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Health Analytics: Gaining the Insights to Transform Health Care



Health Analytics: Gaining the Insights to Transform Health Care

Jason Burke

ISBN: 978-1-118-38304-9 July 2013 272 Pages


A hands-on, analytics road map for health industry leaders

The industry-wide transformation taking place across the health and life sciences ecosystem is mandating that organizations adopt new decision-making capabilities, based on science and real-world information. Analytics will be a required competency for the modern health enterprise; this book is about how to "cross the chasm." The ultimate analytics guide for the health industry leader, this essential book equips business leaders with little-to-no experience in analytics to understand how to incorporate analytics as a cornerstone of their 21st century competitive business strategy.

  • Paints the picture for a new health enterprise, one focused on the patient
  • Explores the financial components of this new operating model, using analytics to optimize the tradeoffs between cost and value
  • Deals with the rising role of the consumer, using analytics to create a completely new health engagement model with individual recipients of care
  • Looks at how analytics can drive innovations in care practice, patient-experienced medical outcomes, and analytically driven novel therapies optimized for the individual patient
  • Presents a variety of text, tables, and graphics illustrating the various concepts being described

Within each section and chapter, Health Analytics assesses the current landscape, proposing a new model/concept, sharing real-world stories of how the old and new world come together, and framing a "how-to" for the reader in terms of growing that particular set of capabilities in their own enterprises.

Foreword xi

Preface xv

Acknowledgements xix

Chapter 1 A Changing Business for a Changing Science 1

The Gathering 1

How Can Medicine Become Smarter? 3

Complexity Exceeding Cognition 4

Learning from Other Industries 6

Nancy 7

Characterizing Health Analytics 8

The Gathering Revisited 10

Chapter 2 Convergence and the Capability Map 11

Nice Job, But . . . 11

Fifty Flashlights 12

Convergence Defined 13

Is Convergence Really Required? 14

The Rush to Health It 17

The Capability Map 18

Putting the Capability Map to Use 21

Health Analytics as a Discipline 23

Notes 25

Chapter 3 The Four Enterprise Disciplines of Health Analytics 27

Heresy 27

Health Analytics for the Nonanalytical 29

Information Management 30

Statistics 36

Information Delivery 39

High-Performance Computing 41

Maturation and Scale 42

Enterprise-Class Analytics: Putting it All Together 44

Chapter 4 Dealing with Data 47

Callimachus 47

Not a Drop to Drink 48

Defining Data 48

Big Data 49

Growth in Data Provisioning 52

The Excuses Every Leader Needs to Know 54

Building for Tomorrow 58

Conclusion 60

Chapter 5 BEST Care, First Time, Every Time 63

By Dr. Graham Hughes Chief Medical Officer, SAS Center for Health Analytics and Insights

Medicine: Art, Science, or Both? 63

Leveraging Evidence to Deliver Improved Outcomes 66

What are Clinical Outcomes? 68

Supplementing the Unaided Human Mind 72

Health Care’s Dark Fiber 74

Identifying Hidden Patterns 75

Chapter 6 Financial Performance and Reimbursement 79

Goals 79

Structures and Models 80

Many Names, Common Attributes 83

What is Needed 86

Surviving and Thriving 91

Chapter 7 Health Outcomes Analysis 95

No Leeches Necessary 95

Orientation 96

The Big Seven þ One 97

Timing is Everything 98

Groupers 100

The Population-Patient Pivot 101

Patients Like this One 104

One Model, Many Beneficiaries 107

The Role of Rules Engines 109

Challenges in Health Outcomes Analytics 110

Health Outcomes Analytics in Practice 113

The Marvelous Leech 114

Note 115

Chapter 8 Health Value and Cost 117

An Asymmetrical Industry 117

Kaplan and Porter’s Stand 120

The Elusive Health Value 121

Dissecting Value 123

Linking Costs to Risk 132

Value Innovation 133

Note 134

Chapter 9 The New Behavioral Health 135

Dangerous Portals 135

The Health-Mindedness Gene Experiment 136

Engel’s Model 137

The New Evolving Science of Behavioral Health 138

What You Are 140

What You Experience 142

What You Do 143

What You Believe 145

Influencing Change 145

Putting Into Practice 146

Outcomes 148

Notes 149

Chapter 10 Customer Insights 151

The Consumerized Patient 151

Will the Real Customer Please Stand Up? 151

What Are Customer Analytics? 154

A Framework of Customer Analytics 155

Sharing Insights 161

Adherence 163

Beyond Commercial 165

Chapter 11 Risk Management 167

Risky Business 167

Why Are Risks So Hard? 168

Recharacterizing Risk Factors 169

The Example of Customer Segmentation 170

Risk Interdependencies 171

Everybody in the Pool 173

The Catch 175

Risk Adjustment 176

Borrowing from Other Industries 178

Growing Risks 179

Chapter 12 Quality and Safety 181

Defining Quality 181

Not Your Father’s Toyota 184

On Track 185

Avoiding the Obvious 187

We Just Have to Do This 188

The Growing Inventory 189

Strategy and Performance Management 191

Transparency and Benchmarking 192

Setting Quality Targets 195

Drug Safety 197

The Burden of Insight 198

Notes 199

Chapter 13 The New Research and Development 201

Returning to Alexandria 201

The End of Theory 202

Goals of a New Research Model 205

Characteristics of a New Research Paradigm 207

Target Improvement Areas 209

The Data Conundrum 216

The Big Four 219

One That Does What It Should 221

Notes 223

Chapter 14 Conclusions 225

Taking on Research 227

Five Phases of Value-Based Analytical Innovation 230

Phase 0: The Plan 232

Managing Capability Maturity 233

Wisdom and Health 237

About the Author 239

Index 241