RxEOB

Roopesh Kumar

In today’s information driven society, data is everywhere; from data collected by the millions of wearable health monitors to patient data related to mobile health solutions. This data is collected, examined and distributed throughout the healthcare management chain. When it pertains to big data, being able to find actionable items that can be used to create real-world results is often considered important, but understanding whether or not big data is ultimately useful for healthcare IT is a question that is being considered across healthcare IT organizations.

"Leveraging analytics and creating rules to identify the most effective ways to send the right message to the right patients at the right time is the key for significant cost savings for healthcare providers"

Big Data offers the potential for outstanding value and positive patient outcomes in healthcare management. From predictive analytics to the comprehensive analysis of a health plan member’s preferences and past experiences, Big Data can assist healthcare plans find the path to optimized care. Insurers, PBMs, and ACOs should remember that they already have Big Data at their fingertips, and now is the time to understand how they can leverage that information to drive positive outcomes. These organizations can utilize Big Data to take existing eligibility, claims, formulary, and patient-provided data to create personalize messaging that encourages behavior change towards the goals of improving patient care quality and lower healthcare costs.

A study by McKinsey shows that the implementation of Big Data information could offer transformations for the management of healthcare, but a number of challenges are still in place for health plans and providers to be able to efficiently incorporate Big Data into their overall planning and execution. For example, to properly integrate Big Data into actionable results, a patient portal or messaging platform should be able to use a patient lab result to trigger an email message to the member that not only advises them of the lab test result but also suggest a preferred next step in the health care support process. The Institute for Health Technology Transformation has taken notice of this, stating “Health data is diverse and distributed in hard-to-penetrate silos owned by a multitude of stakeholders. To complicate matters, each stakeholder has different interests and business incentives while still being closely intertwined.”

There can be some caveats in regards to how Big Data can be leveraged for better client outcomes, especially in regards to messaging programs designed for patients. Personalized data that is relevant does not need to wait for the machinations of Big Data output and related analytics to be able to offer outstanding value for patients. Leveraging analytics and creating rules to identify the most effective ways to send the right message to the right patients at the right time is the key for significant cost savings for healthcare providers.

While Big Data is useful for creating the potential for positive outcomes, Big Data by itself will not be able to offer outstanding results without ways to deliver that data from various sources into actions for providers and patients themselves. Big Data efforts can attempt to integrate disparate data sets, and if accessible by an analytics and messaging platform, plans and PBMs can create rules to identify the patient populations who would benefit the most from being sent a personalized message at the right time through the patient’s preferred communication. Using programs to inform patients of benefits, medicine reminders and other pertinent patient notifications can not only raise adherence to beneficial medical programs, but can also offer substantial costs savings for both healthcare providers and patients.

Without useable delivery systems in place to handle the outflow of Big Data as it pertains to individual patients and providers, Big Data will continue to be an often misunderstood, yet rarely utilized, component of the information society of today.

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