Data drives decisions. The quality of the data you use — and how you use it — determines the success of those decisions.
But what makes some data more valuable than others? In life sciences, the value is in how well the data can help you identify, understand and address the priorities of patients and providers, as well as regulators and payers. It also means having the ability to ask — and answer — the right questions.
With the right data and proper analysis, you can gain competitive advantage and improve market agility. But make a misstep, and the repercussions can be costly and far-reaching. This is particularly the case now, given the shift in the health care payment paradigm from fee-for-service to value-based reimbursement.
The ultimate data duo: claims and EHR data
Claims data has been the standard-bearer of information as it relates to the patient care journey. The medical and pharmacy details found in claims data, including enrollment dates, plan specifics and cost information, are critical to analyzing resource utilization and associated costs across the entire health care continuum.
But while claims data can tell us what happened and how much it cost, it misses an important piece of the puzzle: the why. Why was the patient seen? Why did the doctor prescribe one treatment over another? Why did the patient stop taking their medication?
When you can answer these questions, you can better understand the motivation behind stakeholder decisions throughout the health care timeline. But those answers can’t be found in claim forms because they come from one-on-one provider/patient interactions. It is electronic health records (EHR) that offer this more detailed view of the clinical profile of patients through both structured data (vital signs) and unstructured data (provider notes).
Integrated data and the pay-for-value paradigm
The transition from pay-for-volume to pay-for-value is aligning financial incentives and rewards for all stakeholders. When the right patient gets the right treatment at the right time, patients get the best, most cost-effective care and payers, providers and life sciences companies all win.
Achieving success in this new paradigm is easier when you understand how and where your medication is providing the most benefits, and which performance metrics are going to best reflect your impact on the patient population. Integrated claims and EHR data provide this insight, and put you in a better position to develop and market products that can define the marketplace and drive real clinical change.
Learn how the breadth and scale of Optum® integrated data help you drive decision-making. Download our eBook, “Data and the new era of visibility: Using data to drive decisions in life sciences.”
About the author:
President, Optum Life Sciences
Curt has spent the last six years in various leadership roles at Optum and has more than 20 years of pharmaceutical industry and consulting experience, including positions with Merck and Deloitte Consulting. He holds an MBA from Harvard Business School, and a BS in chemical engineering from the Massachusetts Institute of Technology (MIT).