A typical visit to the doctor’s office generally is focused on “fixing” a health problem — or even better, preventing one from happening. In this environment, healthcare practitioners collect patient data, including a medical history, current symptoms, lab results, and physical exam metrics. Up until the last few decades, that healthcare data was stored in a medical record residing in only one place, the provider’s office.
The data was appropriately used to treat the patient and help to prevent illness, but it generally could only be accessed in that specific setting. Sure, a patient could obtain a copy or even self-report the data to another provider who could add their opinion and treatment plan, but quite often, the updated medical information was never merged back with the central patient record.
This fragmentation of healthcare data often happens due to a patient accessing care in different venues such as the emergency room, walk-in urgent care clinics, specialty clinics, or in an in-patient hospital setting. Even with the adoption of Electronic Health Records (EHR’s), healthcare data could still end up dormant in one provider’s office, now just on a server instead of as a paper record.
So, what is happening with our healthcare data today?
What is Healthcare Data?
First, what is considered to be healthcare data to begin with? The basic elements we think about are vital signs like blood pressure, heart rate, temperature, and weight. Results of rapid tests, lab tests, and diagnostic imaging are also relevant components to healthcare data.
Other important metrics may be buried in the medical record but are very important in developing the overall picture for our personal health. They include cancer screenings, vaccinations, and lifestyle choices such diet and tobacco use. Interventions in controlling chronic conditions like high blood pressure, cholesterol, and diabetes also yield some very important data measures to be followed.
Regardless of how the data is defined, the key is standardization. The Centers for Medicare & Medicaid Services (CMS) has developed core measures that have helped to provide guidance in the healthcare industry for data collection. These standard data elements have allowed the public and private stakeholders to assess clinical outcomes across the nation in order to help develop pathways to improve the quality of healthcare.
Where Does the Data Come From?
Now that we know what the data is, where does it come from? I need to introduce a new term here, Healthcare Analytics. Although this term is pretty broad, it basically means data-mining clinical and administrative information sets in order to help improve healthcare outcomes. This is generally done on a large-scale basis in order to get a good overview of the trends in the industry that can be used to help improve the overall quality of care delivered in a singular healthcare system or even at the national level.
The data generally comes from the following:
- Electronic Health Records
- Healthcare Billing / Claims Data
- Administrative Data sets
- Patient Self-Reported data (such as patient surveys)
As technology continues to expand, the sources of information become more accessible in the Healthcare Analytics landscape.
What is the Data Used For?
Ok, we know what it is and where we get healthcare data, but what is it used for? While the universe of uses of healthcare data is expanding on what seems like a daily basis, here are just a few of the most prominent uses in today’s environment:
- The Centers for Medicare & Medicaid Services has taken the lead in the collection and reporting of healthcare data from the beginning. Their National Impact Assessment Report of Quality Measures was just released in June 2021. It is a comprehensive report with the intent to help safeguard public health by the use of healthcare data. Its data elements can be used to help predict trends, improve clinical outcomes, and identify areas of risk, such as patient safety, just to name a few.
- Insurance companies, who hold a treasure trove of historical healthcare data, are using the information to design more targeted plan offerings. For example, by incorporating chronic disease management programs into their coverages, they are helping to reduce both the severity and the costs involved in managing complex illnesses.
- Pharmaceutical companies have very efficiently mined their data in order to create new drug formularies that can help deliver medicines more efficiently and more cost effective. For example, combining cholesterol lowering statins with medications that help to control blood pressure all into one daily dose pill. This type of data-driven innovation also can help with patient compliance in taking their daily medication.
- Employers have utilized healthcare data in order to create targeted wellness programs that focus on the prevention and management of some of the most prominent chronic diseases identified in the data reporting. Programs such as weight management, blood pressure monitoring and control, effective pain management, and nutritional programs related to managing diabetes are just a few of the interventions derived from healthcare data analysis.
What is the Future of Healthcare Data?
This data-driven healthcare is definitely the future of the industry. As consumers, we need to get use to the term EHR Interoperability. In short, it basically means that our personal medical record is going to be in the cloud somewhere on some server, just like our other documents that we use every day at work or school.
So, every time we seek care, any provider will have access to our complete record of previous diagnoses, test results, and treatment plans, including our current medications. Just as important, our medical record will be updated on a real-time basis with the current care we are utilizing.
This interoperability of healthcare data has the potential to greatly improve clinical outcomes along with reducing costs such as repetitive lab testing and diagnostic imaging. Some of the newest technology, Blockchain, has already been employed to help facilitate the decentralized storage and secure transfer of healthcare data.
So, what is happening with our healthcare data? Well, it appears that it has been working overtime on our behalf to greatly improve the quality and outcomes of healthcare for our generation and those to come!
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David W Clark, MPA, CPA
Instructor of Accounting & Healthcare Management
West Texas A & M University
