Healthcare

Manage Resources to Deliver

Optimal Care
Worldwide, the top priority for organizations involved in healthcare is seeing that
the proper care is delivered, wherever and whenever it is needed. Due to growing
concern about the cost of healthcare, there is renewed emphasis on ensuring that
it is delivered efficiently. Nevertheless, maintaining a high level of quality and
protecting public health remain top priorities.

SPSS Inc. has a long history of providing support to healthcare organizations. Our solutions include
statistical, data mining, text mining, and Web mining tools, business intelligence and reporting
software, and survey research products. Used separately or together, they enable organizations to:
n Support medical research
n Improve disease management
n Monitor the quality of patient care
n Improve operational efficiency
n Maintain accreditation
n Combat healthcare fraud
n Protect public health

SPSS software solutions are well suited to healthcare applications. Our solutions use open
architectures, enabling users to access and analyze data from a wide variety of sources and deliver
results in a variety of ways. They are highly scalable, capable of processing the large volumes of
data that healthcare organizations typically generate. Our survey research solutions meet statutory
requirements, such as the U.S. HIPAA (Health Insurance Portability and Accountability Act), as well
as healthcare organizations’ stringent hardware and firewall specifications.
Supporting medical research
Medical research generates massive amounts of data.
Individuals and institutions involved in research rely on
SPSS solutions to efficiently manage the data collection,
analysis, and reporting so that they can spend more time
on the research itself.
Dr. Eric Bremer at Children’s Memorial Hospital in Chicago,
for example, uses an SPSS data mining solution to analyze
microarray data and characterize pediatric brain tumors by
type and stage of development. Dr. Bremer also uses SPSS’
linguistics-based text mining solution to sift through
the research literature in this field and efficiently monitor
new developments. His goal is to create a database
incorporating clinical, pathological, and biochemical
information—and make it available to other researchers
in order to find the best cancer treatments available.
Improving disease management
In delivering healthcare, hospitals, clinics, and individual
physicians use both individual clinical expertise and the
best available external evidence to guide treatment
recommendations. SPSS solutions help providers increase
their awareness of the relevant evidence and evaluate
the strength of that evidence so that, in consultation
with the patient, they can choose the most appropriate
treatment options.
A study done at London’s St. George’s Hospital NHS Trust
is typical of many that shed light on the effectiveness of
medical treatments. Using statistical software from SPSS,
the study evaluated more than 14,000 admissions to the
hospital during a nine-year period. It found that there
was a higher mortality risk when certain types of patients
were moved out of intensive care units rather than being
kept there longer. This helped the hospital choose the
most effective treatment options for its patients and
provided guidelines to other hospitals with similar
patient populations.
SPSS solutions also give payer organizations, such as
government agencies and private insurers, the tools
to identify patterns in patient care that signal the
“mainstreaming” of new treatments and therapies.
In this way, they can determine which therapeutic
approaches improve patient outcomes and minimize
the need for expensive emergency interventions.
Concern over costs
Healthcare costs are expected to continue rising, even
though they already represent a significant share of
gross domestic product (GDP).
Share of GDP spent on healthcare
United States 15.0%
Australia 9.5%
Canada 9.5%
Japan 7.9%
United Kingdom 7.7%
Other EU nations
(average) 9.0%
Source: "Social Health Insurance Systems in Western Europe."
World Health Organization, 2004.
Monitoring quality, improving efficiency
In addition to helping providers evaluate treatment
effectiveness and maintain high levels of patient-care
quality, SPSS software also enables them to improve
operational efficiency and meet accreditation
requirements, such as those of the U.S. Joint Commission
on the Accreditation of Healthcare Organizations (JCAHO).
Analytical tools from SPSS do this by helping providers
negotiate appropriate payment contracts with insurers
and other payers, obtain funding for research, and
efficiently meet regulatory requirements.
To comply with quality-control legislation in the
Netherlands, for example, the Hospital of Walcheren
chose SPSS’ suite of survey research tools. Not only
did this solution improve staff efficiency in processing
patient questionnaires, it also uncovered some unmet
patient needs. By quickly addressing those needs,
the hospital improved patient satisfaction and met
regulatory requirements.
A number of other health providers use SPSS reporting
solutions to monitor operational efficiency according to
a variety of metrics.
For example, the Wesley Hospital Back Rehabilitation
Centre, located in Queensland, Australia, uses SPSS
products to monitor operational efficiency. Each year, the
facility treats more than 60,000 patients who have had
back surgery, suffer from unresolved or recurrent episodes
of back pain, or are unable to return to work. It combined
clinical and operational data to create key performance
indicators (KPIs) that are used to more effectively allocate
staff and other resources.
SPSS solutions also help private sector organizations,
such as health insurers, improve efficiencies and obtain
the competitive advantage they need.
Highmark Blue Cross Blue Shield, which provides
insurance and health-related services to millions of
members in Pennsylvania, uses SPSS products to identify
different characteristics of customers, plan member service
improvements, and compare product penetration rates by
region. This enabled the insurer to identify opportunities
where it could significantly expand its market.
SPSS survey research tools are used to monitor feedback
both within provider organizations and outside them. For
example, a hospital or clinic can continually track
community or legislative support for its outreach programs
and initiatives. SPSS software also can be used to monitor
physician and staff job satisfaction and loyalty—important
factors in managing valuable human resources.
Combating healthcare fraud
It is estimated that, in the U.S. alone, as much as
$500 billion may be spent each year on duplicate or
unnecessary treatments and fraudulent claims. This
clearly diverts resources that otherwise would be available
for treatments patients need. Private payers and state,
local, and federal government agencies have a vital stake
in detecting and minimizing the effects of wasteful or
fraudulent practices.
One state health department, for instance, processes
hundreds of millions of Medicaid claims totaling billions
of dollars every year. The department implemented an
extensive data warehouse project that included an
SPSS data mining component. This award-winning initiative
saved the state millions of dollars in its first year in
operation, in part due to predictive models that detected
the most likely instances of fraud. Because they knew
which cases to focus on, agency investigators had a
higher rate of success in identifying and recovering
improper payments.
While current methods typically catch fraud after payment
has been made, putting payers in the position of trying
to recover funds, new methods are designed to detect
likely instances of fraud before payment has been made.
This minimizes the need for expensive collection efforts
and represents a major step forward in combating
improper payments. The real-time deployment
capabilities that SPSS solutions offer enable
organizations to take action in the small “window” of
time between the submission and payment of claims.
Protecting public health
Public health departments function as monitors,
researchers, and educators. Their staff must watch trends—
both locally and across borders—in both communicable
diseases like influenza and chronic conditions like
diabetes. They must understand the causes behind the
trends. And they must provide healthcare providers and
the public with guidance both in emergency situations,
like the SARS outbreak in 2004, and on an ongoing basis.
The open architectures and advanced features of SPSS
solutions make them ideally suited to helping public
health agencies and organizations. When surveying
the public about their knowledge of and attitudes
toward certain health-related topics, SPSS solutions
protect individual privacy while making it easy for
agencies to collect information through a variety of
cost-effective channels.
Another way in which SPSS solutions can be used is in
syndromic surveillance. This is a process that requires
agencies to analyze health data, “stripped” of any
personal identification, to discover patterns and
associations that suggest the presence of a certain
syndrome and the need for a public health response.
Because data comes from many different sources—
emergency room admissions records, pharmacy sales
records, and public safety incident reports, among others—
openness and the efficient use of computing resources
are essential.

