Finding Actionable Insights from Healthcare's Big Data

Insight. Action. Measure.

Finding actionable insights in healthcare’s Big DataAugust 5, 2015

© Medullan, Inc.

2page© Medullan Inc.

Heather RitchieVP, Product ManagementHeather 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 RossierVP, Product InnovationRyan leads the product innovation team at Medullan. His expertise includes market research and analysis, program management, agile delivery excellence, and lean start up.


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


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?

heather


Where can data help in healthcare?

There is massive potential benefit locked in healthcare’s data.

Population health

management

Precision medicine

Care optimizatio

n

R&D productivity

heather


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 optimizatio

n

R&D productivity

heather


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

!̀

heather


Data

Volu

me

Value

The insight value chain


InfoData

Volu

me

Value


“has context,


InsightInfoData

Volu

me

Value


“has context, is well understood,


Actionable InsightInsightInfoData

Volu

me

Value


“has context, is well understood, and delivers value if addressed.”


Actionable InsightInsightInfoData

Volu

me

Value


Ability to take an action

that will have an Impact

“has context, is well understood, and delivers value if addressed.”


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


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


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


INSIGHT #1:

Spouses Driving Cost Trend

The spend trend for spouses was getting worse, but was

changing that trend actionable?

2011 2012 2013 20140

100

200

300

400

500

600

700

800

Spouses

Em-ployees

PMP COSTS


INSIGHT #1:

Spouses Driving Cost Trend

2011 2012 2013 20140

100

200

300

400

500

600

700

800

Spouses

Em-ployees

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.


INSIGHT #2:

Gaps in Care Worsening for Diabetics

Diabetic costs doubled in 1 year for essentially the same

population. Was that insight actionable?

Total Health Plan Claims

Pharmacy Claims

Office Visit

Outpatient

Inpatient

Medical Claims

$- $3,000 $6,000 $9,000 $12,000 $15,000

20142013


Total Health Plan Claims

Pharmacy Claims

Office Visit

Outpatient

Inpatient

Medical Claims

$- $3,000 $6,000 $9,000 $12,000 $15,000

20142013

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.


HOW WE SEE THE WORLD:

Insight. Action. Measure

INSIGHT

OUTCOME& LEARNING

RIGHT PEOPLE

RIGHT INTERVENTION, RIGHT TIME

RIGHT REFINEMENT

S

Identify the right people and get them to act with the right

intervention.

1

2

3

ACTION

MEASURE


Questions?


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.

SOLD OUT


Thank you!

Ryan Rossier [email protected]

Heather [email protected]

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Finding Actionable Insights from Healthcare's Big Data