Turning data into action: 8 tips for plans, providers

December 1, 2015

Managed Healthcare Executive's State of the Industry Survey findings reveal that most plans and providers are struggling with data analytics. Here are some tips.

While data analytics presents great opportunities for health plans and providers to improve care quality while reducing care costs, many are struggling to realize its full potential. That's according to the results of Managed Healthcare Executive's 2015 State of the Industry Survey, through which more than 600 executives at health systems, health plans, pharmacy benefit organizations, and more, revealed their biggest challenges and priorities moving into 2016.

When asked, "What is your most pressing information technology problem?" the answer that received the highest percentage of responses was, "turning data into action." And, when asked, "How well would you say your organization is using big data to improve healthcare quality and reduce healthcare costs?" only 10% of respondents said "very well."

To help your organize make the most of its data, we asked three industry experts to share their tips.

Scott#1. Foster plan-provider collaboration. While health plans have a large amount of administrative data at their disposal, such as members' basic demographic information, diagnosis codes, and procedure codes, they lack easy access to clinical data, says Greg Scott, national leader of the health plans practice at Deloitte Consulting, LLP. If they had it, and it could be easily combined with administrative data and shared with providers, providers would be able to better identify and address patients' health needs in real time, he says. As a result, it's critical for plans and providers to work more closely together to share data and apply it in real time. "Only by working together can we consolidate and normalize and utilize the various sources and types of data that are required to really have actionable information," he says.

#2. Engage physicians. Physicians are a key aspect of capturing and generating data so their engagement with data capturing technology, such as EHRs, is critical. "... If they don't buy in to the benefits of the analytic outputs, then you have a really hard time getting quality data," says Larry Yuhasz, national practice leader, population health, at Truven Health Analytics.

Yuhasz#3. Offer value-based payment. Value-based reimbursement may help push physicians to become more engaged in data capture, generation, and application. That's because data analytics can help pinpoint key areas where costs can be reduced and quality can be improved. "The financial integration will support clinical integration," says Scott. "... If the money is suggesting that plans and various types of providers need to link arms in a more collaborative way to focus on the information required to make the new value-based payment system work for all the stakeholders, that's big."

#4. Move toward a single data repository. Most plans have many data repositories that are accessed in different ways by different departments, says Anita Nair-Hartman, vice president of strategy and business operations for payer business at Truven Health Analytics. "I think that they are starting to, and I think they need to continue this investment of having a single source of health information to help drive their business."  

Next: Four more tips

 

 

 

#5. Have the right governance in place. Managed care organizations must understand each data source they have, who's responsible for each data source, and what activities they are responsible for within each data source, says Yuhasz. "It's hard work to sit around and identify [governance] and to build it into the organization," he says. "But those organizations that treat it as best practices do very, very well analytically. It's kind of like the roll up your sleeves part of making sure that you get actionable data coming out of your systems."

Nair-Hartman#6. Get CIOs and CMIOs engaged. On the provider side, there has to be much more involvement of the CIO and CMIO in health information technology purchasing decisions, says Yuhasz. "There is very often a misrepresentation about all the different things that an enterprise wide [EHR] may do for you for example, and the board and the C-suite may believe that they've already solved that analytic problem and typically what they find is it hasn't even been done," he says. "The more that the CIO and the CMIO is elevated in helping this to become more of a data-driven buy than a platform buy is important."

#7. Don't get overwhelmed. Plans and providers tend to get caught up in the hype and buzz around big data and they lose focus on what they want to accomplish with the huge amount of data that they have, says Nair-Hartman. "If you think about it in specific chunks of information that is really related to the business problems you are trying to solve and the piece of the healthcare ecosystem you are trying to deal with,  it makes it less overwhelming."

#8. Find the right people for the job. Turning data into actionable information for a plan or provider requires a specific skill set, says Nair-Hartman. "We have noticed that it is becoming more difficult for health plans to find the analytically oriented and business oriented individuals who can bridge that gap to help answer these questions," she says. " ...  A computer can't do that-there's no easy button, it truly does require some expertise in understanding not the business, not just the data, but also the analytics, and putting those three pieces together."