Healthcare is changing, and data is at the core of it

Healthcare is changing, and data is at the core of it: better patient care, more effective treatment, increasingly detailed data on individuals, stronger demographic requirements and eligibility criteria, mixing internal trials data with external research data, … The healthcare organizations that will come out ahead are those that have business drive data, because data will increasingly drive their business.

Healthcare payers are strongly affected by the recent regulatory overhaul (i.e., the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. The markets for health insurance (also known as the health exchanges) have opened up with a strong focus on providing regional, affordable healthcare plans for individuals. To remain competitive in the landscape healthcare payers must now embrace data to ensure differentiation in their plans and pricing: detailed knowledge on eligibility criteria (are you a smoker?, have you smoked in the past 3 years?, what industry are you working in?, …), and their effects on the plans, more additional data sources with a wide variety of accurate data on individuals, … Smart healthcare payers use the regulatory driver wisely, and build out a structured, process and business driven control over data to stay ahead in the changing marketplace. This ensures top-line growth.

Improve the bottom line

Control over data also improves the healthcare payer’s bottom line: more efficient claims processing, and more effective care means less money spent on handling claims. This pressure directly affects healthcare providers, as the healthcare payers are increasing scrutiny on any costs made for care (did we really need this lab test?, couldn’t we infer this condition from family/geography/industry/… information, is cheaper treatment accessible?, …). Again, data is at the core of this business transformation: by bringing together already existing data (financial, clinical, …) used in todays business processes, and by adding external data (classifications, research, …) smart healthcare providers can provide more effective clinical paths, improve patient care while simultaneously reducing cost.

Pharma meets data

The dynamics of the market do not end with the providers: pharmaceuticals also feel the importance of data on their business. The competitive pressure in the market, extremely tight regulation, the enormous (and risky) investments on new drug development, the need for better and cheaper care and the rise of generics force pharmaceuticals to think and execute differently. Data is an important factor: market intelligence, clinical trials and adverse events, classification and harmonization of internal and external various sources, early detection of research, … Business driven data already drives business for pharmaceuticals, both top line (e.g., time to market for new drugs) and bottom line (e.g.., more efficient trials, aligned business processes, …).

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