Reclaiming Healthcare with Data

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Reclaiming HealthcareThrough DataTony HermannMedicine used to be simple, ineffective and relatively safe. Now it is complex, effective and potentially dangerous.Sir Cyril ChantlerFormer Dean Guys, King and St. ThomasMedical and Dental School,Lancet, 1999Addressing questionsI need an MRI. Where should I go?How many times do they need to take blood from me?How many members are diabetic? What will happen if they dont have their eye exam?Do you know what it costs to have a total knee procedure? Where?What costs are increasing the fastest and why?How many members do we care for that are not taking their hypertension medications?Who can answer these questions for me?Healthcare InformaticsVision: To provide reliable healthcare-related data, reports and tools to theWEA Trust and other stakeholders at the right time and right place.TeamLori, Brenda, Jared, Tony, and Jeff Outside consulting: Data scientists, vendors Tools MedInsight, Data Warehouse, Business Objects, WHIO, InfoTool, R

Employer Group Report

Defining wellnessDiabetics getting eye exams, Hgb A1c, foot examAll chronic conditions compliant with taking their chronic medicationsMembers getting annual checkupsIncorporating clinical data with claim data for evaluation

AsthmaDiabetesExamining chronic conditionsWhat is variation?MRI for technical component vary from a billed price of $975 to $3,128 per serviceWhy are chest X-ray single view only used 0.9 per 1,000 whereas a two view chest is used 56.8 per 1,000? Which is safer?What is your story?

What is appropriate care?From Nov. 2013 until June 2014, a patient had 128 Chest X-rays doneA patient recently had more than 30 heart catheterizations doneIs it appropriate to only do therapy or wait for an MRI with a stable knee injury?

What are we doing now?Reviewing data and acting on it within Provider Network Management and Member Health ServicesProvidersProceduresPopulationsDiagnosesCreating new metrics

Anticipatory care: Predictive modeling

The future of reporting

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