Five ways data will disrupt healthcare in 2016

If there's one thing that healthcare executives learned in 2015, it's that the industry isn't for the faint of heart.

From value-based care to increased transparency for patients, the very nature of how healthcare is being delivered and what patients expect is rocking the industry to its core.

With the New Year will come more disruption as leading healthcare organizations use cloud technology to transform vast amounts of data into insight and action leaving behind the antiquat-ed, reactive healthcare status quo.

Here are five ways that data will drive changes in the way healthcare is delivered in 2016:

1. Testing prix fixe models for procedures. Borrowing an idea from the restaurant industry, the Centers for Medicare & Medicaid Services is implementing mandatory bundled payments for popular procedures, starting with Comprehensive Care for Joint Replacement in 2016. CMS is hoping data gathered from the CCJR program, which will bundle all costs for knee or hip replacement for the entire episode of care—from surgery through rehab—will demon-strate the benefit of forcing more seamless communication and exchange of real-time data between the surgical hospital and the post acute care center, resulting in more accountability and better patient outcomes. Since cost overruns from extended rehab will become the re-sponsibility of the surgical hospital, the hospital will have a strong incentive to stay engaged to ensure the patient recovers within the length of stay and cost per day guidelines.

Bundled payments will also drive different behavior from post acute care skilled nursing fa-cilities. These facilities will be interested in demonstrating that they deliver effective care while working within the bundled payment model, setting them up to be paid more based on quality, and positioning them for more referrals.

The prerequisite for successful collaboration within a bundled payment model will be the abil-ity to seamlessly share live data across various healthcare entities that have historically been disconnected.

2. Powering big-box healthcare. Large retailers, like CVS, Walgreens, Target and Walmart, are getting into the healthcare business by opening clinics in their retail locations. These clinics, which can handle anything from strep throat to sports physicals, have already begun to dis-rupt the traditional relationship between the doctor and patient. The doctor is at a true disad-vantage as these retailers are masters of data-driven consumer marketing. 2016 will be the year that healthcare providers wake up to the fact that they need to begin behaving more like these retailers if they are to retain their patients. This will require healthcare specific customer relationship management solutions that enable providers to identify and segment potential pa-tient groups, reach patients with timely and targeted messages, and build loyal relationships with patients using data and behavioral insight.

3. Making big data personal. While there is a vast amount of data available about patients that could make their lives healthier, most of this data isn't in a form that's actionable or being tapped by healthcare providers. For example, a November 2015 MIT Technology Review ar-ticle found doctors from a number of specialties are unsure how to utilize the fitness tracker data their patients bring them. Healthcare providers need to do a better job of unifying and harnessing the data that's available.

That includes identifying relevant key data sources—both traditional and nontraditional—to create a real-time, holistic profile of the patient. For example, data is available about individ-ual buying patterns at grocery stores, which can be helpful in better understanding how diet may impact a patient who is diabetic.

An increased focus on the consumer across all phases of his healthcare journey— healthy, acute or chronic—will place intensified focus on data rich cloud technology that unifies many data sources to more proactively detect the needs of individual consumers, drive action, and enable providers to aid in better health management.

4. Healthcare Relationship Management coming to healthcare. Electronic medical records have garnered significant attention over the past several years due to meaningful use require-ments. Yet these systems, while an effective way to manage internal clinical processes, aren't capable of enabling health systems to successfully build long-term relationships with patients. This is where healthcare relationship management platforms thrive. EMRs are built to serve as systems of record as opposed to systems of engagement. They are designed to maintain pa-tient medical records, capture clinical documents and notes, manage medication lists, capture codes used to support billing, etc. When it comes to engaging with patients or providers be-yond the internal clinical process, a healthcare relationship management solution is required. By combining healthcare-specific CRM with robust profiling and targeted communication capabilities, healthcare relationship management technology makes it possible to truly engage with patients, providers and other stakeholders to deliver on the promise of an outstanding customer experience. This goes beyond relationships with patients. Healthcare organizations can use HRM systems to better manage important relationships on the business-to-business level. For example, the laboratory can manage its relationships with providers, helping them to exceed client expectations while also increasing revenue and keeping costs in check.

5. Personalized medicine for the masses. As sequencing costs continue to drop, genomics will become increasingly prevalent as a key component of the patient profile. While tapping ge-nomic data to treat and prevent disease with precision is incredibly powerful, personalized medicine goes well beyond treating those who are very ill by bringing a customized experi-ence to all consumers of healthcare across the entire care continuum. No doubt, the rise of consumerism is driving massive change in healthcare as patients demand better and more per-sonalized service for their healthcare dollar. In order to compete in this consumer-driven, quality-based environment, providers must deliver personalized medicine that tailors the healthcare experience for each patient's needs and delivers a level of service that will keep patients coming back. The emergence of healthcare cloud technologies designed to harness the data needed to drive one-to-one engagement makes personalized medicine for the masses a reality for healthcare organizations.

In 2016, the wild ride will continue for healthcare leaders. Yet those who understand the role that data will play in healthcare, and take steps to harness the vast amounts of data available, will find that they are positioned to compete and win for decades to come.

About the author: Brad Bostic founded hc1.com to address the critical need for healthcare sys-tems, diagnostic laboratories, ambulatory service providers, and post acute care organizations to deliver an outstanding client experience. As the leader in healthcare relationship management, hc1.com powers healthcare relationship management across 700 client locations spanning five countries, including Cleveland Clinic, Sonic Healthcare, Alere, and Labors.at. hc1.com has been recognized with numerous awards including the Red Herring Global 100, Mira Health Technolo-gy Innovation and Excellence, and Frost & Sullivan Best Healthcare CRM for Diagnostic Labs. 

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