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Health Analytics. Gaining the Insights to Transform Health Care. Wiley and SAS Business Series

  • ID: 2329804
  • Book
  • August 2013
  • 272 Pages
  • John Wiley and Sons Ltd
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Praise for Health Analytics: Gaining the Insights to Transform Health Care

"Health care leaders in the next decade must be able to guide their teams in the use of mission–critical health care analytics. Jason Burke has distilled this complex subject to a structured, commonsense framework that is a pleasure to read. His readers will gain significant advantage in the world of provider risk and ACOs, and will be revisiting charts, tables, and entire chapters frequently for sage advice."
Paul Bleicher, MD, PhD, CEO, Optum Labs

"Health care is among the largest and most complicated industries on the planet, such that one would expect to encounter advanced practices. However, health care has yet to encounter its own industrial revolution, one in which data–driven organizations disrupt the status quo to deliver ever better results and greater value. In his seminal book, Jason Burke helps us understand how to ′paint a picture of a different future′ for health care, using data to define activities, prioritize responses and interventions, and optimize scarce resources, all to drive to a better ′new normal.′"
Don McDaniel, President and CEO, Sage Growth Partners

"Passionate, connected, and wonderfully insightful Jason offers a pragmatic framework to create meaningful value through health care analytics. He has an uncanny knack for demystifying the modern health care ecosystem comprising patients, providers, payers, policymakers, and pharmaceutical organizations and describing the role of health care analytics as the connective tissue that will transform medicine."
Richard Thomas, CIO, Quintiles

"There are several unimpeachable statements that one can make regarding the future of health care: 1) despite wishes of many stakeholders to the contrary, our ′system′ of health care delivery and financing will radically change; 2) quality, patient satisfaction, efficiency, integration, coordination, and cost–effectiveness will replace volume as the drivers of medicine; 3) there will be winners and, most assuredly, losers; and 4) essential to winning will be measurement and the use of real–time information to guide decisions. If those engaged in health care delivery (or health policy) wish to be among the future winners, those who successfully reconstruct the health care system, they need to read Jason Burke′s Health Analytics. Far more than a lucid explanation of the difference between data and information (and how to ensure that the latter is an integral driver of operations), this book is a strategic map to the future. Filled with wisdom and yet incredibly engagingly written, Health Analytics promises considerable return on investment for anyone interested in the health of individuals or organizations (i.e., virtually everyone)."
David R. Rubinow, MD, Meymandi Professor and Chair, Department of Psychiatry and Director of Innovation and Healthcare System Transformation, School of Medicine, University of North Carolina at Chapel Hill

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Foreword xi

Preface xv

Acknowledgements xix

Chapter 1 A Changing Business for a Changing Science 1

The Gathering 1

How Can Medicine Become Smarter? 3

Complexity Exceeding Cognition 4

Learning from Other Industries 6

Nancy 7

Characterizing Health Analytics 8

The Gathering Revisited 10

Chapter 2 Convergence and the Capability Map 11

Nice Job, But . . . 11

Fifty Flashlights 12

Convergence Defined 13

Is Convergence Really Required? 14

The Rush to Health It 17

The Capability Map 18

Putting the Capability Map to Use 21

Health Analytics as a Discipline 23

Notes 25

Chapter 3 The Four Enterprise Disciplines of Health Analytics 27

Heresy 27

Health Analytics for the Nonanalytical 29

Information Management 30

Statistics 36

Information Delivery 39

High–Performance Computing 41

Maturation and Scale 42

Enterprise–Class Analytics: Putting it All Together 44

Chapter 4 Dealing with Data 47

Callimachus 47

Not a Drop to Drink 48

Defining Data 48

Big Data 49

Growth in Data Provisioning 52

The Excuses Every Leader Needs to Know 54

Building for Tomorrow 58

Conclusion 60

Chapter 5 BEST Care, First Time, Every Time 63

By Dr. Graham Hughes Chief Medical Officer, SAS Center for Health Analytics and Insights

Medicine: Art, Science, or Both? 63

Leveraging Evidence to Deliver Improved Outcomes 66

What are Clinical Outcomes? 68

Supplementing the Unaided Human Mind 72

Health Care s Dark Fiber 74

Identifying Hidden Patterns 75

Chapter 6 Financial Performance and Reimbursement 79

Goals 79

Structures and Models 80

Many Names, Common Attributes 83

What is Needed 86

Surviving and Thriving 91

Chapter 7 Health Outcomes Analysis 95

No Leeches Necessary 95

Orientation 96

The Big Seven þ One 97

Timing is Everything 98

Groupers 100

The Population–Patient Pivot 101

Patients Like this One 104

One Model, Many Beneficiaries 107

The Role of Rules Engines 109

Challenges in Health Outcomes Analytics 110

Health Outcomes Analytics in Practice 113

The Marvelous Leech 114

Note 115

Chapter 8 Health Value and Cost 117

An Asymmetrical Industry 117

Kaplan and Porter s Stand 120

The Elusive Health Value 121

Dissecting Value 123

Linking Costs to Risk 132

Value Innovation 133

Note 134

Chapter 9 The New Behavioral Health 135

Dangerous Portals 135

The Health–Mindedness Gene Experiment 136

Engel s Model 137

The New Evolving Science of Behavioral Health 138

What You Are 140

What You Experience 142

What You Do 143

What You Believe 145

Influencing Change 145

Putting Into Practice 146

Outcomes 148

Notes 149

Chapter 10 Customer Insights 151

The Consumerized Patient 151

Will the Real Customer Please Stand Up? 151

What Are Customer Analytics? 154

A Framework of Customer Analytics 155

Sharing Insights 161

Adherence 163

Beyond Commercial 165

Chapter 11 Risk Management 167

Risky Business 167

Why Are Risks So Hard? 168

Recharacterizing Risk Factors 169

The Example of Customer Segmentation 170

Risk Interdependencies 171

Everybody in the Pool 173

The Catch 175

Risk Adjustment 176

Borrowing from Other Industries 178

Growing Risks 179

Chapter 12 Quality and Safety 181

Defining Quality 181

Not Your Father s Toyota 184

On Track 185

Avoiding the Obvious 187

We Just Have to Do This 188

The Growing Inventory 189

Strategy and Performance Management 191

Transparency and Benchmarking 192

Setting Quality Targets 195

Drug Safety 197

The Burden of Insight 198

Notes 199

Chapter 13 The New Research and Development 201

Returning to Alexandria 201

The End of Theory 202

Goals of a New Research Model 205

Characteristics of a New Research Paradigm 207

Target Improvement Areas 209

The Data Conundrum 216

The Big Four 219

One That Does What It Should 221

Notes 223

Chapter 14 Conclusions 225

Taking on Research 227

Five Phases of Value–Based Analytical Innovation 230

Phase 0: The Plan 232

Managing Capability Maturity 233

Wisdom and Health 237

About the Author 239

Index 241

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Jason Burke
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