Predictive analytics in healthcare helps manage high-risk patients

Predictive analytics in healthcare helps manage high-risk patients

Just because someone works in a hospital doesn't mean she knows how to navigate the healthcare maze, leverage it to take care of herself, or how to use a blood pressure cuff despite seeing one every day on the job.

Sometimes people forget that healthcare workers are patients too -- and that they also can benefit from predictive analytics in healthcare.

That's where Maiken Himmel comes in. As the employee nurse navigator for Baptist Health Floyd in New Albany, Indiana, she is essentially the case manager for Baptist's employees.

"I help them manage their health and wellness, provide a lot of personalized information, education, resources, utilization, and, bottom line, try to help them manage their health and save them money which, of course, saves the hospital money," she said.

Himmel is using Advanced Plan for Health's (APH) Poindexter risk engine for population health management, which includes data analytics and predictive analytics in healthcare, to help her do her job as nurse navigator; a job created by APH.

"We'll introduce nurse navigator programs where a nurse will start to directly engage the at-risk population within the health plan," Taylor Godbey, executive vice president and chief operating officer at APH, said. "The system itself is designed in a way that we can more efficiently get to actionable data so we can be proactive."

APH's technology is aimed at helping organizations which provide health plans to their workers identify where there is risk among their population.

Godbey said health plan expenditures are one of the biggest costs that any organization -- not just healthcare organizations -- has. "Having insight into what's driving cost is very important," he said.

Dealing with all that data The real win, the real value in this is that you're able to help the people [who] need it the most. Godbey explained the technology will find key indicators such as financial, cost, quality, and clinical driver indicators and pull them into one report. "The bottom line is you can't manage what you can't measure," Himmel said. "Everything that I'm able to measure helps me navigate, not only our employees, but their families as well through the healthcare maze." "If I need to get on there any time and want to see, as far as high cost payment, how are we doing from a per member per month standard … did things change from the utilization [for example]," she said. "All of those things I can see." APH allows Himmel to drill down into the data -- and saves her from having to move from report to report -- and manipulate the data so she can look at exactly what she needs to, whether that's in terms of insurance costs, looking at the diabetic population, who has been going to the ER and how frequently, whether there are any care gaps and more.

 

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