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Healthcare Analytics

Each week, the #HITsm community does a Twitter chat. This week it was hosted by @ahier and was focused on the topics of analytics. It was good timing considering we’re going to be innundated with healthcare analytics discussions at HIMSS 2014. Here is a look at the questions asked during the chat:
T1: What true models for analytics and data driven healthcare actually exist?

T2: Who’s going to win the analytics market battle: EHR vendors or the analytics specialty vendors?

T3: Should certification for analytics and clinical data warehouses be included in meaningful use?

T4: What are the concerns and benefits around marrying clinical, claims, and consumer retail purchasing data?

You can find the full transcript of the chat here. For those not wanting to read the whole chat, here are some tweets of mine I think you’ll find interesting:

I think this gives you a pretty good view into what I think about healthcare analytics. I’d love to hear yours.

February 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Big Data, Predictive Analytics Priorities For Healthcare Organizations

Leveraging big data and healthcare analytics are key initiatives for C-suite healthcare executives, but barriers to making progress still remain, according to an item in iHealthBeat.

According to a survey by the eHealth Initiative and the College of Health Information Management Executives, about 80 percent of CIOs and other C-suite healthcare executives see big data and predictive analytics use as important goals for their organizations, iHealthBeat reports.

But it won’t come easy. In fact, 84 percent of respondents said that implementing these strategies and tools are a challenge for their organization. And only 45 percent said they had a plan in place to manage the growing volume of electronic data.

The survey, which questioned 102 executives in May and June, found that 90 percent of respondents used analytics for quality improvement, 90 percent used analytics for revenue cycle management, and 66 percent used analytics for fraud prevention. Also, 82 percent of survey respondents said that population health management is important to their analytic strategy.

Meanwhile, 82 percent of those responding said that health information exchange is important, according to iHealthBeat.

As for data sources, administrative- and claims-based data were most used, at 77 percent and 75 percent respectively. Eighteen percent of respondents’ staff were trained to handle the data, and 16 percent used third-party organizations to overcome staff shortages for data analysis.

Despite execs’ enthusiasm for big data/predictive analytics use, however, significant obstacles remain to rolling out such programs, iHealthBeat reports.  According to a separate CIC Advisory survey, budget strain and lack of needed skills is delaying the use of analytics at many healthcare organizations.

According to that survey, building an enterprise analytics system is held back by the difficulty of integrating different analytic systems. Moreover, most organizations don’t have a dedicated analytics or business intelligence team, and many rely on outside analytics consultants.

All of that being said, it seems guaranteed that hospitals and other healthcare organizations will eventually find a way to leverage big data. Healthcare organizations expect to keep ramping up their spending on data discovery and predictive analytics in coming months and years, research suggests.

In the mean time, however, there’s a ton of work to do, staff to be hired and trained and integration to be done. It’s going to be an uphill battle.

August 16, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Business Intelligence And The Smart EMR

A new study by KLAS suggests that while providers are giving thought to business intelligence needs, they still haven’t honed in on favored vendors that they see as holding a leading position in healthcare. That may be, I’d suggest, because the industry is still waiting on EMRs that can offer the BI functionality they really need.

To look at the issue of BI in healthcare, KLAS interviewed execs at more than 70 hospitals and delivery systems with 200 or more beds.

When asked which BI vendors will stand out in the healthcare industry, 41 percent of respondents replied that they weren’t sure, according to a story in Health Data Management.

Of the other 59 percent who chose a vendor, IBM, SAP, Microsoft and Oracle came up as leaders in enterprise BI applications — but none of the above got more than 12 percent of the vote, HDM notes.

Vendors that did get a nod as standing out in healthcare-specific BI included Explorys, Health Catalyst, McKesson and Humedica (Optum). IBM and Microsoft were also singled out for healthcare use, but respondents noted that their products came with high price tags.

Meanwhile, QlikTech and Tableau Software were noted for their usability and data visualization tools though lacking in full BI toolsets, according to HDM.

While these stats are somewhat interesting on their own, they sidestep a very important issue:  when will EMRs evolve from transaction-based to intelligence-based systems?  After all, an intelligence-based EMR can do more to improve healthcare in context than freestanding BI systems.

As my colleague John Lynn notes, EMRs will ultimately need to leverage big data and support smart processes, becoming what he likes to call the “Smart EMR.”  These systems will integrate business intelligence natively rather than requiring a whole separate infrastructure to gather insights from the tsunami of patient data being generated today.

The reality, unfortunately, is that we’re a fairly long way away from having such Smart EMRs in place. Readers, how long to you think it will take before such a next-gen EMR hits the market?  And who do you think will be the first to market with such a system?

