How technology is changing the health care delivery system for the better

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Technology is improving the way patients receive health care, providing better outcomes, lowering costs and creating a better patient experience.

“The use of technology in health care has a lot of untapped potential, and advanced analytics and artificial intelligence are reinventing how health care is delivered,” says Ian Blunt, vice president of Advanced Analytics for Highmark Blue Cross Blue Shield. “The health care experience is becoming more integrated, coordinating the parts of the system to work together and easing the burden of patients having to chase services.”

Smart Business spoke with Blunt about how technology is helping patients proactively address their health care needs.

How are technology and advanced analytics improving the delivery of health care?

Technology is transforming health care, helping to develop new approaches, innovate and provide a simplified experience for patients. Predictive models, developed using data from aggregated past patient experiences, can identify those who could benefit from care management. That information also allows the health care system to understand what interventions are needed to mitigate the risk of chronic illnesses and ensure that patients get the most appropriate treatment and the right level of support at the right time.

Analytics looks at historical patterns of similar patients with similar experiences, using that data to predict future outcomes for current patients. Looking at the treatment associated with past successful outcomes creates the opportunity for intervention up to three months earlier than with patients being treated without access to this data. And that helps improve outcomes, reduce costs and, in some cases, prevent a condition from advancing.

How can data analytics help reduce costs for patients?

For example, with a heart attack, intervention begins the minute a member enters the emergency room. The hospital delivers care and stabilizes the patient, and the insurance company starts to think about case management to ensure the best course of treatment.

The case manager will create a discharge plan for a smooth transition back home and work with the patient to make sure after-care instructions are being followed, reducing the risk of rehospitalization. That person will make sure the hospital and the primary care physician are well coordinated and that all care needs are being met.

Technology allows the insurance provider to base recommended care on what it knows works, using real-world data in real time. That allows it to understand what in its care management programs is working, and which areas need to be revisited to improve outcomes. Analytics don’t just trigger intervention, they help understand how effective that intervention is, allowing predictions of future outcomes to evolve as more data becomes available. Advanced technology and data help the right member receive the right care at the right time, which improves outcomes and reduces costs.

Highmark has found that members who actively engage with us after leaving the hospital help ensure the best outcomes and save up to $721 per month in health care costs versus those who don’t.

How do members benefit as technology continues to play a bigger role?

Technology is helping the health care system become more integrated, run more smoothly and provide better outcomes, lower costs and a better experience. There is a long way to go, but technology is helping us get there.

Advanced analytics and artificial intelligence have huge potential to improve health care. Bringing technology to bear will provide for a simplified, more proactive, personal experience, in which patients have to supply less information and do less chasing of services. Technology is helping achieve better outcomes and allowing the industry to remove obstacles to receiving the right treatment at the right time.

Employers should engage employees and help them understand the services available through their insurance coverage, giving them confidence in the support that exists. Encourage them to take an active role in their health care and take advantage of the services their insurance coverage offers. ●

INSIGHTS Health Care is brought to you by Highmark Blue Cross Blue Shield.

Ian Blunt

Vice president of Advanced Analytics
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