HIMSS14: Why We Need Healthcare Intelligence (As Well As Intelligent Healthcare)

Healthcare intelligence sounds like an oxymoron, since so much about the U.S. healthcare system befuddles the mind. I set out, a seeker among the 37,000 attendees at the HIMSS14 annual conference and exhibition in the gargantuan Orange County Convention Center in Orlando, Fla., to find someone who could un-oxy this moron. My wanderings led me to Ben Loop, Vice President of Care Coordination and Analytics for Siemens.

Ben Loop, Vice President of Care Coordination and Analytics for Siemens

“I’m responsible for three businesses that all have to do with how you use data and information to make better choices and drive performance improvement,” said Loop. Aha, I thought. He explained that the Siemens Healthcare Intelligence solution aggregates and standardizes data across an enterprise to monitor performance at all levels of an organization. Healthcare Intelligence gives organizational leaders rapid access to detailed analytics so they can better achieve the outcomes associated with value-based purchasing, bundled payments and accountable care.

For example, Loop described how the Medicare value-based purchasing system is now using metrics to make certain outcome measures a standard for increased revenue. Requirements began with process reporting, then escalated to outcomes and most recently to cost controls. Siemens creates solutions to use business process management technology to assist in producing better results for these healthcare providers. A healthcare intelligence component is also integrated to provide better workflow and cost containment.

When I asked Loop to provide an analogy, he brightened and mentioned TurboTax, the tax preparation software. “You provide all the information and you hit ‘file,’ but you need to know where you are — on the high risk or the low risk of being audited, right?’” said Loop. “So TurboTax is looking at all the rules and regulations around filing your tax return. It’s figuring out whether there’s questionable information and then it’s evaluating you — Are you OK, or are you going to get a call in six months from the IRS?

“So that’s essentially what we’re trying to do here in an analytics environment,” he continued. “Are you doing the right thing; how are you doing on quality, on outcomes, do you have risks that you can correct? We’re trying to help people provide better performance.”

The underlying dirty little secret about healthcare intelligence and other IT solutions is that the American system badly needs the help. “The healthcare IT market globally is dominated by the U.S. — easily 75 percent,” Loop said. “Not necessarily because we’re screwed up, but we had health systems that could make capital investments to push the envelope. But we did create a volume-based business and that created a highly-fragmented care delivery system where we were really spending a lot of money and resources in areas like revenue for volume that weren’t necessarily the right thing for individuals.”

So my journey concluded with a sort of answer. Healthcare intelligence is…getting smarter and becoming indispensable to providers who want to survive in the new reimbursement environment.