Thriving in value-based healthcare requires new data driven business capabilities that will only be enabled with a focused data strategy. Innovation in Care Delivery, Risk Sharing, and Cost Control all require a foundation of data supporting analysis, insights, modeling, measuring, and decision support. Data strategy is now a critical path dependency for organizations to survive relentless pressures on quality, outcomes, and costs.
Data Quality Matters. Industry-wide, the demand for data is on the rise, but many organizations struggle with its quality. With so many disparate and disconnected sources, errors and inconsistencies are common. This is particularly pervasive with business critical data used in processes across the enterprise including the inability to see claims, clinical and lab data holistically, in a truly longitudinal patient record as well as aggregated at the population level. This severely limits the ability of the organization to positively influence patient outcomes and costs. Additionally, the diversity of data sources and standards for every organization has meant that there is no “one size fits all” solution that can integrate the data necessary on patients, physicians, providers, locations, employees and procedures.
Gartner’s, Measuring the Business Value of Data Quality, states “poor data quality is a primary reason for 40% of all business initiatives failing to achieve their targeted benefits…data quality effects overall labor productivity by as much as a 20%.” In healthcare, these types of challenges are compounded by the complexity of the data itself, an intricate regulatory environment and organizational structures that can impede actionability. This manifests itself through care delivery missteps and inefficiencies; difficulty in capturing and gaining visibility into the true cost of care and revenue leakage; the inability to make timely, data driven decisions; reduced patient satisfaction; and compliance risks.
The need for a focused data strategy – one step at a time. You have to have a strategy for how you’re going to bring the data together. What are the processes that ensure data is reliably being collected? Who holds the data, and who really understands it? And most importantly – how are we going to leverage this data asset to advance quality, outcomes and costs?
A high-performing network of primary care physicians, specialists and clinics, wanted a better way to provide primary care physicians with the information they needed to help improve outcomes on value- based contracts. In an effort to do that, they provided monthly quality reports to their doctors. But the information was delayed, disjointed and not actionable. Physicians did not have the information necessary to improve their performance – and in some cases the physicians were not being credited for the good work they were already doing. They actually possessed the right sources of information. But because of the way it was segregated in different systems, it couldn’t be accessed and interpreted in a meaningful way.
In order to truly influence patient outcomes, Sense Corp worked with physicians to identify key areas where reliable information could provide decision support and identify gaps in care. The team drove out a data strategy that benefited both business and clinical stakeholders. Instead of monthly reactive reports, the care teams began receiving robust weekly reports filled with specific, actionable input.
By focusing on what matters, the network was able to ensure adoption and usefulness for their physicians. The results were meaningful with a measurable increase in HEDIS performance metrics and overall health plan performance and nationally recognized success in improved patient care.
Your organizations’ financial resilience hinges on your data strategy. Success in value-based contracts requires the ability to manage risk through each episode of care. Improving outcomes requires end-to-end visibility across the spectrum of care.
Is your data an asset or liability? How do you know? And more importantly, what’s your strategy to make it an asset?