Category: Big Data

Healthcare Data is Growing, But Are Health Plans Making the Most of It?

According to a report from Dell EMC, healthcare data is growing astronomically, at a rate of 48 percent per year. In today’s healthcare economy, payers are looking to leverage that data to provide better service, more customized plans, and improved care for their members. Data analytics enable payers to harness data insights to bring better focus and clarity to costs and utilization so they can improve the services they offer to members.

How can data analytics support your plan? We’ve outlined five ways to make the most of your data:

  1. Enhance member engagement and experience – As reimbursement shifts from volume to value, analytics tools can reveal the clinical opportunities that lead to healthier populations. St. Joseph Hospital, part of Covenant Health, leveraged MedeAnalytics Population Health to analyze their self-insured cost and utilization data. With those insights, they had the knowledge they needed to help improve the health and wellness of employees and their families while also reducing costs.
  2. Lower costs and improve affordability – With costs on the rise, it’s crucial for health plans to analyze healthcare economics to steer high-cost members toward quality care and pinpoint patterns that reveal opportunities for savings. With the help of our analytics platform, St. Joseph Hospital, gathered insights from their data and reduced total pharma costs by 20 percent and per member per month (PMPM) costs by 12 percent, saving nearly $2.5 million in 2016.
  3. Reduce operating costs and inefficiencies – Health plans are always looking to improve efficiency, grow revenue and reduce overall costs. With an intelligent analytics platform, health plans can increase value-based contracts and reduce outsourcing costs for quality reporting. Presbyterian Healthcare Services (PHS) uses MedeAnalytics in an effort to adopt a comprehensive analytics approach and establish a data driven-culture. With MedeAnalytics, PHS balanced their costs, utilization, quality, risk and outcomes.
  4. Improve client satisfaction and retention – Better employer communication leads to better client relationships. That’s why it’s important to foster a personalized, interactive dialogue. With analytics, your health plan can deliver highly tailored, automated reports to employers, increasing employer retention and improving client satisfaction.
  5. Increase profitability and revenue growth opportunity – Analytics provide health plans with the necessary tools to increase value-based contracts, allowing them to grow revenue by upwards of 25 percent. With MedeAnalytics, PHS achieved measurable ROI in clinical, operational and financial areas of their enterprise, realizing more than $11 million in savings.

The untapped data available to health plans is key to member satisfaction. Investing in an intelligent analytics platform can help uncover the valuable insights that help health plans achieve success in a new healthcare economy.

Looking to learn more? Review our infographic on health plans or request a demo.

Finding Success with Big Data Analytics in Healthcare

The healthcare industry is in a state of flux, but one thing that remains constant is the focus on cost and quality. To achieve success in value-based care, healthcare organizations need to invest in the right tools. In fact, a recent study found that 70 percent of healthcare leaders believe health IT tools are essential for growth.

MedeAnalytics client Soyal Momin, vice president of data and analytics of Presbyterian Health Services (PHS), recently connected with Jennifer Bresnick of HealthIT Analytics during HIMSS18. They discussed the challenges of balancing cost and quality, and Momin outlined a step-by-step plan that helps his organization make the best use of their data and analytics investment.

Momin noted that PHS found it increasingly difficult to oversee its entire business—eight hospitals, a statewide health plan and a growing multi-specialty group—from one integrated view. Balancing the organization’s costs, utilization, quality, risk and outcomes became a challenge. But by following the step-by-step plan, PHS achieved measurable ROI in all clinical, operational and financial areas of their enterprise while reducing redundancies and achieving quick wins. By extending analytics across the enterprise and eliminating point solutions, PHS saved more than $11 million.

Momin’s plan includes the following best practices:

  • Start with a solid foundation—A solid foundation and leadership buy-in helps to create an analytics program that is scalable, sustainable and set for success. Setting up recurring meetings will encourage ongoing support from top executives.
  • Outline concrete goals—These should outline opportunities that will make a measurable impact on a specific clinical, operational or financial function. It’s important to work with a team to develop these goals so everyone understands the objectives and the activities required to achieve them.
  • Create an integrated enterprise data warehouse—This allows organizations to profile their data and address any existing data quality issues. Data quality and integrity form the foundation for every initiative going forward, so it’s essential to devote time to develop those resources.
  • Know when to ask for help—Organizations need to be mindful of where their expertise lies. Overextending in-house capabilities will only lead to failure, which is why PHS turned to MedeAnalytics. With data analytics and expertise in both the payer and provider spaces, MedeAnalytics helped PHS add value within their integrated data analytics model.
  • Slim down your systems—It can be challenging to determine which data tools are right for multiple initiatives, so it’s important to centralize as many analytics initiatives as possible and only keep tools that are necessary.
  • Deliver results—Defining the value and communicating the gains back to the organization’s leadership is the final step along the pathway to big data analytics success.

