Five ways data can improve patient outcomes

Sept. 9, 2020 / By Becky Pelov

To improve patient outcomes and drive value-based care success during COVID-19 and beyond, health plans need to use data for efficient and effective decision-making. However, many health care organizations struggle to provide the right data at the right time to the people who need it. Having seamless data aggregation, enrichment, refinement and transparency is crucial to leveraging data to achieve improved patient outcomes. Plans need to utilize a single source of truth to manage patient risk, identify populations that need interventions and measure cost and quality.

One way data can be used is to track and measure disease progression. By using a classification system that stratifies the populations’ illness burden, a health plan can identify members that are most in need of care management. Plans can then target those at-risk patients, conduct outreach and match them to appropriate resources and programs. Chronic patients tend to cost the plan the most in both allowed dollars as well as potentially preventable services. Getting these patients into an appropriate care management programs can both reduce costs and unnecessary utilization.

Another way data can be helpful is to identify unnecessary services. Unnecessary services cost the plans unnecessary dollars. They also can contribute to patient outcomes. When providers are able to minimize the amount of unnecessary services and ensure members are being seen in the appropriate care setting, it can reduce the costs to the plan and improve patient outcomes. Utilizing tools to measure the quality of providers can also help improve patient outcomes. 

The COVID-19 pandemic has brought the consequence of not having a flexible analytics platform to ensure actionable, relevant and accurate information available to light. I hosted a webinar with America’s Health Insurance Plans on September 17 where I go into more detail on tracking and measuring disease progression as well as the other unique ways to use data to improve patient outcomes including understanding continuity of care and specialist use, tools for improving primary care coordination, detection of gaps in care. 

Becky Pelov is a consultant with 3M Health Information Systems.

Access our AHIP webinar archive.