August 14, 2017 – Healthcare providers often have little choice but to focus completely on conquering the constant stream of EHR grunt work, reporting requirements, and minor administrative emergencies that make up the majority of day-to-day practice.
While it may sometimes be difficult to see how the daily burdens of checking boxes on quality assessments or scrutinizing reports on patient flow metrics can contribute to the broader objectives of the Triple Aim – let alone to the ultimate goal of creating more innovative and productive communities – healthcare big data analytics is starting to become a platform for architecting a new vision of what it means to be a smart society.
Economic wellness and good community health are inextricably linked. Communities with lower unemployment rates, higher average incomes, and more potential for continued economic growth are also less likely to experience high burdens from chronic diseases, substance abuse, and other detrimental population health issues, the Blue Cross Blue Shield Association foundearlier this year.
Longer life expectancy is correlated with higher economic performance in regions that experience more positive health outcomes, the study indicates, giving public health officials and policy makers a strong incentive to invest in cutting-edge healthcare delivery systems that prioritize preventive, proactive, and accessible care.
A smart society is a healthy society – and a healthy society makes good use of its big data, adds a recent report by the Center for Data Innovation (CDI), a think tank based in Washington, DC.
In order to craft a healthcare system with lower costs, better outcomes, and a quality experience for entire populations, providers need to be intimately linked into data about their communities – and they need to give as much as they receive.
Investing in analytics infrastructure, including electronic health records (EHRs) and the Internet of Things (IoT), can help regional stakeholders contribute to smart societies prepared to meet the many socioeconomic and environmental challenges of the future.
“Decisions made today that affect the extent to which a state participates in the data economy will have long-term implications for its future growth, as data plays an increasingly larger role in many different sectors across the economy,” the report says.
“Early adopters will benefit more quickly from using data to address a multitude of challenges, and by positioning themselves at the forefront of data-driven innovation; also will be able to grow and attract data-driven companies in a wide range of sectors that will make them the future hubs of the data economy.”
Some states have already taken up the challenge and seen great success, leading the nation in healthcare price transparency, EHR adoption, electronic prescribing, connected device deployment, and policies that prioritize open data.
The report recognizes Colorado, Maine, and New Hampshire for their efforts to collect and publish healthcare price transparency information on public-facing websites that enable patients to make more informed decisions about their care.
With robust all-payer claims databases (APCDs) that allow stakeholders to collect, analyze, and disseminate key information about out-of-pocket spending and overall costs, these states are among the few that have made sharing such information a top priority.
Many more states have made significant progress on electronic health record adoption, due in large part to the EHR Incentive Programs.
EHRs are often considered a fundamental necessity for big data analytics, since they collect much of the clinical data used to fuel algorithms for risk stratification, clinical decision support, and predictive analytics for patient safety and monitoring.
Massachusetts takes the crown for the state with the highest levels of EHR implementation in both the hospital and physician arenas, followed very closely by Wyoming, Washington, Minnesota, and Indiana.
Utah, New Hampshire, Maryland, Massachusetts, and Washington are also the most well-connected by broadband internet, which is crucial for organizations investing in cloud-based data storage and services, telemedicine, and patient engagement tools like portals and secure messaging.
Meanwhile, New York’s recent laws making e-prescribing mandatory for controlled substances has propelled it to the top of the list for electronic transmission of prescription data, while residents of Utah and Hawaii are the most likely to own wearable Internet of Things devices that collect information on fitness and other health-related metrics.
These investments in healthcare data infrastructure have helped to make Massachusetts and Washington two of the most-wired states in the nation, taking first and second place, respectively, on the list of top overall innovators.
Communities that have not yet broken through the barriers of infrastructure development should be aware that Investment in analytics and open data across the healthcare, education, government, and manufacturing sectors brings substantial rewards.
“The US Department of Commerce estimates that the private sector uses government data to generate annual revenues of as much as $221 billion annually,” the report points out.
“And, globally, the McKinsey Global Institute estimates that open data has the potential to create $3 trillion to $5 trillion per year in additional value across education, transportation, consumer products, electricity, oil and gas, health care, and consumer finance sectors.”
Reaping these benefits of big data – and producing generally healthier communities with higher economic potential – requires providers, payers, policymakers, and other stakeholders to invest heavily in strategies that will make the most of this important shared asset.
