By Monica E. Oss, Chief Executive Officer, OPEN MINDS
The executive team with the better data can make better decisions, assure better outcomes for consumers, improve staff and customer satisfaction, and deliver more value to payers. But how? We’ve talked about descriptive analytics (looking at historical data and scorecards) and predictive analytics (the use of data, algorithms, and machine learning to identify the likelihood of long-term future outcomes based on historical and demographic data). But the next generation is “adaptive analytics.”
Currently, 70% of health systems are still using descriptive analytics or retrospective data to understand what has already happened. Predictive analytics remains a largely uncharted territory. But adaptive analytics could shift the paradigm and drive the increased use of data that informs future action—by provider organizations, in tandem with health plans—to improve the effectiveness of clinical care as well as productivity of clinical professionals. Adaptive analytics is the real-time data capture from various inputs including—but not limited to—customer interactions, use of artificial intelligence and traditional inputs, followed by immediate processing and sharing of data insights to inform decisionmaking across teams. Adaptive analytics relies not just on historical data but also on near real-time interactions and responses to a service or action or a consumer preference to help trigger how actions/interventions can be adjusted to drive a desired outcome. Think of adaptive analytics like a GPS—the routes are mapped in the system but adjusted quickly based on real-time data about traffic, road closures, and driver preferences (for shortest routes, no tolls, no highways, etc.). In essence, adaptive analytics is about intuitively guiding next steps and actions based on how best to support consumers quickly.
We heard about how one integrated delivery and financing system, UPMC Health Plan, is leveraging adaptive analytics to improve care, in our conversation with their Vice President and Chief Medicare Officer, Angela Perri. And we’ll learn more on September 21 when Ms. Perri delivers the keynote, Leading A Technology Transformation—Tech & Analytics To Improve The Consumer & Clinical Professional Experienceat the 2021 OPEN MINDS Executive Leadership Retreat.She will provide a roadmap to adaptive analytics—and describe how UPMC has built systems to use multi-dimensional analytics intended to improve outcomes and consumer experience. The application of adaptive analytics allows for personalization of services as well as population health management. Ms. Perri will share her experiences based on her oversight of UPMC’s internally developed clinical software solutions that span the health plan and network hospitals, telehealth, the plan’s member mobile app, and the RxWell behavioral health hybrid coaching tool. She will explain how she worked in partnership with their information technology (IT) team and department of health economics (DoHE) to design requirements for real-time data, aligned ‘intelligent workflows,’ and business rules to drive quality and affordability across UPMC’s book of business.
UPMC has adopted three best practices for adaptive analytics—distilling data down to actionable insights, breaking down silos in data sharing, and enhancing consumer engagement. To prevent clinical teams from “drowning in data,” UPMC has redesigned systems to push out data quickly—but only data that clinical professionals can use in the service delivery process. Underpinning the concept of actionable data is reducing fragmented data structures or tools that naturally silo physical, behavioral, or social (influencer/determinant) data. Typical organizational silos as well as the payer-provider divide can limit the access and subsequent value of data in many organizations.
Ms. Perri said, “What we’ve tried to do using data and analytics is to bring the person alive, by highlighting key insights across our teams enabling a holistic team approach in real time. Information isn’t separated out as medical or social determinants but rather: ‘This is Angela’s profile and here’s what’s going on with her.’ This allows all of our clinicians to really operate at the top of their licensure and for our non-clinical teams or partners to work together in tandem.” It’s also important for health plans to share information with provider organizations. “Providers have the personal relationships with the members, but they may not have social determinant information as an example. The goal is to share relevant information in a way that fosters greater coordination to support the members’ health needs and positive outcomes,” she added.
“What we’re doing is taking everything we know about that member-patient and turning it into actionable information through the analytics for targeted follow-up,” Ms. Perri said. This is critically important in all transition of care scenarios, for example. She explained, “Using analytics intelligence, teams may stagger the timing of follow up to ensure those coming out of the hospital setting are contacted quickly—meeting people where, when, and how they need. The power of adaptive analytic models together with our tools and software is that it both demands and facilitates active, ongoing learning in real or near real time in a constant feedback loop. So, depending on an individual’s specific needs, which could be about a medication change or perhaps stability at home, we are learning and adjusting continually to improve the member experiences when they are most vulnerable. It’s this intentional design that leverages data to create smart workflows that sets our teams and members up for positive outcomes.”
The benefits of this approach in terms of improved results and productivity are evident, but the question for many executive teams is how to get started. Ms. Perri’s advice is to start the process with the desired outcomes, to map out what data is needed to achieve those outcomes, and then work backwards. This does require careful planning of workflow design and technology—but the payoff in terms of improved outcomes, improved revenue, and increased health plan referrals can be significant in a competitive market.