Providers embracing clinical & business intelligence

'IT cannot explicitly drive your analytics and big data efforts; the drivers need to come from the business and clinical side'
By Mike Miliard
10:12 AM

"One of the first things we're seeing organizations do is begin to stratify their organization," says Gaston. "They want to stratify their physicians, and how they practice and what they charge and how they bill. They want to stratify their patient population: Who are their patients? Where do they come from? How do they engage with the organization? Is it primarily acute care setting services? Is it ED services? They want to see how frequently their patients engage with their organization."

Next, he says, "they begin to stratify their organization as a whole: 'At what level are our departments performing at, holistically? And how does all of this work together?' It boils down to how do we identify those areas that might help us with fee-for service billing, but could be seen as a liability or great expense for the fee-for-value area we're dipping our toe into."

And how does the technology itself fit into all these big plans? Are providers making the right choices when it comes to IT deployments?

"I think a lot of providers aren't necessarily jumping off a cliff and buying big data warehouses and big analytics solutions right now," says Gaston. "A lot of providers are leaning toward homegrown solutions and using readily available tools."

Even something as seemingly humdrum as Microsoft Excel, after all, can help turn raw data into insights and knowledge.

Providers are "using what they have on hand, in beginning to find their way around their data," says Gaston. "We're still at the point where we're trying to develop analytical skills and capabilities, and this hasn't been broadly operationalized yet."

At HIMSS15 in Chicago there were countless companies purveying all types of clinical and business intelligence tools, touting the analytical insight they could offer toward better population health. Still, it's early.

"There are certainly a lot of vendors out there doing exciting things, but there's no one tool or collection of vendors where you can say these are the leaders in this space in healthcare analytics," he says. "There's a lot of play out there and a lot of opportunities."

Healthcare may lag other industries in its analytical prowess, but just think how far it has come.

"When managed care was proposed and tackled decades ago, the IT horsepower wasn't there to back it up," says Gaston. "People didn't have the data, we certainly didn't have electronic medical records. Or as broad access to claims data as we do now.

"Other industries have led the way in information technology that supports analytics and data-driven decision-making, and it's very well-refined: retail, manufacturing, Internet companies have advanced that tremendously and there are examples all around us," he says.

"But healthcare is a much more complicated industry, and that leads to some of the problems why some of the traditional tools don't fit very nicely."

But certainly "the horsepower is there across the board," says Gaston, "and some of the best opportunities are being exploited and developed by a big broad swath of people eager to demonstrate analytics prowess."

Geisinger has spun off its C&BI tools into its xG Health Solutions subsidiary, bringing its renowned accountable care and pop health technologies to market. UPMC is marketing its analytics. Mayo Clinic, too.

"And it's all good stuff," says Gaston. "I think the trick is going to be what is right for your organization and a good fit. For your geography and demographics. the size of your organization. And your maturity – are you ready to embrace those tools and put them into play?" So much "depends on the organizational dynamics," he says.

Still, there's no question that skepticism remains about just how much all this data can actually accomplish for your garden-variety provider.

"When you think of the Gartner Hype Cycle, big data is sort of right near the pinnacle of the hype cycle," Pettit suggests. "If we follow the cycle, I wouldn't be surprised if (soon) we start getting into the downside. There's been a lot of hype, promising the moon, now what does it actually look like. Is it worth it? There will be a lot of questioning around that."

That said, "big data does have big promises," he adds. "But we need to be discerning in what these promises really are. And as with anything – as we saw with EMR adoption – there are costs associated with it. It's not going to bring world peace. But it is going to bring improvements in healthcare."

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