Learn more about PHS’ journey toward a data-driven culture here. If you’re interested in learning how our data platform can help your organization achieve success, request a demo or contact us here.

HIMSS18 Series: Artificial Intelligence Will Boom in the Next Five Years

Last week’s HIMSS18 conference, the world’s largest health IT conference, brought together 40,000+ of the smartest minds in healthcare to collaborate, showcase new ideas and work together to solve some of the industry’s biggest issues. Similar to last year, Artificial Intelligence (AI) was top of mind at this year’s event. In honor of this trending theme, we connected with our Chief Technology Officer, Tyler Downs, on why AI is such a big focus and what we can expect in the next five years.

If you looked at the HIMSS lineup, most exhibits, sessions and symposiums revolved around this emerging technology. The reason AI is making such a big splash is due to its potential with data. The healthcare industry has endless amounts of data that health systems, both small and large, are dealing with. As reported in the Medical Futurist:

The amount of available digital data is growing at a mind-blowing speed, doubling every two years. In 2013, it encompassed 4.4 zettabytes, however by 2020 the digital universe – the data we create and copy annually – will reach 44 zettabytes or 44 trillion gigabytes.”

AI helps to properly manage and make use of all this information and that’s why it will hold continued importance in the next five years. Today, we see maybe one percent of the population analyzed with AI. However, in the future, the industry will be able to make sense of larger data sources from various entities to get a holistic picture of the patient. This 360-view will help users make more informed clinical and coverage decisions based on patients’ needs at a broader scale.

To stay ahead of this trend and properly develop AI applications, here’s some advice for healthcare organizations to follow:

1.) Tie data to actions

A big mistake that is often made when building AI applications is not working around the data. Let the data help guide you and always ensure the information connects to an action.

2.) Get on board with security applications

Engage in conversations early and often. This will help to understand who owns what and define a source of truth.

3.) Collaborate and validate

AI applications are not a one-person job – a lot of trial and error is required. Make sure you involve the right people throughout the process to help build and validate your model.

The saturation point with healthcare data is now and the industry needs more solutions to help manage the abundance of information. Data holds the key to the steps the industry needs to take to further connect patients and providers and outline useful information to guide clinical care.

If you’re interested in learning more about HIMSS18 – check out our blogs on the conference here and here. If you’re looking for more insight from Tyler on the power of technology – check out his recent blog on Machine Learning.

HIMSS18 Series: Artificial Intelligence Will Boom in the Next Five Years

Last week’s HIMSS18 conference, the world’s largest health IT conference, brought together 40,000+ of the smartest minds in healthcare to collaborate, showcase new ideas and work together to solve some of the industry’s biggest issues. Similar to last year, Artificial Intelligence (AI) was top of mind at this year’s event. In honor of this trending theme, we connected with our Chief Technology Officer, Tyler Downs, on why AI is such a big focus and what we can expect in the next five years.

If you looked at the HIMSS lineup, most exhibits, sessions and symposiums revolved around this emerging technology. The reason AI is making such a big splash is due to its potential with data. The healthcare industry has endless amounts of data that health systems, both small and large, are dealing with. As reported in the Medical Futurist:

The amount of available digital data is growing at a mind-blowing speed, doubling every two years. In 2013, it encompassed 4.4 zettabytes, however by 2020 the digital universe – the data we create and copy annually – will reach 44 zettabytes or 44 trillion gigabytes.”

AI helps to properly manage and make use of all this information and that’s why it will hold continued importance in the next five years. Today, we see maybe one percent of the population analyzed with AI. However, in the future, the industry will be able to make sense of larger data sources from various entities to get a holistic picture of the patient. This 360-view will help users make more informed clinical and coverage decisions based on patients’ needs at a broader scale.

To stay ahead of this trend and properly develop AI applications, here’s some advice for healthcare organizations to follow:

1.) Tie data to actions

A big mistake that is often made when building AI applications is not working around the data. Let the data help guide you and always ensure the information connects to an action.

