Highmark looks to create 'data-driven care plan for every member' with Google Cloud

As part of its ongoing collaboration with Google Cloud, Pittsburgh-based Highmark Health hopes to one day have a "data-driven care plan for every member," chief analytics officer Richard Clarke, PhD, told Becker's.

The payer-provider recently teamed up with the cloud giant on two new projects: a "healthcare data engine accelerator" to use data and analytics to improve its value-based care, and a "digital front door" app for its health plan members.

The initiatives expand on Highmark's Living Health program, a collaboration between the health system, Google Cloud and Verily, the life sciences arm of Google parent company Alphabet.

Dr. Clarke said Google Cloud's data analytics power is a natural fit for Highmark, an integrated $22 billion health network with about 6.8 million members in its health plans and the owner of Allegheny Health Network, an eight-hospital system also based in Pittsburgh.

Google Cloud's "healthcare data engine" technology helps create interoperability across Highmark Health and with outside organizations. "The accelerators are Google Cloud stepping up and saying, 'Hey, let's actually work together to put the Lego bricks together,'" Dr. Clarke said.

Highmark Health's accelerator will focus on value-based care, a big part of its mission as an integrated system. The project will merge clinical and claims data to identify population health metrics, suggesting treatment plans to providers.

"This interoperability engine reduces as much friction as possible, so we're not asking providers to leave their workflow and go somewhere else," Dr. Clarke said. "We're trying to introduce everything in a seamless way, so the right thing to do is very easy for them to execute."

The first use case at Highmark has been to make recommendations for patients who are headed toward a total joint replacement. One possible suggestion may be to refer them to Sword, a virtual physical therapy company that Highmark has invested in.

"This is just a place for us to start," Dr. Clarke said. "The end state for us is we'll actually have a data-driven care plan for every member based on everything that's going on for them. But that obviously is in the future."

The improved interoperability has also allowed Highmark to share data back and forth between its providers and community-based organizations to make sure patients' social determinants of health are being addressed, Dr. Clarke said.

Meanwhile, the My Highmark app, which was designed by software company League, will allow members to check the status of their claims and deductibles, schedule appointments and do virtual visits. My Highmark is starting with employees and select clients before moving on to the larger membership base.

"This will allow us to build a personalized, engaging platform that frankly, will be a place that people keep coming back to, hopefully on a daily basis, to manage their health," Dr. Clarke said.

Dr. Clarke started in the new role in April 2020, after having worked in analytics for the health system since 2016. He is pleased to see more clinical insights being derived from healthcare data, and said the collaboration with Google Cloud will only further that work.

"We can't deliver on our promise to reinvent health without these types of partnerships," he said.

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