SPSS aids healthcare organizations

Our customers rely on us for both reliable, innovative software and in-depth industry expertise.
SPSS products are used by:
n Five of the seven largest healthcare provider organizations in the U.S.
n 14 of the 16 hospitals on U.S. News & World Report’s 2005 “honor roll”
n More than 300 hospitals in the NHS Trust in the U.K.
n The top five private payers in the U.S., who insure more than 150 million consumers
n AXA and BUPA, two of the leading insurers in the U.K.
n Many county, state, and federal healthcare agencies, including those serving densely populated areas
n Medical researchers at numerous universities and public health agencies, including those conducting
research on genomics and other groundbreaking therapies
n Leading not-for-profit medical associations and foundations
Meeting new challenges
The cost of healthcare will continue to be a concern,
particularly in industrialized nations as older people,
who require more healthcare resources, comprise a
higher proportion of the population.
One way to help curb costs is to cut down on the amount
of paper handling involved in every phase of healthcare,
from visiting the doctor to picking up prescriptions to
paying doctor and hospital bills. Already, there is a trend
toward computerized physician order entry and electronic
medical records, and many payers give physicians and
patients the ability to access claim information online.
Increased use of the Web offers opportunities for improved
communication among all parties involved in healthcare.
Consumers use the Web to research medical conditions,
treatments, and caregivers, and to purchase medications.
Physicians and other healthcare providers increasingly
communicate with each other, with patients, and with
payers electronically. In this area, SPSS’ Web mining
solution can assist organizations, since it provides a clear
picture of who is visiting a site, when they are visiting it,
and what they do there.
For medical researchers and public health officials,
the trend toward digitizing healthcare information offers
exciting opportunities. More data than ever before will
be available—some of it data that could not previously be
analyzed, such as doctors’ and nurses’ textual notes.
SPSS text mining can help researchers and others
uncover hidden associations in these new sources of data,
adding to the accuracy of current predictive models.
Technology to play a key role
Numerous studies show that healthcare organizations
increasingly recognize that information technology
improves their ability to operate more efficiently and deliver
the quality of care that is required. IDC projects worldwide
software spending by healthcare organizations to grow by
a compound average growth rate of 5.9 percent a year,
reaching $10.5 billion by 2008. (Source: “Worldwide IT
Spending 2003-2008.” IDC, #31544, 2004.)
SPSS is committed to continuing to provide healthcare
organizations with the powerful yet flexible predictive
analytics solutions they need in order to carry out their
vitally important missions.
For more information on SPSS solutions for healthcare, visit
www.spss.com/healthcare or call your local SPSS office.
To learn more, please visit www.spss.com.
For SPSS office locations and telephone
numbers, go to www.spss.com/worldwide.
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products named are trademarks of SPSS Inc. All other
names are trademarks of their respective owners.
© 2006 SPSS Inc. All rights reserved. HCIB-0106