By Benjamin Novinger
InformationWeek Healthcare recently covered an IDC Health Insights report on where IT in the health insurance market might go in the next five years. According to this IDC report, “During the next five years, IT vendors serving health insurance companies will experience a highly volatile market as health plans shifts their focus from providing care management services to developing strategic health management solutions.
The article, in part, speaks to such imperatives as cost management, agility, care management, clinical analytics integrated with health management and so on. Clearly, another indicator of the sea of change to which HP’s Dan Klein referred in his recent blog post, Bringing Healthcare Systems Together via a Holistic Approach. So what does this suggest are the key needs to be considered? There are many. But one I’d like to suggest is sophisticated, integrated, reliable analytics or medical informatics that translates the plethora of data from so many sources into actionable information.
Data can be analyzed with progressively more sophisticated methods and progressively more actionable results. A simple predictive modeling example I like to use in my discussions of medical informatics and health services research includes:
- Basic data gathered (counts and sums): We have 35,000 individuals in our population with diabetes.
- Secondary Data (averages and rates): The patients cost us $7,000 this year, a 15% increase over last year.
- Information (benchmarks or trends): The national prevalence rate for diabetes is 8.3%; ours is 12%. Hypertension is a major co-morbidity for diabetes.
- Knowledge (goals and targets): Using a predictive model, we can assign patient-level risk scores using a statistical technique to identify which diabetics will be hospitalized next year.
- Wisdom (Actionable information): We can now efficiently allocate care management resources to help reduce avoidable hospitalizations for high-risk patients.
The above example may seem daunting; however, it demonstrates that with the right mix of resources and knowledge of research techniques, this kind of actionable information can be created in just a few weeks without the need for lengthy system implementations. The point, of course, is that substantial changes in healthcare industry and the market shifts that InformationWeek reported will drive not just the need, but in my opinion, the absolute requirement for the most actionable information. To achieve this, I believe it will become more and more necessary to integrate rigorous informatics into the system.
Those who do not embrace this imperative are potentially at risk of being left behind by those who successfully take on this challenge and turn the wealth of data they accumulate into something that helps drive their healthcare business in the most efficient, effective, and quality-oriented directions.
As I’m writing this, I am also thinking about the role of cloud computing. I’m sure this raises enterprise security concerns in the minds of many healthcare IT professionals. But one thing that cloud computing can do is facilitate communication and data gathering. Perhaps a private or hybrid delivery cloud is the answer if, indeed, you think the cloud should play a part.
What do you think? Do you agree (in whole or in part)? What are you experiencing? Have you taken steps in this direction and, if so, what have you encountered?
While the opinions above are my own, you may find some of the Healthcare Solutions information from HP of interest in your journey to strategic health management: