Inc. Better Lives I N N O V A T I O N F O R We improve the healthcare experience through human-centered digital solutions

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