Shifting payment models based on quality and value are fueling the demand for insights into the health of populations. This demand requires the analysis of vast amounts of patient data. For example, before healthcare organizations can implement pre-emptive care programs, they must first identify the relative risk of their patient population. This is based on a variety of clinical, financial, and lifestyle factors, including:
- Problem list of patients, especially chronic conditions
- Procedures, medications and other hospital data
- Claims information
- Risk factors such as tobacco, alcohol and drug use
- Availability and accessibility of health services and social support.
As illustrated in Figure 1, a healthcare population typically includes a relatively small percentage of the highest-risk patients, though these least healthy patients usually account for the biggest percentage of overall healthcare costs.
Figure 1: Level of patient risk associated with population segments and
their cost implications; a relatively small segment of the population
accounts for a disproportionate percentage of healthcare costs