To accelerate progress, the Centers for Medicare & Medicaid Services (CMS) last month announced that it would provide innovators and entrepreneurs access to CMS data, such as Medicare claims, in order to conduct approved research focused on improving care and developing tools that benefit consumers. CMS also said it would make data available to researchers more frequently—on a quarterly basis—rather than annually.
“[A]s the delivery system transforms from rewarding volume to value, data will play a key role. We hope that this new policy will lead to additional innovation and insights from the CMS data,” said Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics.
In a recent Harvard Business Review article, Mayo Clinic professors Nilay D. Shah, PhD, and Jyotishman Pathak, PhD, suggest “key elements that are crucial for healthcare to truly capture the value of big data.” These include integrating different data sources, such as early work being pursued through collaborations like the National Patient-Centered Research Network (PCORnet) and the research collaborative, Optum Labs. Other elements include generating new insights about patients using new methods of analysis, as well as engaging physicians, patients, and policymakers to translate knowledge into practice.
An example of how big data can be leveraged in large-scale quality improvement efforts is a study published last month in the Annals of Internal Medicine focused on repeat emergency department (ED) visits in six states. According to the Associated Press, these states were among the first to link patient records across hospitals, enabling them to track patients getting care from multiple institutions. Looking at ED data from 2006 to 2010, the researchers found that people revisited an emergency room about twice as frequently as previously reported, with 1.5 million revisits, or one-third of all revisits in the study, being made by the same patient to different institutions.
The Annals researchers suggest specific areas for potential interventions to improve care, such as improving communication infrastructure between institutions, encouraging ED physicians and administrators to “develop and keep updated state or national benchmarks for revisit rates,” or developing interventions to address “specific conditions with high revisit rates or costs.”
In an accompanying editorial, Kumar Dharmarajan, MD, MBA, and Harlan M. Krumholz, MD, MS, of the Yale School of Medicine write that studies are needed to understand more about patients who have revisits, and that “the frequency at which ED visits occur suggests that revisit measures might serve as the foundation for future performance measures.”
The intensified focus to make big data analytics that drive improvement a sustainable nationwide reality has resonated through a host of NQF’s ongoing efforts, including a recently issued draft white paper, “Data for Systematic Improvement,” that outlines strategies to make healthcare data more useable and transparent. The final paper will be distributed on July 31.