Integration, interoperability, and health information exchange
Without seamless access to large datasets, healthcare stakeholders can only work with fragments of insight into a patient’s clinical, financial, and socioeconomic challenges. The industry has been working diligently to improve the flow of data between disparate EHR systems and across geopolitical boundaries, with promising results.
In 2015, more than 80 percent of federal acute care hospitals exchange laboratory data, radiology reports, clinical summaries, or medical lists with outside healthcare providers, and more than 90 percent of hospitals with these exchange capabilities can access external data at the point of care, the ONC says.
But much work remains before communities can reliably access complete and accurate big data for actionable decision-making.
Incompatible data standards, poor information governance, misunderstandings of privacy laws, and a widespread lack of talent and resources are all making it difficult for the industry to communicate freely.
Regional health information organizations (RHIOs) and state-level health information exchanges (HIEs) have provided critical support, training, and resources to improve the integration of data systems at the local level, and continue to play a vital role in communities looking to expand their information exchange and large-scale analytics competencies.
Providers unsure of how to proceed in the big data environment may wish to investigate membership in one or more health information exchange organization to absorb the best practices that can jumpstart their data-driven initiatives.
A stronger value-based business case for sharing information
In order to make information sharing worthwhile, however, providers need to see some financial benefit from their investments in new infrastructure.
Value-based care and pay-for-performance reimbursement arrangements not only make a strong business case for data sharing, but also contribute to the overall health of communities by stressing proactive care management, care coordination, and collaborative decision-making aimed at cutting costs.
Making providers financially responsible for long-term patient outcomes encourages organizations to embrace predictive analytics, risk stratification, population health management, and individual attention to patients and their caregivers, creating stronger relationships with the neighborhoods they serve.
In turn, patients who are more educated about the impact of their decisions outside of the clinic may advocate for more attention to the community determinants of health, including more parks and open spaces for exercise, expanded options for choosing healthy diets, or chronic disease care programs based in schools, churches, and other shared social centers.
Success with value-based care requires strong big data analytics competencies and a commitment to altering traditional fee-for-service mentalities that promote volume over value.
Thus far, the transition has not been an easy one for healthcare providers, but continued commitment from payers and industry leaders appears to be paving the way for eventual success.
A committed focus on developing data analytics competencies, engaging patients in population health management programs, and increasing data transparency to encourage shared decision-making will help to support this ongoing trend.
Connected devices and the Internet of Things
The Center for Data Innovation highlights the use of connected devices as one of the hallmarks of a smart society, since Internet of Things adoption indicates a community with high technical literacy and an interest in using data to enhance lifestyle factors.
“These technologies can be used for many things, including monitoring roads and bridges, automating household appliances, monitoring health and fitness, and improving agricultural efficiency,” the report explains. “Harnessing the potential of smart devices and the data they generate for economic and social good will be one important opportunity in the coming years.”
The healthcare industry has led the way in the development of the IoT, with wearable fitness bands among the most popular consumer-grade devices on the market.
Medical-grade devices, including blood pressure cuffs, heart monitors, and telehealth platforms have also skyrocketed in popularity as patients seek more convenient and efficient ways to monitor their chronic conditions.
Continued development of health-specific devices is a lucrative area of interest for providers and vendors. But sensors and devices that monitor environmental factors and the built environment have major implications for healthcare, as well.
Air and water quality are clearly connected to the health and wellbeing of residents, while metrics collected from transportation systems, smart buildings, energy systems, and even smart televisions can provide crucial insight into the challenges, habits, and experiences of individuals as they go about their daily lives.
As the social determinants of health become increasingly important to providers who are becoming financially responsible for patient lives outside of the clinic, data collected from the broader Internet of Things will continue to be a highly valuable asset for providers, public health officials, and community planners.
The collection and intelligent use of IoT data, combined with more robust data sharing infrastructure and a financial incentive to deliver proactive care, can help communities create the strong foundations of health that can translate into economic prosperity, productivity, innovation, and improved wellness.
“Technologies that make it easy to collect, share, and use data empower businesses, researchers, government agencies, and citizens alike to draw new insights, make better decisions, develop valuable new products and services, and generate considerable social benefits,” the report concludes.
“The potential for data-driven innovation hinges on the collection, sharing, and use of data. Thus, states that enable the technological infrastructures to support these functions are in a better position to capture the value of data innovation.”