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executive

brief
09.13 eb 7755

Bigger Data, Better Outcomes


Five Ways U.S. Healthcare Can Save Billions

The rise of big data is more than a technical challenge. 2. Delivering higher-quality healthcare
Its a business imperative. Companies in every industry With the emergence of accountable care organizations
are actively harnessing the volume, variety, and velocity (ACOs)and with chronic conditions more prevalent than
of multistructured data across a broad range of channels everhealthcare systems and payers must find innovative
for sustained competitive advantage. ways to deliver quality healthcare at a manageable cost.
In the U.S. healthcare industry, companies have the A big data solution can help organizations gain a better
opportunity to use big data analytics, new data sources, understanding of a number of variables, such as treat-
and advanced algorithms to transform processes and ment compliance and communications preferences, that
advance patient care while minimizing waste and fraud. can drive up the cost of care. The right solution can help
The question isnt whether health organizations will predict when individuals need intervention, and it can be
benefit. The question is how much. In fact, analysts at used to design programs that offer evidence-based
McKinsey & Company estimate that seizing the big data guidance for selected high-cost services based on
opportunity could save U.S. healthcare as much as real-world expected outcomes.
$300 billion per year.1
3. Streamlining health delivery systems
Where do those savings come from? In short, every-
where. A high-performance big data solution can deliver The Institute of Medicine estimates that wasteful spend-
deep, comprehensive insight at scale, integrating infor- ing in the U.S. healthcare systemthat is, spending that
mation from a broad range of sources and impacting can be eliminated without reducing the quality of care
every part of the businessfrom the doctors office to may add up to $750 billion every year, or 30 percent of
the head office. medical expenses. 2 It reports that much of that waste
arises from inefficiencies in administrative systems, lack
of care coordination, and the unwarranted use of
Save With Big Data healthcare services.
Here are five major areas where health organizations
stand to benefit from putting all of their data to work. Some of these issues may be addressed by implementing
electronic health record (EHR) technology to meet the
meaningful use objectives mandated by federal law,
1. Engaging patients in their preferred channels
but those solutions will achieve only modest improve-
As the healthcare industry offers greater degrees of ments if they fail to integrate with other stores of data in
specialization, patients often see multiple providers for the system. A big data solution can simplify the analysis
their care. In this complex environment, its more important and understanding of a truly comprehensive medical
than ever for health systems and payers to keep all parties record by combining a broad range of standards and
informed and engaged, actively influencing customers formats, including optical character recognition (OCR)
choices to achieve the best outcome at minimal cost. technology, Health Level Seven (HL7) data, and more
traditional structured data types.
A data-driven marketing solution can empower health
systems to achieve deep insight into the preferences and 4. Measuring the effectiveness of health processes
behaviors of individuals across a broad range of chan-
nels. For example, these solutions help organizations Even as healthcare organizations rush to meet regulatory
understand all the touch points of a particular patient or requirements and curb rising costs, they often lack the
member across the full range of available channels, tools necessary to measure their progress. Accurate
including the Web site, call center, and direct mail. The measurement will only become more crucial as margins
solution can even detect the tone of words appearing on shrink and competition intensifies under the provisions of
social media sites to predict disenrollment, anticipate the Affordable Care Act (ACA).
formal complaints, and trigger adjusted messaging to
manage negative sentiments.
executive
brief
09.13 eb 7755

The right big data solution will apply advanced probabil- Perpetrators of fraud hope that their schemes will get
ity models to fine-tune predictive analytics, giving lost in the noise of data throughout the system, but
healthcare systems and payers the ability to reduce automated analysis can isolate the anomalous signals
false-positive predictions and continually learn from new pointing to fraudulent behavior. For example, a high-per-
developments in the market. That level of insight pro- formance big data solution is capable of detecting which
duces meaningful metrics with stunning accuracy so that claims may have originated from fraud rings because
organizations can make truly informed decisions. these claims often fail to reflect the normal distribution
of patient ages, diagnosis codes, or procedure codes
5. Staying one step ahead of fraud found in the general population. This type of analysis
separates computer-generated false claims from legiti-
Researchers at Truven Health Analytics (formerly Thom-
mate claims.
son Reuters) estimate that fraud and abuse cost the U.S.
healthcare system as much as $175 billion every year. 3
Abuses happen at all levels of the system, from the Learn More
intentional provision of unnecessary services to the
deliberate misuse of Medicaid benefits. All this can be To discover how healthcare solutions from Teradata
minimized with the proper tools. can help your organization cut costs and optimize care,
visit www.teradata.com/healthcare.

endnotes
1. Big Data: The Next Frontier for Innovation, Competition, and Productivity, McKinsey & Company, May 2011.
2. Best Care at Lower Cost: The Path to Continuously Learning Healthcare in America, Institute of Medicine,
September 2012.
3. Where Can $700 Billion in Waste Be Cut Annually from the U.S. Healthcare System?, Thomson and Reuters,
October 2009.

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