July 26, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Survey: Confusion Slowing Meaningful Use Compliance

While Meaningful Use is likely to spur improvements in health IT, confusion over regulations — and the need to pursue other pressing HIT projects — are slowing down MU compliance, according to a new study.

The survey was conducted by Stoltenberg Consulting, which spoke with health IT managers, clinicians, HIT vendors and government agencies that attended this year’s HIMSS event.

Researchers asked which areas in which HIT will achieve the biggest improvements over the next 12 months.  The biggest group (35 percent) named Meaningful Use, while 19 percent said health information exchange, clinical integration and mobile health were due for the most growth.

When asked what might hold them back from meeting Meaningful Use requirements, 29 percent said confusion and/or ambiguity in the regulations were a challenge. Others named competing health IT projects (23 percent) and a lack of key resources such as funding, IT skills, talent and time (17 percent).

The survey also asked respondents what issues were likely to dominate HIT discussions this year.  Respondents favored health information exchange (62 percent), followed closely by mobile health (58 percent) and clinical analytics (54 percent).

As part of the survey, Stoltenberg also asked survey respondents which problems HIT executives would most likely attempt to solve with the help of a specialized IT consulting firm. The responses included ICD-10 (25 percent), Meaningful Use (25 percent), clinical and business intelligence (23 percent), cloud computing (21 percent) and CPOE/clinical systems implementation (20 percent).

May 3, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

The Big Takeaways from The Breakaway Group Healthcare Forum at TEDMED

I had the tremendous opportunity to spend the day hearing and interacting with a group of healthcare leaders across the entire spectrum of healthcare. I was invited to the Healthcare Forum as a guest of The Breakaway Group. They’d told me that the group would have a large number of influential people in healthcare and they were right. Along with recognizable names like Dr. Farzad Mostashari, Glen Tullman and Lee Shapiro were a number of hospital CEOs, CIOs, and CMIOs. There were doctors, insurance executives, and many other executives which made for a very well rounded and interesting discussion.

I won’t go through an entire recap of the event and all the things that were shared during the various presentations. If that interests you, go and read through my @ehrandhit tweets and check out the #simplehealth hashtag and you’ll get a good overview of everything that was presented from those of us live tweeting the event.

I do want to highlight a couple key takeaways and then suggest a list of major themes we’ll be confronting in healthcare.

Farzad Mostashari, MD was the event keynote with a great view on the future of healthcare. Farzad’s intro was perfect when Charles Fred, Founder & CEO of The Breakaway Group, said, “The wedding of healthcare and technology is over and Farzad has joined us for the marriage.”

Farzad’s message covered a lot of ground including a message of optimism for healthcare, the need to affect all parts of healthcare both small and large, and using the “most underutilized resource in healthcare…the patient.” He also talked about the need for some accountability in healthcare. Farzad suggested that there’s no “scale” in healthcare that we can step on and know how well we are doing. We need the data to be able to tell us how we are doing so we can improve. Without the data we almost always overestimate how good we are and underestimate the things we’re doing poorly.

One of the most powerful concepts Farzad discussed was around being careful not to change healthcare from a social contract into a financial contract. He said, “Incentives and money aren’t always the same.” This point was illustrated brilliantly by one of the attendees who said, “An ACO should be the way we live and breathe healthcare every day and not just a reimbursement program.” I think we often need a reminder to not let the business of healthcare overwhelm the care provided.

Finally, for those of us who love EMR and EHR, Farzad offered this incredible perspective on where we are at when it comes to EHR progress, “We are at about 50% EHR adoption and about 5% workflow adjustment.” It’s the first time I’ve seen him acknowledge the idea that EHR adoption isn’t enough. In fact, the initial implementation of an EHR is just the very first step in a process of really optimizing the EHR for your workflow and for improved patient care. It does make me wonder what things ONC might do in the future to try and address the 95% of EHR workflow adjustments that remain.

I’m sure I’ll be pulling nuggets of information out of Dr. Jennifer Brull, Bill Rieger, Dr. CT Lin, Ashwin Ram, and Heather Haugen’s talks in future posts. They all offered some unique insights into quality of care, EHR leadership, patient engagement, patient portals, and EHR implementation.

Here’s the list of themes from the day as identified by those who attended:

  • Using Data
  • Transparency
  • Need for Leadership to Change
  • Adoption vs. Implementation (EHR)
  • Patient and Family Involvement in Care (through social media often)
  • Change Happens at a Different Pace for Different People

And then we identified the following important future healthcare topics:

  • Interoperability
  • Social and Mobile
  • Patient Engagement
  • How Do We Ask the Best Questions
  • Make the Right Thing to Do, Easy
  • Big Data, Small Actions (for doctors and patients)
  • Changing Reimbursement

The Healthcare Forum at TEDMED was a well organized event that provided a lot of food for thought. My only complaint from the experience was that pretty much everyone in the room could have been a speaker at the event. Thinking about that makes me wish there had been more time to hear from those in the audience. Although, it isn’t a bad thing to leave us thirsting for more.

