Payers, providers and vendors harness data for better health

BOSTON—The strategy to utilize data to improve health and lower costs is shared by members of the provider, vendor and payer communities, according to speakers at the mHealth + Telehealth World Congress 2013 on July 26.

At Adventist Healthcare, an integrated, healthcare delivery organization based in Gaithersburg, Md., a medical home pilot program that used analytics to curb unneeded prescription drug spending and readmissions in the highest cost employees saved the system $1.2 million, according to Arumani Manisundaram, director, center for connected health at the organization.

The program targeted 6.3 percent of all patients—a total of 121 individuals—who accounted for 60 percent of costs. This subgroup saw at least 15 different providers and nine prescribing physicians.

In the pilot, personal health nurses were assigned to these high risk patients’ primary care physicians, and were responsible for: dietary counseling; appointment assistance; exercise plans; pharmacy assessment; and appointments for baseline screening. It cost each physician $250 per month per member for this service.

“They encouraged people to make healthy changes,” noting that they could receive insurance discounts if they maintained a healthy weight or did not smoke.

Of those high-risk patients who participated in the program, 48 percent shifted to the moderate risk level by the end of the pilot. Many stopped taking medications that the pharmacy review identified as unneeded. “It would not be possible without the analytics framework we had in place,” said Manisundaram.

Meanwhile, on the payer’s side, Dan Conroy, head of business development, Carepass Platform, Aetna, discussed its development of a portal that captures personal health data from a variety of apps—including those focused on diet, sleep, exercise and health management.

Using these data, the platform allows users to create goals, such as running the equivalent of the distance between New York City to Boston, adhering to medication or smoking cessation.

“It’s really discovering apps that can help you get to a healthier version of you,” said Conroy. The platform is a benefit of Aetna members, although available to all consumers.

From the vendor perspective, Vishal Dubey, vice president, technology delivery at Dacadoo Americas, discussed the Dacadoo platform, which focuses on disease preventions and provides a health score of 1-1,000 to individuals based on three domains: the body, feeling and activities.

The score reflects data obtained from tracker apps, with automatic data logging happening in real-time on fitness, sleep and other activities. “It’s not only about the volume of data, but the speed and variety of data.”

Like the Carepass Platform, Dacadoo uses the principles of gaming, psychology and analytics to motivate users.  

Although the score is not a diagnostic tool, “it’s a simple message to react to and compare against,” he said.

Dacadoo is sold to insurance companies and employees, and they can receive de-identified aggregated data reports on their employees’ health. However, the user ultimately controls the data on an individual level, he said.