These business pressures will have a growing impact on the bottom-line of large regional medical institutions. Wal-Mart and CVS are using their large-scale big data logistics services to market and deliver basic consumer level care at price-points that hospital have considered too low. These new entrants are interfacing directly into the insurance reimbursement systems as a healthcare provider and carefully managing their administrative costs to be more competitive than hospitals and physician-based practices. They also offer the consumer the convenience of easy access to the pharmacy right after seeing the care provider (usually a nurse).

Better Disease Coding
Right now the US healthcare system is planning on moving ICD-9 to the ICD-10 coding system. Standardized codes are used to improve consistency in recording patient symptoms and diagnoses across the healthcare system. The new ICD-10 system updates medical coding from approximately 13,000 to 68,000 codes. This will increase the specificity of the information conveyed in the codes and enable more fidelity for use in health IT systems for both financial and clinical decision support. However, HHS has currently proposed delaying ICD-10 compliance by one year until October 1, 2014.

[Big data and public health, part 2: Reducing unwarranted services.]

Improving the fidelity of the medical coding system and shifting healthcare claims processing from a batch model to a near real-time model will be a step in the right direction. This has been successfully done before. Wall Street moved from 7 days to settle trades, to hourly settlements. Big data processing can address the large amount of automation needed between the systems and back-office processes for healthcare administrative data.

Using big data to track assets and supplies
Another area of hospital administrative costs that big data can help support is tracking assets and supplies within the hospital environment. This ranges from ensuring the logistical supply chain is in place to ensuring medical supplies are properly stocked and ready for use. It also includes knowing where supplies are or will be needed in the case of emergency response to large-scale disasters. Hospitals including the Veterans Administration’s more than 150 hospital centers are looking at how to use Radio Frequency Identification (RFID) tagging to track assets and supplies.

Assets in the hospital need to be tracked on a real-time basis to know where supplies and equipment are and ensure efficient utilization rates. Some supplies like catheters need to be linked and tracked on a per-patient basis to ensure that they are not inadvertently forgotten on a patient and result in further medical complications. Tracking these medical supplies and linking with the patient’s record will significantly increase the administrative big data challenge within hospitals.

[Part 1: How to harness Big Data for improving public health.]

Lots of healthcare administrative systems need to be integrated (interoperate) to make the health care claims and billing system work. Data from multiple sources needs to be integrated. While standardization will help, the reality is that there will always be some variety in the different systems. Big data integration can address the “mesh” of interoperability to support integration across the systems.

In the next article, I will address how big data can be used to reduce healthcare provider inefficiencies and improve the coordination of care across multiple healthcare delivery organizations.
 

Roger Foster is a Senior Director at DRC’s High Performance Technologies Group and advisory board member of the Technology Management program at George Mason University. He has over 20 years of leadership experience in strategy, technology management and operations support for government agencies and commercial businesses. He has worked big data problems for scientific computing in fields ranging from large astrophysical data sets to health information technology. He has a master’s degree in Management of Technology from the Massachusetts Institute of Technology and a doctorate in Astronomy from the University of California, Berkeley. He can be reached at rfoster@drc.com, and followed on Twitter at @foster_roger.