Healthcare Analytics: What It’s About & Why It’s So Important

Healthcare analytics is robust and increasingly critical as a sub-industry and set of tools driving many critical decisions in the arena of healthcare, both in the U.S. and globally. All healthcare analytics are built on a foundation of data, but that data is only as useful and as powerful as it is effectively analyzed, and then applied, to improve clinical and business processes and outcomes. 

Use of Healthcare Data Analytics Goes Beyond Research & Policy

It is well known that some categories of healthcare data analytics have become increasingly important to providers in the evolving model of value-based care and its impact on how healthcare providers are measured and financially compensated by participating insurance plans. Significant investments are being made to measure quality and outcomes, along with the traditional measures of utilization and related expenditures.

Interestingly, the healthcare analytics being leveraged in value-based care are just as useful and important to business organizations that market and sell products and services to healthcare providers, insurers, and employers. 

If your medical technology allows patients to recover with fewer complications or get discharged sooner, then your commercial teams are going to need to know how facilities or their medical staff rank in terms of outcome. 

Data that was originally used by healthcare researchers and health policy experts is increasingly available to other businesses serving the healthcare industry. With the availability of software-based platforms, your team no longer needs to be experts in databases, servers and all the investment required to intake, manage and analyze large amounts of data. 

Data-analytics as a service allows your commercial teams to focus on what they do best and instead outsource the activities required to easily mine, filter, sort, and otherwise utilized these invaluable data sets for marketing, sales, and business development purposes. 

What Types of Healthcare Data Are Collected & Analyzed?

Claims & Cost Data

The analysis of health claims data, outcomes in delivering care and related healthcare costs allows providers, insurers, and employers to identify individuals who are high utilizers of healthcare, particularly those who utilize more costly healthcare services. Aggregating potential overutilization at the individual patient level may also uncover which healthcare providers may be underutilizing or overutilizing certain services or procedures. These analyses allow stakeholders to focus on, and determine, better or different courses of action including communications with and treatment for these individuals.

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Claims data is typically captured and organized on the basis of health condition and diagnosis (ICD-9 and ICD-10 diagnosis codes (related to health condition and diagnosis) and CPT codes). Be sure to check out our primers on how to use these healthcare code sets in your commercialization activities, available here.

Traditionally the goals of analyses leveraging claims and cost data have been improved healthcare outcomes and reduced costs. Today, sales and marketing teams use these data sets to better understand the local market in any given geography and to focus limited resources and matching their technology or service with the healthcare providers who can benefit the most. 

Quality Data

Over the past ten years, both government payers of healthcare as well as commercial payers, have increasingly been linking quality data and outcomes to reimbursement including both performance-based incentives and penalties.

Healthcare providers and the payers of healthcare have used clinical data analytics and quality measure to:

• Improve health outcomes
• Reduce waste and associated costs
• Track quality metrics
• Streamline operations
• Improve profit margins
• Achieve shared savings goals

For example, to participate in certain reimbursement programs, hospitals must report quality metrics such as healthcare-acquired infections, hospital readmissions, survival performance and compliance with safety and quality standards.

But it’s not just healthcare providers and payers that can benefit and learn from these various measures of quality and outcomes. Non-provider businesses that have products, services, or processes that help providers achieve these benefits and have data that tie a company’s products and solutions to these results will have a significant competitive edge over those that don’t.

Physician Referral Data

Data analysis of physician referral patterns, volume, and frequency, by condition and treatment, is extremely powerful information for providers and insurers, as well as marketing and sales organizations that target and provide related solutions to providers and health plans.

Knowing how physicians share and refer patients to other doctors, hospitals, and facilities, is powerful. A thorough understanding of referral patterns helps teams understand where to focus their messaging and awareness building. 

You can also mine these existing relationships for introductions from your existing clients to other physicians or medical groups who may benefit from your service or technology. Conversely, many medical technology firms are helping their customers identify opportunities for outreach and education activities to ensure their community benefits from the latest investments and advances available to their patient populations.

On-the-Ground Benefits of Healthcare Data Analytics

Depending on the user, healthcare analytics can provide many measurable benefits. 

For providers and insurers, healthcare analytics is primarily utilized to further the achievement of the Triple Aim: 

• Improving the patient experience of care
• Improving population health outcomes
• Reducing the per capita cost of healthcare

However, healthcare analytics is now being evaluated for its potential application to the additional aim of the more recent Quadruple Aim which adds an emphasis on joy, well-being, and resilience among care teams in addition to the three elements of the Triple Aim.

The potential benefits of the collection and analysis of healthcare data are:

• Reducing healthcare costs
• Reducing administrative costs
• Clinical decision support
• Improved care coordination
• Innovations in diagnosis and treatment of health conditions
• Improving patient health outcomes
• Improved patient satisfaction and experience
• Increased patient engagement and adherence
• Limiting fraud and abuse
• Limiting frustration, dissatisfaction, and burnout among provider care teams

Sales and marketing teams looking to commercialize their medical technologies and services should anticipate having conversations with their customers about the healthcare measures and data that indicate how their targeted hospitals and doctors are performing. These teams should also anticipate explaining and validating how their technology fits into the Quadruple Aim, other stakeholders are laser-focused on. 

Sir Francis Bacon originally introduced the idea that “knowledge is power.” In today’s world of healthcare data, the analysis and effective application of knowledge in the form of data is where the ultimate power lies.

Schedule an appointment with Carevoyance and we’ll provide a free consultation to brainstorm with you and your team on how to get the most out of your healthcare analytics data, empowering your company with knowledge designed to enhance your targeting criteria and focus on the best opportunities.

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About the Author

Carevoyance contributor Lonnie Hirsch is the Founder and CEO of Hirsch Healthcare Consulting, one of the premier consultants and strategists for helping medical practices and hospitals across the U.S. and in other countries achieve profitable top line and bottom line growth.