Although healthcare payors have been crunching data for years to figure out risks associated with patients, other healthcare sectors are now following suit because of pressure to do more with less.
Here is a glimpse of how commercial payors, pharmacy benefit managers and healthcare companies are using data to improve patient outcomes:
• WellPoint, a commercial payor in Indianapolis, uses an IBM supercomputer called Watson to suggest treatment options for physicians based on medical records, research databases and other sources;
• Heritage Provider Network, a physicians group in Northridge, Calif., is sponsoring a competition for the best algorithm to identify which patients are likely to be sent to the hospital within a year;
• Memorial Sloan-Kettering Cancer Center in New York City is working with IBM to build a tool for cancer treatment drawing on patient histories, clinical knowledge and molecular and genomic data;
• Health Management Associates, a hospital operator based in Naples, Fla., is working with technology partners to predict admissions by looking at patterns in patient and operational data and ranking the likelihoods of admissions associated with various factors;
• Express Scripts, a pharmacy benefit manager, plans to launch a program that will study data to identify and intervene with patients less likely to take prescriptions correctly. The program will begin with medicine for high blood pressure, asthma and osteoporosis.
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