Written by Ayla Ellison (Twitter | Google+)  | May 27, 2014, Becker’s Hospital Review


From population health management to identifying gaps in care, clinical analytics play a vital role in accountable care. Dave Caldwell, executive vice president at Campbell, Calif-based Certify Data Systems, a subsidiary of Humana, provides fourways clinical analytics can be used to help sustain a successful accountable care organization model.

1. Care coordination. Clinical analytics tools can improve care coordination in accountable care relationships by “translating disparate healthcare data into real-time actionable health intelligence,” says Mr. Caldwell. Analytics tools can offer care teams a true 360-degree view of an individual’s medical profile to enable informed decisions at the moment of influence. By using clinical analytics, physicians participating in ACOs can “have a more complete discussion with their patients at the point of care, improving the physician-patient relationship and care coordination across the healthcare ecosystem,” adds Mr. Caldwell.

“As more data sources are utilized for analysis, clinical corroboration/validation tools that filter out time decayed, irrelevant and non-corroborated data will become more critical in creating an accurate and comprehensive patient profile,” says Mr. Caldwell.

2. Population health. It is important ACOs’ clinical analytics engines have the ability to function in both real-time and in batch mode for population analysis. By using analytics, ACOs can run population reports “to detect compliance levels to specific quality measures and identify other areas of concern to improve health outcomes,” says Mr. Caldwell. In addition, prospective analyses can be utilized to notify ACO care teams of possible interventions to avoid future medical or financial risks, he adds.

3. Decrease costs and improve reimbursements. ACOs that utilize clinical analytics can offer care teams a more complete patient profile to avoid adverse drug events, close gaps in care and prevent unnecessary tests to reduce costs and improve the patient experience and clinical outcomes, says Mr. Caldwell. Additionally, analytics solutions can help ACOs improve the quality of care while ensuring compliance with care guidelines that ultimately lead to improved reimbursements, adds Mr. Caldwell.

4. Patient experience. Patient engagement strategies such as personalized messaging can be utilized to communicate care alerts to patients and care teams, says Mr. Caldwell. By “combining messaging capabilities with real-time analytic processing,” ACOs can ensure the correct information is delivered to the right individual or care team at the right time, he adds.


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