2.) Get on board with security applications

Engage in conversations early and often. This will help to understand who owns what and define a source of truth.

3.) Collaborate and validate

AI applications are not a one-person job – a lot of trial and error is required. Make sure you involve the right people throughout the process to help build and validate your model.

The saturation point with healthcare data is now and the industry needs more solutions to help manage the abundance of information. Data holds the key to the steps the industry needs to take to further connect patients and providers and outline useful information to guide clinical care.

If you’re interested in learning more about HIMSS18 – check out our blogs on the conference here and here. If you’re looking for more insight from Tyler on the power of technology – check out his recent blog on Machine Learning.

HIMSS18: Top Trends and Themes

Another HIMSS18 conference has come and gone and we finally have a chance to sit back, relax and reflect on this past week. From the constant social chatter, major industry announcements to hours spent connecting with some of the best and brightest in healthcare, this year’s HIMSS was definitely one for the books. As we look back, here are some of the trends and themes that were top of mind throughout the week:

“Get to the cloud. Run to the cloud” 

HIMSS18 kicked off with a keynote address from former Alphabet executive chairman and Google CEO Eric Schmidt who laid out a secret formula for healthcare innovation: data + cloud + powerful networks + reinforcement learning = significant improvements in care. Could this formula change the future of healthcare? We’ll be keeping an eye out to see how Schmidt’s talk inspires the industry over the next few months.

CMS & The White House Put Interoperability on Center Stage

The healthcare industry has long struggled with data sharing with various stakeholders trying to move it forward. Now, CMS and the White House are proposing a solution. “We’re changing to a new era of empowered consumers. We are about putting patients first and making sure patients have access to their healthcare data. You’re hearing that from the White House too,” CMS Administrator Seema Verma shared during a HIMSS presentation. The new initiative, MyHealthEData, aims to get healthcare information into the hands of patients faster and will ensure that patients receive a copy of their EHR electronically via program interfaces or APIs. CMS is also taking steps to ensure hospitals are not involved in data blocking. Will both CMS and the White House push this initiative forward? Time will tell.

Big Tech Comes to Healthcare

Over the past few months, tech companies have been making headlines for their efforts in breaking into healthcare. At HIMSS, this trend continued as Google announced a new tool to help health institutions pull together important data in an effort to nudge the industry forward when it comes to the lack of interoperability between companies. Google Cloud is trying to address this by launching a new API that can ingest all the important health-care data types and is already announcing partnerships with hospital groups, like Stanford School of Medicine.

Patients are #1

At the end of the day, healthcare is all about patients and helping them get the quality care and support they need. HIMSS supported this belief by offering complimentary passes for qualifying patients, patient advocates and caregivers. From the CMS initiative, to new experience platforms, patients were clearly on the top of everyone’s minds. As consumers look to get more involved in their own health, this focus will only increase in the coming months and years.

HIMSS18 came and went in a flash but this year’s conference highlighted one thing: healthcare innovation is top of mind. The slow-moving space is now being inundated by top names in various industries who are looking to make a difference in healthcare quality and costs.

Thinking that AI is missing from this list? Check out our earlier blog dedicated to all things AI with commentary from Tyler Downs, our chief technology officer. Not able to make it to HIMSS or didn’t have enough time to schedule a meeting with us? Contact us here: http://medeanalytics.com/company/contact

HIMSS18 Series: PHS Shares How to Drive Enterprise ROI at the Largest Health IT Conference

Starting on Monday, March 5 more than 40,000 healthcare industry experts will land in Las Vegas for the HIMSS conference, the largest health IT event in the U.S. There are thousands of speaking sessions and showcases to see that will teach you everything from how to build APIs to making sense of genomics.  

We’re especially excited to attend and hear our own MedeAnalytics’ customer, Soyal Momin, Vice President of Data and Analytics at Presbyterian Healthcare Services (PHS), present an educational session at the conference. The session titled, Driving Enterprise ROI by Eliminating Data Silos, will take place from 11:30-12:30 p.m. PT on Tuesday, March 6 at the Venetian Convention Center in Palazzo D. Soyal will address how after three years and many resources invested in an enterprise data warehouse, PHS needed an action plan and analytics solution that could turn raw data into business value. Soyal will discuss how PHS adopted a data-driven culture that allowed the health system to save more than $11 million and outline best practices to achieve this level of success, including:

  • Creating business value from enterprise wide data and analytics strategy and execution
  • Assembling an infrastructure around people, process and technology to drive a data-driven culture
  • Discussing stakeholder buy-in and organizational-wide support by leveraging change management tools and creating a culture of inclusion across the enterprise

Can’t make the session? Make sure to download the presentation and review the materials on your own here. We’ll also be at HIMSS so don’t miss out on a chance to chat with us – you can schedule a meeting with us here. To achieve similar success as PHS, check out our enterprise analytics solution: http://medeanalytics.com/solutions/enterprise-analytics.  

