ACOs make progress in using big data to improve care (Modern Healthcare)

Health Catalyst's Ross Gustafson, right, meets with Dr. Robert Wieland, executive vice president of Allina Health's clinics and home-care services. Allina partners with Health Catalyst for its big data effort, which fuels its ACOs.

Health Catalyst’s Ross Gustafson, right, meets with Dr. Robert Wieland, executive vice president of Allina Health’s clinics and home-care services. Allina partners with Health Catalyst for its big data effort, which fuels its ACOs.

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[Posted 01/17/2015 By Joseph Conn]

Accountable care organizations across the country are in sharply different stages of aggregating and using patient data to improve quality of care and reduce costs.

Only a handful of the largest and most sophisticated ACOs have established a “big data” warehouse that will let them pull together information from a variety of sources to help optimize care for individual patients and for their overall enrolled population. But many ACOs are developing the capacity to track patients in real time when they go to the hospital or the emergency department so they can intervene quickly to improve cost and quality outcomes.

One Medicare Pioneer ACO that is well along in using big data analytics is Minneapolis-based Allina Health. Its ACO has about 21,700 attributed Medicare patients and it also operates a commercial ACO. Its data analysts have produced about 60 data dashboards, enabling Allina providers and administrators, with the click of a mouse, to track outcomes against a variety of performance measures and target improvement efforts. For example, Allina’s ACOs can track blood glucose, blood pressure and cholesterol levels for patients across the entire Allina system, or by clinic regions, individual clinics and even by individual physicians.

Allina launched its big data effort in 2008, contracting with Salt Lake City-based data storage and analytics systems developer Health Catalyst to build its integrated data warehouse. This multifaceted database gathers information from 42 sources, including clinical data from Allina’s electronic health record as well as information about costs, claims and patient demographics.

“With our ability to identify just who these patients are out of the several million who access Allina in a given year, we can define a panel of like patients and match them up with caregivers and care managers who can most impact positively the care they’re receiving,” said Ross Gustafson, who until Jan. 1 was vice president of performance resources for Allina. He now has a similar post at Health Catalyst under a new health information technology outsourcing and partnership deal with Allina.

“We’re able to get very specific, near real-time information and data on (ACO patients’) health and track our performance on key measures that we could be rewarded for,” he said.

But most smaller ACO providers aren’t that sophisticated yet. They primarily are using data already pooled in their own and their partner providers’ EHR systems, experts say. For many of these ACOs, accessing, sharing and analyzing these smaller pools of data, then figuring out what to do with the results, present their most formidable information challenges.

For example, the Aledade Delaware ACO, which just started this month, offers its physician partners software that lets them search their EHRs, find patients with multiple diagnoses and weigh the severity of their conditions. Physicians then can stratify those patients with the most urgent risks and care needs, said Dr. Horatio Jones, who leads IT efforts at Stoney Batter Family Medicine in Wilmington.

The Aledade ACO has an advantage since Delaware was the first state to develop an operating statewide health information exchange, the Delaware Health Information Network, or DHIN. “Our main objective is we’re trying to work on the transition-of-care aspect,” Jones said. Success will depend on timely notifications when patients go the hospital or the emergency department, information that the DHIN exchange will provide, he said.

Most ACOs are still a long way from the holy grail of being able to gather a vast amount of data from wide-ranging sources and use them in real time to improve care. It’s envisioned that one day health systems will be able to aggregate and quickly analyze a range of data, including online records of consumer purchases, social media posts, geocoded information showing enrolled members’ proximity to parks and other recreational amenities and genomic data.

Gartner, a research firm that watches the technology market, estimates it will take five to 10 more years before big data attains the “plateau of productivity” on the firm’s Gartner Hype Cycle and becomes widely adopted in healthcare, said Vice President Robert Booz. The big data phenomenon is now over what his firm calls the “peak of inflated expectations.”

“There is so much left for us to do with regular data, we feel there are years to work there,” said Dan Burton, CEO of Health Catalyst…

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