Healthcare data analytics and insurance system reform

The U.S. healthcare system is on a journey – a journey to the future. When we get there, we need to be sure that environmental conditions are right; if they are not, the system — and possibly all of the system’s patients — will be at grave risk.

The uses of healthcare data analytics are often described as having three stages of maturity: descriptive analytics, predictive analytics and prescriptive analytics. Descriptive analytics encompass the clinical recordkeeping with which we are all familiar from implementations of electronic health record systems. All test results, encounters, admissions, procedures, care plans and more are documented, so that — at least within the four walls of a particular system — we have a reasonably accurate historical record which supports clinical care and operations. Predictive analytics require a large volume of descriptive data showing trends or outcomes in order to be able to predict — for example — how a particular patient would respond to a particular therapy. Prescriptive analytics, when they are more broadly ready for prime time in healthcare delivery systems, will generate clinical recommendations for individual patients (if X is found, then do Y); a subset of prescriptive analytics, precision medicine, where algorithms can recommend therapy based on a patient’s sequenced DNA and likely response to therapies, is already yielding positive results.