Read more coverage from TEDMED from Xerox on the Real Business at Xerox blog and follow@XeroxHealthcare.

April 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Big Data Could Generate $450 Billion For Healthcare System

Here’s some information that should give all of us something to chew on  this week, courtesy of the always-interesting Jane Sarasohn-Kahn at the HealthPopuli blog.  In a recent piece, Sarasohn-Kahn pulls data from McKinsey & Company suggesting that if big data is properly harnessed, it can produce nearly — wait for it — $450 billion in value for the healthcare system.

As always, however, there’s a catch. This value explosion can’t happen, McKinsey says, unless big data is leveraged across five dimensions of care. These dimensions, which McKinsey calls “new value pathways,” offer opportunities for better efficiencies and economies of scale for the health system, HealthPopuli notes.

The five dimensions include:

Right living, in which big data is used to help patients take an  active role in staying healthy, by such mechanisms as daily health reminders and getting patients to seek care early when problems do arise.

Right care, in which big data tools, particularly coordination of data across providers and settings, make sure that patients get the right care at the right time.

*  Right provider, in which data analytics matches patients with the ideal provider for their situation, sometimes to lower-cost providers that can provide appropriate care.

*  Right value, which uses big data analysis to reward providers who produce the best outcomes.

*  Right innovation, a pathway in which big data is mined to promote continuous improvement and productivity in healthcare processes as well as R&D.

Sounds great, doesn’t it?  Well, maybe not so much given what has to change. To travel down these pathways, McKinsey notes, it will take re-aligning several key forces in the healthcare system, including privacy and data security, a shift to  value-based reimbursement, partnerships across industry segments currently found in deep silos (such as payors and providers), and data analysis capabilities current lacking in the health IT workforce. Sigh. And  I was feeling hopeful there for a bit.

As Sarasohn-Kahn notes, one way McKinsey sees to meet some of these goals more quickly would be to promote transparency as a cultural norm. But honestly, the silos we see today exist for important institutional and competitive reasons. If we want key partners in the big data effort to cooperate, it’ll probably take a governmental club to that head. Hey, ONC, are you ready to get rough with those who don’t want to play in the same data sandbox?

April 16, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Healthcare Big Data vs Skinny Data

I have heard a number of people talk about healthcare big data was all the buzz in the healthcare IT world. There’s little doubt that there’s a lot of conversation happening around big data and analytics in healthcare. While I think there’s tremendous value to be found in healthcare big data, I’ve been more intrigued by what Encore Health Resources calls skinny data.

You can read more about the Encore Health Resources CoreANALYTICS announcement, but the approach is what I find really interesting. Instead of trying to create a huge enterprise data warehouse that can be all healthcare data for everything, they instead decided to focus on created a smaller solution that just focused on one major problem: meaningful use.

Encore Health Resources was open about the reason why they chose to go with a skinny data model as opposed to a full enterprise data warehouse model, time and budget constraints. They basically were asked to produce a result with a limited budget and so there wasn’t time or money to do anything but achieve the desired results. One of the architects of the system said, “If you can give me the extra data for free, then give it to me. If it costs [time or money] more to get that data, then don’t do it. Although, if you don’t give me these other data elements, then I’m going to have issues.”

It seems like a pretty simple concept to me that makes me wonder why I haven’t seen more of it in healthcare. Encore has taken these concepts and started to expand beyond meaningful use and into other areas like at-risk populations, clinical analytics for care coordination, and financial analytics.

I asked them if CoreANALYTICS would eventually grow into what essentially becomes an enterprise data warehouse. They suggested that it wouldn’t likely ever get that large, but I can see a path to that type of result.

What I do love about skinny data is that it’s user the information a hospital has available and creating actual results. It’s one thing to have the data, but it’s what you do with that data that really matters.

April 2, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Healthcare Big Data Trends Leading To Analytics Spending

Ready to exploit big data? So are your competitors, and they’re preparing to spend big bucks in areas where they’ve historically been weak, such as predictive analytics and data discovery, reports  HealthcareITNews.

Technology vendor Lavastorm Analytics recently surveyed more than 600 technology professionals in healtlhcare and other industries about their IT investment plans for this ear.

Right now, researchers found, three-quarters of respondents still routinely use Excel for self-service analytics processes, and 35 percent use the R programming language.  Of the remaining 24 self-service analytics tools listed by the survey, 17 of them were used by less than 10 percent of the audience. In other words, once you get past R and Excel for analytics, there’s little agreement as to what works best.

