Automating Population Health Data Initiatives

Population Health success starts with data…

Population health (PH) has growing momentum across the healthcare industry. Hospitals, health systems and other healthcare provider organizations are putting data to work to improve patient care and lower expenses with a variety of data-driven initiatives. One of the primary considerations in developing PH programs is marshalling the array of information sources and the volume of data involved. Automation is a clinical, technical and financial ally in overcoming data challenges to develop robust PH initiatives that result in positive outcomes with lower costs.

Population Health…

PH is defined as “applying analytics to healthcare, patient data and larger groups of individuals to gain actionable knowledge, improve patient care and reduce costs”. Its success largely depends on the ongoing, accurate analysis and management of existing and new data. PH is a cornerstone of accountable care models and other payer / managed care arrangements in which fixed contract rates are developed for specific patient care (as opposed to fee-for-service arrangements) and coupling cost of care with quality of care to large, defined patient populations.

High care, cost and risk patient populations are afforded a greater level of strategic attention resulting in better and more affordable outcomes. Apart from accountable care models, providers and payers for some time have been stratifying patient types, diseases, treatment paths and associated financial / medical risk by drilling down and across the vast amounts of available data. They are both seeking to identify treatment patterns that lead to better outcomes in less time and with less cost.

PH initiatives begin with gathering and measuring demographic / clinical / financial information gleaned from a variety of sources including:

  • Academic / industry healthcare cost and care research
  • Actuarial care and cost figures / risk statistics
  • Government statistics, public health organization statistics
  • Hospital, health system, primary care records
  • Patient, consumer healthcare data (including patient-generated health data)
  • Payer / insurer cost and care figures
  • Pharmacy medication adherence and cost data

The data ramp up from start to finish in the development of PH initiatives is steep starting with basic patient data comprised of disease, age, sex, comorbidities and other variables. Based on insights derived from raw data, patient types, care protocols, costs and other information the initial profiles and risk scores are characterized. While some elements have shared attributes, each has its own context, value and impact. One miscalculation unbalances the accuracy of care / cost and anticipated outcomes.

These are applied individually or collectively to make accurate assumptions and decisions necessary to build effective PH programs. It’s an interlocking stream of information combining patient details, diagnosis codes, timelines, costs, care providers, locations, payers and other comparative statistics that are diced and sliced via algorithms and formulas to develop optimum protocols to achieve care, cost and risk goals. RPA is the resource to accurately, quickly, comprehensively complete the data exercises required in these processes.

Working with the information resources above, a PH development program evolves:

  • Locate, select, integrate, prepare data according to disease / patient type(s)
  • Analyze, validate, report care and cost trends of individual, group and broad populations
  • Define patient segments to focus on, locate gaps in care
  • Determine and rank risks, develop patient personas for programs to support
  • Develop treatment strategies, protocols, programs based on data, targeted patient types
  • Implement with appropriate patient populations, monitor care, cost and outcomes
  • Assess previous, present, ongoing performance; fine tune into the future

Program features, staffing needs and other requirements are roughly defined as well as goals and objectives. It widens in volume and complexity as care, cost and comparative data is intertwined to derive trends and ultimately actionable insights upon which to base effective, refined PH program development. The stream of data continues once programs are put in place as care, cost and outcomes performance measures are continuously monitored. Accuracy, speed and responsiveness is necessary in PH data management to align with structure, process and outcomes. RPA serves as a digitized workforce to support PH initiatives from inception through launch and ongoing program management. It economically and dependably manages the large scale, simple or complex data challenges involved along the way.

PH challenges resolved by RPA…

Cost

  • PH requires significant investment; costs are generated from medical, administrative, technical and other resources which also encompass discussions, development, implementation and ongoing management of programs. RPA completes even the most complicated data exercises in a fraction of the time it takes for accomplished teams of data professionals to complete. Automation drives data production workflows; staff time and associated costs devoted to manual data entry and other PH data management activities is minimized. PH programs progress quickly from inception to go-live without pauses required for staff / data catchup and other process delays that generate expense. Data fatigue, overtime, hiring of temporary staff and / or costly software and technical upgrades are avoided.

Consistency

  • PH relies on calculations to be uniformly applied hundreds, thousands, millions of times to select, compile, analyze and report data results. RPA directly adheres to the step-by-step processes laid out for it and does not skip or forget edits or entries. Results are systematically generated in expedited, exacting manner; inconsistent data workflow production is eliminated which saves on time, costs and speeds decision making. Clinicians, administrative staff and payers benefit from its reliability and have complete confidence in production, quality and presentation of data.

Complexity

  • RPA self-sufficiently navigates through simple or extended series of data manipulations involving dozens of steps and upon completion moves onto the next without human intervention. PH algorithms involving numerous individual measurements are rigorously run via RPA; reducing the need for large, diverse sets of data to be processed in stages. RPA follows the most intricate pathways; complex processes are completed in predictable streamlined fashion sooner than any manual data entry means could accomplish. More advanced PH initiatives can be developed based on better, richly informed data-driven decisions.

Flexibility

  • The variety of data categories, programs, systems and processes used in PH is wide. Each has its own characteristics, structure and processes that do not readily interface with others. Accounting for the numerous stakeholders involved in PH projects is important; the same set of data may need to be analyzed from several different perspectives. RPA is effective within and across patient, medical, financial applications in one or multiple locations; quickly and accurately processing data according to requirements of clinical, administrative or payer stakeholders. RPA enables economic, high speed interoperability within and between data sources and organizations.