Health IT Headlines for 2018

2018 is already off to a strong start with the J.P. Morgan Healthcare Conference and StartUp Health Festival making headlines last week. As 2018 progresses, we want to share the trends that we expect to make headlines this year:

  • Mega merger and acquisition activity – 2017 was filled with notable M&A activity including CVS and Aetna, Humana and Kindred and Optum and AMGA, to name a few. We expect to see this activity continue throughout 2018 as payers, providers, pharmacies and more look for ways to innovate, meet consumer demands and ultimately improve the quality and cost of care. Bruce Carver, associate vice president of payer services at MedeAnalytics, shares additional thoughts on recent merger activity in our blog.
  • Consumerization of healthcare – With consumer-facing companies outside of the traditional healthcare space making moves to enter the industry (like Amazon, Apple and Google), consumer focus is critical. In 2018, this focus will only increase as consumers continue to demand user-friendly and easy to use platforms and interfaces. With all the competition in the industry, healthcare organizations will have to ensure they are keeping the consumer top of mind to stay ahead.
  • Emerging technologies, like AI, will take the stage – In 2017, the adoption of AI technology made headlines across all industries, healthcare included, as organizations looked for innovative ways to leverage this new tool. As we head into 2018, companies like Google will continue to lead the pack by working with startups that are focused on finding ways to leverage this technology to improve care. We recently sat down with our CTO, Tyler Downs, to discuss trends in AI in healthcare and to hear how companies can use AI to power data and analytics.
  • Clarity around industry uncertainty and policy changes – With the Trump administration and new faces in prominent health IT positions, the industry saw major shifts in 2017. According to a recent poll, healthcare is the one topic keeping both Democrats and Republicans up at night. 2018 will hopefully bring some clarity to the shifting tide as policies get ironed out and the state of Obamacare is decided. Regardless of these policy changes, providing patients with the best quality care should remain the industry’s top priority.

With all the new trends, emerging innovations, policy changes and more, is your organization prepared? Check out our solutions page to learn how MedeAnalytics can help you find success in the new year or contact us for additional information. 

A Year In Review – Our Top Blogs from 2017

As snow starts to fall across the country and temperatures decline, winter and 2018 are here! 2017 was a busy year for the healthcare industry, from the new administration, ground breaking treatment advancements, the potential of artificial intelligence and most recently, the CVS and Aetna health merger. 2017 has also been a busy year for us at MedeAnalytics with new hires, customer announcements, speaking sessions and more! As we gear up for the new year, we’re looking back and highlighting our top three blog posts from 2017:

Meet MedeAnalytics’ new CEO, Paul Kaiser – In May, we were excited to announce our new CEO, Paul Kaiser, and in June, we had a chance to connect with him to learn more about his background, his company observations thus far and his future plans for the company. Our blog outlines the opportunities our CEO sees for Mede clients and how we can continue to support them amidst the everchanging healthcare landscape.

Enterprise Analytics and Beyond: A Q&A with our Vice President of Healthcare Provider Solutions – In March, our blog explored top provider concerns and offered insight from a Mede executive on the challenges that lay ahead and continued importance of investing in an Enterprise Analytics (EA) strategy. The post outlined proactive approaches for providers to take to ensure a seamless EA strategy, including training and educating clinical leadership, establishing realistic goals and empowering self-service. The post concluded by outlining how analytics’ role in reporting and identifying care and cost improvement opportunities will only grow in importance in the years ahead.

Driving Enterprise-Wide Change by Breaking Down Data Silos and Creating a Data-Driven Culture – At this year’s Big Data & Healthcare Analytics Forum MedeAnalytics’ client, Soyal Momin, Vice President of Data & Analytics at Presbyterian Healthcare Services, discussed how, thanks to a partnership with MedeAnalytics, the organization was able to harness their data and adopt a data-driven culture across their organization. During his presentation, Soyal outlined how the approach promoted outcome-driven clinical excellence and allowed the organization to achieve ROI in the clinical, operational and financial areas within their enterprise. Soyal will also be speaking at HIMSS18 this year and we can’t wait to hear his presentation!

