Aggregating data is only the first step
Kristin Rodriguez, Health Plan Alliance
01/24/2017
Last month, 14 Alliance member health plans came together in San Antonio, TX for the Alliance 2016 Informatics Value Visit. While the meeting was jam-packed, the sessions that resonated most with the group were the seven health plan case studies.
7 Can’t Miss Informatics Health Plan Case Studies
Community Health Plan of Washington
Their journey to integrating data from their clinics, claims, and risk adjustment to drive their P4P program and close care gaps
Slides | Audio
Sentara Health Plans
Using data to empower ACO leaders to have tough conversations about practice variation
Slides | Audio
Optima
How moving to cost transparency drove big efforts in managing costs and sharing risk across the system
Slides | Audio
SummaCare
An exploration of how clinical informatics strategy drives the health services operational structure
Slides | Audio
Community First Health Plans
Their low-cost approach to ensuring edge server data submissions are accurate
Slides | Audio | Toolkit
Presbyterian Health Plan
The challenges a data and analytics transformation presents for a provider owned health plan
Slides | Audio
Passport Health Plan
Overcoming data silos to impact Stars with a strong focus on pharmacy data
Slides | Audio
Data that isn’t actionable, reliable or accessible isn’t very valuable
Every health plan case study tackled a different challenge; and yet, a common theme was apparent. For health plans to be successful in today’s marketplace, data can’t just be collected and stored — it has to actionable, reliable and accessible to make a difference for clinical and business goals.
Data isn’t the point — it’s finding the data that fits the purpose we care about… and that is easier said than done.
Alliance member health plans have come far in data governance and yet many in attendance felt there are still meaningful challenges in this area. Soyal Momin, VP of Data and Analytics at Presbyterian, discussed their initiative to assign data stewards within the business units, so that the responsibility of data integrity is “baked in” to individual roles and scope of responsibility. This issue of data integrity and governance feeds another tough challenge every plan faces…
Providers have to trust the data.
Joe Hearst, Director of Clinical Analytics and Quality Improvement with Sentara Health Plans, detailed what he calls the five stages of grief providers must experience when presented with data and highlighted that the magic really happens when the conversations he has aren’t about the integrity of the data, but rather what that data is telling him about how they are serving their members. This sentiment was echoed by Julian Bester, Program Manager – CHC Technology Services, Community Health Plan of Washington. Julian detailed the implementation of CHPW’s data asset, noting that only 10% of effort was on implementation. The other 90% was on adoption, and a notable portion of that effort was driven by providers’ trust issues with the data and their willingness to adopt its use in the clinical setting.
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You have to get the data insights into the hands of those who need it, at the right time, and communicated in a way the end user can leverage to improve their performance.
That’s what many of those engaged in conversations around the coffee cart, at dinner and in the hallway care about. And we all face challenges on the way. Soyal shared Presbyterian’s 7-fold path, and pointed out that evolving into organizations that make data-driven decisions isn’t just about having the right tools or the right processes or the right skill sets, but a robust portfolio of all of these. Developing analytics talent within the organization and recruiting data scientists with change management and leadership skills is a must, not to mention continuing to develop infrastructures that can support the strategic imperatives we all face in this tough industry.
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What’s next for Alliance informatics programming?
The Alliance is actively planning informatics programming for 2017, so stay tuned for more opportunities to engage with your peers around these critical issues at virtual events coming soon. In the meantime, don’t forget — using the Alliance member discussion forums, you can continue these conversations with your peers all year long.
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