Advancing healthcare informatics: The power of partnerships

Health insurers, assuming the role of data aggregator and leveraging their technology and analytics capabilities, offer significant value to all health care stakeholders. Early experiments in the formation of Accountable Care Organizations, as well as the mobilization of Health Insurance Exchanges, offer a window into how even adversaries can team up to produce better results for patients and the bottom line. Based on the Health Research Institute’s in-depth spring 2012 informatics report, Advancing healthcare informatics provides more insight into the opportunities for the health insurance industry.

Advancing healthcare informatics: The power of partnerships

Today insurance companies and providers alike hold a treasure trove of data, but the real power comes when the two are merged and “data” makes the magical leap to highly valuable “information.” A handful of innovators have begun this transition, pulling together disparate sources of data. These early experiments offer a window into how even adversaries can team up to produce better results for patients and the bottom line.


Health insurers in the role of data aggregator can learn even more about their members by looking into other available health data sources. Opportunities to review untapped data sources rich with consumer information exist in each of these groups.

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Public & Community Health

With the move to community rating, insurers need to understand the medical trends that are occurring within the broader population and how their member population compares. This provides another avenue to quickly identify emerging trends, evaluate against their member population, and implement relevant care management programs.

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Insurers can bridge gaps in care using medical claims, health assessments and wellness programs paired with information residing in EMRs. This provides an opportunity to address gaps in care plans, enhance quality and outcomes of care, and reduces unnecessary Emergency Department hospital visits.

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Social Media

Access to social media data will provide insurers with information. Insurers that leverage social media to engage and solicit feedback may see an increase in member engagement, brand awareness, and opportunity to provide and collect more insights on health matters.

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Pharma / Life Sciences

The pharmaceutical and device industry has a wealth of information that can also complement patient health records. The combination of medical claims, prescriptions, history, and lab results, not only strengthens clinical research studies, but also the ability to identify new ways to improve health.

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Data collected from worksite wellness programs designed for employees can further complement wellness initiatives, resulting in additional cost savings and improved health outcomes. Using employee data collected by employer’s can reveal more information about employee behavior to develop a more complete profile for the payer.

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Pulling all this data together into a single patient profile allows the physician and patient to make better treatment decisions together. The consumer experience becomes personalized, health outcomes are improved and costs decrease.

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feel integrating data is a top technical goal for informatics in next two years

Source: PwC’s HRI report, Needles in a haystack: Seeking knowledge with clinical informatics