Maximizing the power of integrated data with the MedInsight Data Science Portal

Southeastern Health Partners (SEHP) – a clinically integrated network consisting of four healthcare systems, including 13 hospitals and 3,600 providers – sets its continuous improvement goals high.

The Greenville, South Carolina-based organization is already recognized by the Centers for Medicare & Medicaid Services for consistently ranking among the most efficient Accountable Care Organizations.

Even so, SEHP was looking to do more, especially in the areas of chronic disease management and post-acute care.

SEHP IT consultant, Dino Capone, was tasked with updating the organization’s data landscape into a single infrastructure that would allow its partners to bring diverse data feeds together and create custom inquiries, without the need for IT support.

Then he learned about the MedInsight Data Science Portal – a platform that streamlines data integration, aggregation, and modeling for predictive modeling and powerful evidence-based decision making.

“It fit exactly what I was looking for,” Capone said.

Challenge: A platform that serves all partners equally

SEHP had relied on a data infrastructure that had been extensively customized for the network’s largest member system, without taking into consideration the needs of partners whose technological infrastructure and level of available personnel were at a different level.

The organization sought a platform that would serve all the partners equally while also being able to pull network data into one place and “have it match up and work together,” Capone said.

SEHP CEO Keith Newnam wanted to provide data to their providers faster, at the point of care, to enable them to quickly recognize and address care gaps. Most importantly, he sought to leverage the full potential of a growing body of data to gain deeper insights into the drivers of healthcare gains and losses.

Action: Data Science Portal as a comprehensive solution to gain quality insights from data sets

The goal was a solution that would minimize the work of creating data sets to shorten the distance between high-quality analytics and proactive solutions for improving utilization and quality of care across the CIN.

As part of a collaborative approach to finding the best solution, the MedInsight client services team listened carefully as the SEHP team described the goals for the project as well as the gaps and challenges of the current system. The MedInsight Data Science Portal was identified as the right choice for reaching SEHP’s objectives.

Results: Reporting that is in the hands of providers quickly

Today, while the DSP implementation is less than a year old, it has already begun to improve the organization’s ability to get data into the hands of its providers quickly, including the ability to see member enrollment data in their Epic dashboards months before the details of a new contract had been finalized.

“We can use these tools to drill through and provide a list of very specific members that need additional services that are not being provided. What can we do to make their lives better and also bring utilization down? That’s where I see an opportunity.”

SEHP IT Consultant Dino Capone

Having the information at the point of care ensures that opportunities to intervene and address care gaps do not go overlooked, Capone said. “Having that information lets them know what kind of a plan (members) are on, what the different annual wellness visits look like. It lets us tell them who is missing annual wellness visits so we can provide that information and inject it into their process,” Capone said.

MedInsight DSP allows the organization to create specific queries and dashboards to organize and drill down into the data, making it easier to understand. Integrating MedInsight benchmarks and additional data sets from national databases provides a window into where they are meeting their goals and where they are falling short. The result is improved visibility into opportunities to close care gaps and increasingly ambitious goals that include tapping into the portal’s AI capabilities.

“I want to look at risk and look at risk models that tell me about rising risk, declining risk, chronic risk,” Capone said. “The top 10% of utilization – there is not much you can do; they are going to be in the hospital three to four times a year, every year and you cannot stop it, but that next tier? People are moving in and out of that next tier. If you can identify ahead of time the ones that are going to move from that tier, into the top tier, that is when you have an opportunity to make a difference and intervene.”

The level of drill-through that DSP enables is the “cool part,” Capone said. “We can use these tools to drill through and provide a list of very specific members that need additional services that are not being provided. What can we do to make their lives better and also bring utilization down? That is where I see an opportunity, and an opportunity that you can tie dollars to.”

DSP already enabled the network to quickly deliver data to dashboards, including Epic, where providers can see member data months before it would have been available otherwise.

“We have come a long way in a very short period of time. Having a resource that you don’t have to manage at the systems level but can do all these higher end things with is phenomenal.”

SEHP IT Consultant Dino Capone

The platform significantly improved the organization’s ability to accurately attribute member data: “What happened in September based on claims data is only a fraction of what actually happened in September, and yet the payers are providing us with what happened in September now,” he said. “DSP allows us to combine that data with MedInsight and identify a member across all providers and say this is what is going on with them. We are able to be much more proactive.”

At the same time, he said, DSP is more efficient than using business intelligence (BI) to create data sets. Using DSP, he said, is faster, more efficient, uses fewer objects, and creates less room for error.

Capone says the platform has the potential for continuing innovation as the integration of EMR and claims data creates opportunities for increasingly targeted queries that will drive improvements in care coordination.

“We have come a long way in a very short period of time,” he said. “Having a resource that you don’t have to manage at the systems level but can do all these higher end things with is phenomenal.”

About Southeastern Health Partners

Southeastern Health Partners is a clinically integrated network (CIN) formed as a joint venture between AnMed Health, Bon Secours St. Francis, Self Regional Healthcare and Spartanburg Regional Healthcare System to provide a high-performing, high-quality, high-value organization capable of managing the healthcare needs of diverse populations in the Upstate.

Learn more: southeasternhealthpartners.org

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