But the coming months should bring some big changes in this landscape, Lavastorm’s research suggests. As the desire to exploit big data grows, providers are planning investments that will allow them to exploit it. Nearly 60 percent of respondents plan to increase their investments in areas where their capacity is limited.

Those areas include gleaning insights from data (25 percent), accessing data (22 percent) and having the ability to integrate and manipulate data (19 percent), HealthcareITNews says.

To meet those goals, providers intend to invest in predictive analytics (51 percent), big data (35 percent), dashboards (32 percent), reporting (31 percent) and data exploration and discovery (30 percent). At the same time, 27 percent said that they’d invest in advanced visualization tools and 24 percent self-service analytics tools for business users.

All this being said, my hunch that providers probably aren’t particularly sure where they’re headed with this technology yet.  I’d like to have seen Lavastorm ask which clinical or business goals, specifically, they hoped to meet by making these investments, wouldn’t you?

March 26, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Expanding HIEs Taking Role As Backbone For Reform Efforts

It looks like we may be seeing a tipping point for HIEs, which for many years have seen only isolated successes. According to a new report from the eHealth Initiative, the number of HIEs has grown meaningfully between last year and this year, and this year should see many new HIE organizations form.  Perhaps more importantly, it looks like HIEs are taking their place as the backbone for up and coming reform efforts.

When eHI reached out to survey HIEs, it found 322 organizations to survey, up from 255 last year.  Of that group, 88 HIE initiatives are at the highest stages of development on eHIs HIE development scale, an increase of 13 from last year.  As researchers see it, we’ll see even more growth and maturing technologies in 2013.

Over the last several years, the HIEs which have stayed on their feet and matured have almost all been propped up by federal dollars. Twenty-seven of the advanced HIEs surveyed said that the single most substantial source of funding they had was from the federal government; also, 22 of these HIEs were classified as state designated entities.

Unlike the past, however, it seems that HIEs believe they can survive without grant money from the government.  Of 39 state-designated entities responding to the study, 37 said they believe it is ‘very likely’ or ‘likely’ that they will remain operational after the HITECH dollars stop flowing.  An additional 31 of the SDEs said t hat it is ‘very likely’ or ‘likely’ that they will be financially sustainable three years from now even without additional federal dollars.

Now, here’s where it gets really interesting (to me at least). As part of the study, the eHealth Initiative asked some questions about how HIEs were playing into preparations for the full rolllout of health reform.

What they found out is that HIEs are increasingly playing a major role in health reform-related efforts such as ACOs and/or Patient-Centered Medical Homes.  More than half (109) of the HIE respondents said that they are supporting ACOs or PCMHs.

The HIEs aren’t just dumb pipes either;  not only are they offering technical infrastructure, they’re providing data analytics services around cost efficiencies and quality improvement.

Looks like 2013 should be a pivotal year for HIEs. I for one am excited to see what HIE organizations will be able to accomplish over the next 12 months prior to full rollout of health reform.  Go team HIE!

December 3, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Study: EMR ROI Stronger In Low-Income Setting

Well,  here’s some information which caught my eye right away. According to a new study published recently in the Journal of the American Medical Informatics Association, EMRs can provide a good return on investment for hospitals located in low-income areas.

In the study, researchers studied the what happened when a tertiary hospital in Malawi implemented an enterprise- wide EMR system.  The felt it was important to evaluate an EMR implementation in a low-income area such as this, the authors noted, because such hospitals face obstacles unlike those in more prosperous areas, such as marked supply and staff shortages, which might change the effect of such a system.

To examine the impact of the EMR, researchers looked at three areas: length of stay at the facility, transcription times and lab use.  The hospital saved an estimated $284,395 per year in U.S. dollars. By the third year of operation, the EMR  started generating a positive ROI, and by five years, it provided net benefit of $613,681, according to FierceEMR.

This is an inspiring study for those who hope to see EMR success stories, as until recently, there’s been little if any information to suggest that EMRs can offer a substantial savings on operations, much less help to generate a profit.

This doesn’t necessarily mean that hospitals aren’t generating savings or even profits by implementing an EMR.  As we noted in a previous story, few hospitals are planning for and implementing EMR ROI measures early in the game, according to a recent study from Beacon Partners.

If hospitals don’t dig in and integrate EMR ROI measurements into their strategic planning, it’s not surprising that they aren’t getting the fullest picture of what their systems are delivering. Backward-looking measurements aren’t likely to do as much as measurements built on a hospital’ls entire vision for success. Let’s see what happens when hospitals focus on ROI as a top-of-mind item going forward.

November 23, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.