Healthcare in 2012 is undergoing a major upheaval. The major drivers of this are the escalating, unsustainable cost of quality healthcare, healthcare reform, the consolidation of physician practices and hospital systems, and the drive towards full deployment of electronic health records. In response to these driving forces, the healthcare system is currently engaged in a bold experiment in risk management known as the Accountable Care (ACO). Insurers and the government are working with provider organizations to financially reward providers (or to financially penalize them as the case may be) for the quality of the care they deliver, and the cost of delivering that care. Provider groups are being asked to take financial risk for both cost and quality, in a major shift from the traditional fee for service models currently deployed.
Healthcare providers are rapidly learning the lessons that insurers have developed over decades – to manage financial risk in healthcare, it is necessary to understand their patient populations and to identify and mitigate risks within these populations. Insurers have traditionally used financial models based on incomplete and inaccurate claims data to develop risk models that allow the prediction, and occasionally the management of such risks through disease management programs, etc. While these models involved the use of massive amounts of claims data and were nominally “big data,” the understanding of population health requires far more detailed data about healthcare which can only be found in the actual records of medical care, recorded in electronic health records (EHRs).
This talk will discuss the use of aggregated, longitudinal EHR databases, predictive data analytics and data visualization as a key success factor in the transformation of healthcare and the ACO strategic initiative. Big data healthcare databases are the necessary component in provider efforts to improve the quality and cost of care through exception management and process redesign. Providers who are able to use big data healthcare databases to improve financial and quality performance may be able to navigate the choppy waters of ACOs and healthcare reform and emerge as intact and independent entities.
Allen is one of Humedica’s co-founders and presently serves as Vice President of Corporate Development and Marketing and is responsible for the company’s partnerships, marketing, and new business opportunities. Previously, he was a Director at Leerink Swann, a leading health care investment bank, where he helped develop the business plan and raise capital to launch Humedica. With nearly 20 years of health care experience, Allen held management positions at Biogen and Biogen Idec, including Director of Decision Support. In that role, he managed a team responsible for the company’s forecasting, market research, managed care analyses, sales force design and compensation plans for the Neurology and Dermatology business units. Prior to joining Biogen, Allen co-founded MORPACE Pharma Group, a forecasting and consulting firm for the pharmaceutical industry. There he led the company’s integration of secondary data sources, demand forecasting, and the development of a global physician panel. Allen began his career as a reporter for The Pink Sheet, covering pharmaceutical industry issues at the FDA and Capitol Hill, and also previously worked at Decision Resources managing multiple publications. He received his bachelor’s degree from Brandeis University.
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