Time

  • Time is an irreplaceable resource which contributes to cost and use of all resources utilized in PH initiatives. PH is built on historic, real-time and forecasted data; outcomes / trends are perpetually refined based on results, new data and changes in healthcare treatment standards, costs or other variables. RPA operates at a digital processing pace 24/7 regardless of peaks and troughs of activity. From inception, development, to go live and ongoing production; RPA shrinks timeframes while enabling adjustments / tweaks to data for immediate insights without delays. Providers and payers are on top of outcomes and readily refresh, sharpen results when new data insight opportunities arise.

Accuracy

  • The effectiveness and ROI of PH initiatives is based on accuracy from start to finish. Analytics, insights, decisions and PH program development all pivot on exact management and measurement of data. Even slight variations in data integrity or interpretation can erase clinical and financial gains for medical professionals, provider organizations and payers. RPA fortifies PH initiatives with precise data. When errors or exceptions in data are triggered, RPA channels them into a report for review / remediation while clean data is accurately and continuously processed without delay. Exceptions receive focused attention and rerun via RPA for quick, comprehensive and precise results. Data workflows and results are seamlessly completed.

5 RPA technology applications in PH initiatives…

Data Extraction

  • RPA can expediently locate, identify, extract and organize large volumes of precise details involving open or discrete data from single or numerous sources and distribute it as required by stakeholders as they need it in development, implementation or maintenance of PH programs. Data exercises requiring pushing / pulling data are readily completed via RPA without ongoing human monitoring / manual data manipulation.

    • On the provider side, data retrieved from legacy systems, archives, present EHR systems or other sources (custom, proprietary databases, etc.) for comprehensive PH insights
    • Payer, actuarial, research, government and other healthcare data taken from vast data repositories is mined, combined, refined

Risk Management

  • Risk management clinical and financial algorithms can be especially complex and lengthy. One error as a result of an incorrect keystroke or missed step can lead to misinformation and care / cost issues. RPA systematically manipulates and processes even the most advanced risk management formulas with uniform accuracy and expedited speed. Care and cost elements are soundly measured to minimize risk and maximize outcomes for PH programs.

    • From a high level; RPA can be applied to multiple data elements in risk scoring required to calculate whether to accept, control, transfer or treat it
    • At a granular level; using RPA to develop, operate, monitor and improve data relative to clinical / financial performance measurement based on seemingly insignificant changes in outcomes

Reporting

  • PH always entails monitoring ongoing results. RPA’s technical attributes enable users to develop reporting assets which are quick, accurate and encompassing. Its exacting ability to execute high volume, simple or complex data selection and compiling of multiple data factors and / or sources empowers it to readily produce uniform results for standard or ad hoc reporting purposes. Actionable data is readily available for use by clinical, administrative, payer and other stakeholders.

    • RPA has great utility in auto-generating routine large or small scale compilations of data pre-formatted and ready to produce with or without manual prompting
    • In ad hoc reporting situations, RPA is applied to accurately and quickly avoid time consuming inquiries which may require one or many staff members to manually process data

Integration

  • There are numerous steps involved in accessing, selecting, compiling and analyzing data from multiple databases, files, applications and systems. Further alignment of analytics and processes is an arduous task if done manually and a high pressure burden if changes are required on short notice. During PH program development, frequent adjustments are made to assess, justify, build and launch initiatives. As programs are underway, new data from other sources can be introduced into the PH data equations and / or existing data reallocated in a different direction. RPA systematically executes data integration so data is kept on the move for easy access, analytics and reporting.

    • RPA is used to collect, combine, deliver data on singular or group patients from distinct categories / types of information such as demographics, EHR, imaging / test / lab results, procedures, CPT / ICD codes, coverage / payer information or distribute the details into standard or custom measurement platforms for further analytics
    • Being application / system agnostic, RPA’s flexible technical attributes enable it to work in Citrix, .Net, Access, Excel, SAP, Unix, Windows, discrete / open field data, PDF, API, EHI, PACS, RIS, CIS, DICOM, HL7, Cloud, Web, medical devices, PC, midrange, mainframe environments

Communications

  • The internal and external communications of PH are integral to its success. Internal stakeholders include leadership and strategic staff members of PH initiatives; external stakeholders are comprised of partners / vendors involved with PH and of course, patients. Automating numerous elements of PH communications optimally supports patient care, improves collaboration and prevents information gaps.

    • Communications managed by RPA can be digital / text or print communications issued to patients for individual PH concerns, care updates, wellness events, appointment reminders and other needs
    • Advanced communications automate alerts to staff, payers when certain codes or combinations of codes in data require immediate attention, additional monitoring or other clinical / financial issues

Moving forward…

Successful PH programs are inherently data dependent. RPA is a clinical, financial and technical ally for patient, medical, administrative, provider organization and payer stakeholders:

  • Excellent user satisfaction; medical, administrative, technical and other staff can focus on strategic matters so organizational productivity increases while data burden decreases
  • Cost effective; functioning as a digitized workforce operating at peak performance 24/7 regardless of staffing levels or workload and does not require expensive technical upgrades
  • Technically accommodating; empowers users to maximize the array of valuable data used in population health initiatives encompassing patient, provider, payer and other applications / sources
  • Precisely efficient; extraction, compiling, calculation, reporting, integration, sharing and other actions are fully executed through completion of process
  • Uncompromising accuracy; exact data pathways are rigorously followed; deviations found in manual, human-driven processes are eliminated and validation concerns erased
  • Millisecond speed; simple or complex multi-step processes within and across high volumes of data are completed in fractions of the time required by human manual data manipulation

RPA is the pivotal resource to transform PH data from a costly, intimidating burden to a valuable, engaging asset. Patients, providers, payers and other stakeholders are empowered to benefit from impactful and economic PH initiatives to advance higher levels of patient care at lower cost.