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A New Era of Transparency in Healthcare

In the healthcare arena, most of us associate “Big Data” with the industry’s steady push toward electronic health records (EHRS), the systematic aggregation of digitized medical records which gives healthcare providers a more complete and accurate view of their patients’ medical histories. While EHRS are clearly patient-centric, another breed of big data is emerging which will put healthcare providers under the microscope: Public Data. 

Under the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) has greatly expanded efforts to publish data about the costs of care, the quality of care, and disparities across geographies or providers. Leveraging that CMS data, many entrepreneurs, think tanks, and other organizations have created analytical tools that aim to satisfy the public’s great hunger for meaningful information on which to base decisions about personal health. One example is MicroStrategy’s Public Health App, which provides individual scorecards for 880,000 healthcare providers based on $77 billion in Medicare spending. 

As a result, today’s “consumers” (patients) have more information on doctors, nurses, hospitals, nursing homes, home health agencies, and insurers than ever before. In advance of potential medical procedures, consumers can now use publicly available data sources to answer questions such as:

  • How do other patients rate their experiences with a particular physician or facility?
  • Which doctors in my area use electronic health records?
  • Which doctors in my area perform the most of a given surgery or procedure?
  • Which hospitals have lower surgical infection rates and higher patient satisfaction scores?

This new era of transparency in the healthcare industry will expose providers to new levels of public scrutiny and competitive pressure. As such, healthcare organizations must ensure that they’re more informed about their own performance and satisfaction metrics than the most informed consumers. By understanding how public data is influencing consumer decisions and perceptions, providers can proactively control their own narrative and address potential shortcomings.

But, providers shouldn't view this new level of transparency as a threat; instead, by fully harnessing public data, healthcare organizations can uncover new insights that can help them expand their businesses, increase their operational efficiency, and deliver a better patient experience. Further, the most powerful insights come from analytical tools that allow healthcare organizations to combine this public data with their own internal, proprietary data sources.

By leveraging public data, providers can investigate how they’re performing compared to their peers or competitors by getting answers to questions such as:

  • How do my key quality measures compare with my peers and competitors?
  • How do patients rate their experience with my facility or my care in comparison with my    peers?
  • For given procedures, are my charges and total payments received in line with my peers?

Likewise, a healthcare organization could use public information to uncover new business opportunities by posing questions such as:

  • What specialties will see demand increases due to changing patient demographics?
  • Are there underserved communities in certain geographies into which I may want to expand?
  • >Are their shortages looming in certain physician specialties within my market?

Or, an organization could examine public data to uncover inefficiencies or anomalies in their doctors’ time management or billing practices, researching questions such as:

  • Which doctors in my area perform the most of a given surgery or procedure?
  • Are they performing more of their work at my hospital or that of a peer/competitor?
  • Are doctors associated with my practice billing in a way that may garner unwanted publicity?
  • How is a doctor’s time distributed across different procedures, visits, and treatments?
  • Which doctors in my facility are referring more patients to doctors outside of our practice/network?

The new era of transparency should be rewarding for everyone in the healthcare ecosystem, from patients to providers to payers. It will make organizations and physicians more accountable and ultimately result in a higher level of patient care. Those hospitals and healthcare organizations that are able to incorporate and leverage public data within their own analytics systems will be able to deliver the critical insights needed to gain an edge on their competition.

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