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Patients, payers and providers all share the goals of better care and lower costs. Clayton Nicholas, Conduent Healthcare’s senior vice president, healthcare provider industry leader, discusses how analytics helps achieve those goals.
In your opinion, why are analytics in healthcare necessary and even inevitable?
Each of us has a different genetic makeup. We live different lifestyles in terms of how we eat, our level of fitness, whether we smoke or other habits we might have. We live in different socioeconomic environments that determine our level of access to care and our ability to pay for care. In terms of the provision of care, all of these different factors impact our ability as patients to improve our health, and for healthcare payers and providers to provide the right level of care – care that will improve patients’ health needs based on their specific circumstances. In being able to meet patients’ needs based on their specific circumstances, analytics is extremely powerful and important.
Analytics leverage data across all the different areas impacting patients’ lives to provide more personalized care to patients, and for payers and providers, that more personalized care means better outcomes for patients, which translates into being able to provide higher quality care at lower costs.
What types of improvements can healthcare payers and providers make by incorporating analytics?
There are a lot of different applications for analytics. In the drive to improve outcomes, for example, payers and providers are starting to use predictive analytics to identify high-cost and high-risk populations. Using diagnosis data, vital sign data and lab data gathered when a patient is in the hospital, predictive analytics can determine, for example, whether that patient will be readmitted to the hospital after discharge.
Providers can also use analytics to create more proactive interventions and programs to prevent readmission, and it can be used to improve communication between patients and providers and payers.
Do you have any advice for those who recognize the importance of analytics, but aren’t sure how to get started?
Data drives analytics. Most organizations have data at their fingertips that they can leverage – it’s a matter of being able to actively manage that data and make use of it while also augmenting it with additional data as the organization matures in its use and application of analytics.
There are different ways to get started right away with smaller, more opportunistic things. For providers, inpatient data is now being integrated with outpatient data to create a more holistic record and to have a better picture of a patient’s overall care inside and outside the hospital.
Payers heavily use their claims data but are now augmenting that data with personal information on the patient, which makes the claims data more timely. This fuller picture also can be used to help patients make better decisions about their care. For example, pointing them toward a lower-cost but still high-quality outpatient imaging center for imaging services rather than getting those services in a higher-cost setting.
We’re seeing the market creating more population health solutions by taking advantage of a broader set of data and identifying populations to target for quality improvements and cost savings. Organizations interested in applying analytics to targeted populations can start with smaller segments that they can easily understand. Eventually, they can scale up to create broader solutions.
What is your role at Conduent Healthcare, and how important are analytics to your work?
I lead our healthcare provider industry group in which we provide care management and analytics solutions to one-third of the hospitals in the U.S. We also provide community health solutions in more than 35 states and have a technology adoption software that clinicians use to improve patient care and outcomes. We also provide consulting to help our customers think through and redesign their clinical processes and strategies so they can provide better care.
Analytics is extremely important to our business. One of our key areas of competency is being able to bring in and aggregate data, apply analytics to that data and then help providers use that information to improve the quality of care and their bottom line.
Here’s an example of how we can use analytics to help providers. It was recently announced by the Centers for Medicare and Medicaid Services that 241 hospitals received penalties due to excessive hospital infection rates. Hospital infections cost the U.S. hospital industry more than $30 billion a year. One of the things we can do with analytics is predict whether a patient will have a hospital-acquired infection. That high degree of specificity means that we can provide more timely information to clinicians so that they can take the steps to prevent an infection, which results in an overall improvement in their quality of care and protects their bottom line from penalties due to excessive rates of hospital-acquired infections.
About the Author
Senior Vice President, Healthcare provider industry leader, ConduentMore Content by Clayton Nicholas