Recently, our family switched health insurance providers. Each family member had to go through various health checks, and each check was driven by the age of the family member concerned. I’d say this process has a lot to do with value based care—a healthcare model that prioritizes value over volume, which insurance companies are beginning to embrace. But it also may have to do with the fact that insurance companies are beginning to deliver tailored plans based on demographics and other factors. At the same time, insurance providers have seen continuous growth of data and now, with an effort to manage population health, this data can be extremely valuable in gleaning insight to better address patient needs, to improve the quality of care and to reduce costs. However, this insight is critically dependent on the health of the underlying data itself—data of all ages, if you will, that often span multiple generations! So, are insurance companies doing what it takes to effectively manage the health of their data?
Join me as I explore this further.
Just as insurance providers have grown their external member bases, the data they manage has also grown over the years. There is data resident in legacy environments in systems of record, along with the continuous growth of clinical and financial data through increased interoperability. It behooves providers to take the right steps to collectively address the health of the primary citizen of this ecosystem—this exploding data—by evolving the enabling processes, systems and solutions in place.
Insurance companies that take these steps today can position themselves to be more competitive enterprises tomorrow. These steps can be broadly categorized as follows:
1. Collection. There should be a cohesive process in place for the continuous collection and assimilation of the data through integration with the healthcare continuum. The fundamental need to collect such data has only been accentuated with the introduction of newer technologies like wearables and the Internet of Things (IoT), along with the nearly instantaneous sharing of thoughts through various social media channels.
2. Cleansing. The sheer volume of data in healthcare can be overwhelming. Insurance companies should have the capability to weed out what isn’t relevant, and take action immediately on what is.
3. Analysis. Big data does not yield much value without analytics! Enterprises need to have the right skills in place (think: data scientists or even data artists) so they can leverage the right tools and techniques to analyze—with context—the historical data resident in legacy systems as well as the more recent, up-to-the minute data collected through wearables. For example, data could be captured about the well-being of individuals all the time (even during sports… say, golfing)!
4. Insight. Analysis of such data yields valuable insight. Increased volumes of data about the individuals themselves along with the unique health challenges they face, the history of diagnoses made to address these challenges, and the outcomes of years of research can yield incredible insight. The insight is the basis for population health management and a cornerstone of value based care.
5. Action. It’s important to note that insight yields business value only with timely action. Insurance providers can gain a competitive advantage by being proactive about actions that they take based on the valuable insight gained from the analysis of the data. Done right, predictive analytics can also be used to take preventive action in advance, especially when it comes to preventing the outbreak of an epidemic.
There you have it. All the data that insurance providers now have and continue to collect can be a valuable asset, as long as the data has a clean bill of health. It is imperative that providers care for the data and manage its health across its lifecycle so they can take timely action on the insight the data reveals.
By the way, there are other challenges triggered by the explosive influx of data through mobile devices. There’s also the need to control storage costs. But, I’ll save those posts for another day. Meanwhile, what are other steps that the insurance companies can take to manage the health of their data? Please let me know in the comments section below.