2018 will bring a lot of exciting changes to both the healthcare industry and MedeAnalytics! Make sure to stay up to date on industry and Mede happenings via our blog and follow us on Twitter and LinkedIn. Interested in learning how MedeAnalytics can support your organization in the new year? Contact us here

Mississippi Division of Medicaid Establishes Its Second Real-Time Clinical Data Exchange

Just last month, MedeAnalytics announced that the Mississippi Division of Medicaid (DOM) continued to build its data exchange within the state by connecting with the Hattiesburg Clinic (Hattiesburg). This is the second such clinical exchange and the second largest provider of Mississippi Medicaid beneficiaries. DOM built its first connection with the largest provider, the University of Mississippi Medical Center (UMMC), which resulted in more than two million clinical summaries.

On Aug. 1, DOM successfully linked its beneficiary data-analysis system with Hattiesburg’s electronic health record (EHR). MedeAnalytics established DOM’s Medicaid Enterprise Master Patient Index (EMPI) back in 2014 as the core identity management system to allow easy management of a Medicaid patient’s longitudinal record. From there, they worked with DOM to standardize the Medicaid clinical EMPI to support a clinical data interface with its external stakeholders. Since the connection, both DOM and Hattiesburg have shared clinical information on 20,000 individual Medicaid patients, or 100,000 total shared clinical reports. Mississippi is the first state in the nation to establish this method for leveraging Medicaid technology and resources to directly benefit the doctor/patient experience.

Our very own CEO, Paul Kaiser, noted that: “DOM is a model example for Medicaid interoperability and how other agencies across the nation can leverage data to improve beneficiary care. MedeAnalytics has powered the Division’s first major provider data connection since 2016 and we look forward to continually supporting their efforts to expand connectivity with other providers across the state of Mississippi.”

The continued partnership is driving change in healthcare – from informed delivery of care to fueling overall value-based goals and progress. Looking ahead, DOM plans to continue integration with Medicaid-focused health systems, Health Information Exchanges and state and federal agencies. In fact, just last month they went live with their third clinical data exchange connection – Singing River Health System. For additional insights on how MedeAnalytics can help create connectivity, visit our solutions for state government page here. To learn more about our relationship with DOM see here and here.

Mississippi Division of Medicaid Remains the First to Establish Clinical Data Exchange

Each year, state Medicaid leaders from all over the country gather at the Medicaid Enterprise Systems Conference (MESC) to talk about the role of technology in meeting Medicaid and industry initiatives, like value-based care. Our client, Mississippi Division of Medicaid (DOM), spoke on their use of the consolidated clinical document architecture (C-CDA) standard to coordinate care and improve outcomes for their Medicaid beneficiaries. DOM is the first Medicaid agency in the nation to establish clinical data exchange with healthcare providers to directly benefit patients and physicians at the point of care. DOM has successfully exchanged data with University of Mississippi Medical Center (UMMC) which resulted in more than two million clinical summaries. They also recently partnered with Hattiesburg Clinic and shared more than 100,000 clinical summaries.

To achieve this level of connectivity, DOM faced many challenges such as differences in vendor implementation of industry standards and providers’ use of unexpected medical codes. We connected with Ian Morris, Project Manager for the State of Mississippi DOM, to get his take on the overall lessons learned from this project and what fellow government organizations need to keep in mind for similar undertakings. Here are three key takeaways:

  1. Rely on Vendors’ Expertise – DOM would not be able to achieve this level of success without qualified vendors who have the expertise to develop and support the technology infrastructure and needs of real-time data exchange for hundreds of thousands of beneficiaries.
  2. Be Realistic – These projects are time and labor intensive and can take years to achieve. Be patient and work around your trading partner’s various schedules and technologies.
  3. Collaborate – Every stakeholder has different end-goals but these projects are a joint effort. This means that the conversation needs to move away from “my data” and towards “our data” to better coordinate care.

Looking ahead, DOM plans to continue integration with Medicaid-focused health systems, Health Information Exchanges and state and federal agencies. In fact, just last month they went live with their third clinical data exchange connection – Singing River Health System.

To learn more on UMMC and DOM’s success, read our announcement here