Databases Reference
In-Depth Information
If all three parties (payer, provider, pharmaceutical company) work collaboratively
and share data/insights, disease management programs will become cost-effective and
deliver improved patient outcomes at a scale that will further optimize overall health-care
cost structure.
Each party brings unique insight, data, and experiences to assist in the design
and execution of a health-care management program that could make a sustainable
difference.
•
Providers bring the deep insight to a patient's health, longitudinal
view to the patient's disease progression, and hopefully some
historical insight to a patient's past behavior in managing their health.
•
Payers bring a comprehensive view to patient medical claims
across providers, labs, pharmacies, etc. Additionally, they may
have collected one or more health histories to proactively manage
at-risk members.
•
Although pharmaceutical companies do not bring individual
patient data, they do bring a deep understanding of clinical trial
data administered on patient populations from both primary and
secondary market research studies.
Currently, the health-care solutions do not integrate these different data sources at
one place; hence, they lack the ability to do correlations. A big data analytics platform can
effectively become the answer. To illustrate the point, let us look at some examples:
•
Patients with a chronic condition are identified in the outpatient
office for “potential” inclusion in a comprehensive health-care
management program.
•
The treating health-care professional leverages a set of questions
that were developed earlier by patient medical history and
geo-demographic data.
•
The answers to these questions are then combined with the
analytic models to provide a recommendation to the treating
health-care professional as to which disease management
program level is appropriate for this patient.
•
When the patient leaves the outpatient office, depending upon
which disease management program he/she was enrolled into,
he/she receives follow-up in-home visits, phone calls, letters,
email, text messages, and other patient support materials on a
continuing basis.
•
Additional data from payer, provider, and third party are utilized
to initiate follow-ups if the patient does not complete lab tests,
attend follow-up appointments, refill their prescriptions,
and/or in-home technology that indicates the patient is not
being adherent.
