This is the first of a 2-part discussion that explores the role Healthcare Analytics can play in the era of Health Reforms.  Here, we discuss the contemporary realm of Analytics and the challenges to its usage.

Pharmaceutical companies are perhaps the most seasoned users of Analytics in the healthcare market since detailed analysis is central to their efforts in drug research and clinical trials. Other healthcare entities like payers, provider organizations and government agencies haven’t adopted Analytics as enthusiastically. However, this scenario might change rather soon. With State Exchanges set to redefine the health insurance marketplace, most healthcare organizations have understood that they can either adapt to the reforms or perish. As 2013 progresses, healthcare businesses are realizing that they need to squeeze more out of every dollar spent, limit wastage of resources and eliminate fraudulent practices to achieve profitability-cum-compliance. This translates into many operational and administrative changes. Healthcare Analytics can make this transformation less challenging.

Understand the Challenge with an Example
Whether it is managing human and technical resources on a day-to-day basis or preparing for anticipated challenges due to regulatory changes, data integration and analysis remain a constant problem for most healthcare organizations. For most providers, the true cost of delivering care still remains an elusive figure. With so many variables in the calculation, creating achievable operating margins and projecting realistic target costs is extremely difficult. This often leads to budgetary shortfalls and precipitates correctional, revenue-draining cycles like re-staffing/emergency staffing, expensive last-minute purchases and decision-making headaches and the inability to eliminate malpractices.

Understand the Role of Analytics with an Example
A simple example explains the changing scenario and the applicability of Healthcare Analytics. Traditionally, adverse drug reactions were reported by physicians but now, there is a greater push for public scrutiny. Thus, patient-reported contradictory drug reactions are on the rise. Provider managements are being forced to rethink their technology to decipher which application/product can help them anticipate such care-related issues. The idea is to use technology for reducing extra staffing requirements and surveillance costs without compromising the quality of care. Healthcare Analytics can provide the kind of forecasting capabilities that can prevent such a crisis.

What Prevails: Analytics Usage Trends among Healthcare Agencies
An online survey conducted by UBM TechWeb in August 2011 examined how the government healthcare agencies in the U.S. approached the issue of analyzing exhaustive data. The survey included respondents from credible government agencies like the FDA, CDC, NIH and Medicare agencies for the military. Nearly 91% of the government agencies had a preference for using spreadsheets, including paper-based analysis, or spreadsheet-like data in internally-developed software systems. Most of the agencies understood the utility of Healthcare Analytics but 30 percent of them suggested that they didn’t intend to adopt it. Most of the Healthcare Informatics users were rather new to the application, having used it for three years or less.

Two conclusions surfaced:

1. Spreadsheets Lose to Analytics—traditional tools like spreadsheets are still a standard in many healthcare organizations for data summaries and comparisons. While these tools allow a rather basic, rudimentary form of reporting, they don’t offer the kind of precise, decision-making data Healthcare Analytics provides. Without Analytics, forecasting capabilities are seriously compromised as decision makers don’t have access to behavior or resource-utilization patterns. The use of spreadsheets involves a significant amount of dedicated time to inputting and comparing data and still, conclusions extracted from such an elaborate exercise cannot create an early-warning system like a properly executed Healthcare Analytics program. Real time data analysis to pinpoint skewed or underprepared operations is literally beyond the capability of spreadsheets. With analytics, it becomes easier to detect anomalies and uncover possible mishaps, providing a simple way to create a fraud-and-abuse prevention system.

2. Misconceptions Prevail at Large—many healthcare agencies seemed hesitant to use Healthcare Analytics, assuming that high-end analytics is a challenging learning curve. However, this is a misconception. The contemporary world of analytics is user-centric and highly intuitive. The only requirement is to feed correct data. After this, it is merely a series of data drag & drop functions to effortlessly create reports. When questioning the utility of Healthcare Analytics, its handling should be addressed. Data feeding and report creation might be left to IT professionals but when it comes to drawing conclusions from summarized data sheets, results should be discussed with the medical staff. This kind of collaboration ensures that every perspective is taken into account and the most relevant views are created.

Leveraging Healthcare Analytics to the Maximum: Social Media Analytics
Social media represents an underutilized aspect of Healthcare Analytics. Most clinical settings aren’t aware that data consolidation, sharing and analysis can be applied to social media for controlling costs and improving the quality of care. With nearly every clinical setting having a Facebook presence or a LinkedIn page, not using social media to decode the consumers’ preferences/opinions about the healthcare infrastructure, providers, etc. is neglecting highly-relevant information. Social media analytics goes beyond sentiment analysis. This data can also be used for online, social integration by different healthcare organizations for fighting fraud and developing a stronger staff retention system. It allows healthcare organizations to get a realistic insight about the ongoing and expected health related trends and create a proactive vigilance tool against fraud. It can also be used as a secondary alert system to publicize new disease management policies or public health investigations.

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