Big Data in Healthcare Delivery: The Power of HEDIS

First in a Series

By Patrick K. Wier, MBA

This summer’s never ending debate on healthcare in the halls of Capitol Hill and the virtual halls on the internet is so complex it’s hard to wrap your head around. Why are costs so high? Why do there appear so many inefficiencies? The queries go on and on. One place to begin a greater understanding is the revolution that is taking hold in industry overall, however, at a slower pace in healthcare- big data.

Patients, providers, payors and vendors alike have a shared experience within the system through management of patient data in the form of huge stores of physical folders or electronic health records (EHR). Slowly and at large sums of investment practitioners are transitioning to one of the many forms of an EHR. This is an effort to capture the powerful effect of big data. Effectively utilized big data along with other interconnected electric devices the industry seeks to improve health outcomes while lowering costs associated with managing health conditions.

Leveraging technology to connect patients to providers to payors by linking multitudes of patient data while abiding by HIPPA regulations can bring about significant improvements in leading health complications like congestive heart failure, COPD and diabetes. Understanding patient information in a real time manner while learning constraints on the system can lead to more effective utilization of resources and reduce wasteful spending such as needless testing.

Payors and patients can learn which providers deliver greater results through established metric ratings developed by the Center for Medicare and Medicaid Services (CMS). An example of this is seen in the Healthcare Effectiveness Data and Information Set (HEDIS) which collects performance measures across 80 different dimensions of care and service. Insurers are constantly collecting data and rating all providers across the country to assess the effectiveness of health care delivery. Through the use of this scoring system health systems are constantly squeezing increased value in business results aligned with improved health outcomes for numerous health complications.

In conclusion, as more and more providers switch to EHRs payors can adjust payout rates to practitioners and deliver improved health outcomes which ultimately trickles down to the patient. Big data is the driver of progress in the industry and needs to be considered in our national conversation and on Capitol Hill when assessing how we carry out one of the most costly concerns in all individuals and families.

What other means can big data serve and address current inefficiencies in the U.S. healthcare system?  Please leave your thoughts in the comments section.  We would love to hear from you.  You can also contact us at jerrydmann@dmanntraining.com