Optimizing healthcare value with prescriptive analytics – Part 2

Moving from “what if” to “what’s best”

In my previous blog on this topic, I discussed the need to shift analytics from monitoring and reporting of what has happened, to using analytics to make decisions. More specifically, to achieve continuous improvements in terms of quality of care, access to care and cost of care, our decisions need to be informed by data and directed by prescriptive analytics.

This blog shares a specific example of how prescriptive analytics was used to support decisions in community health program changes.

Using prescriptive analytics for decision making in healthcare

I like to think of using prescriptive analytics in two ways: 1) when we know the questions to be asked and, 2) when we don’t. For example:

1)     What is the impact of directing 911* non-emergent patients to alternative care services other than the emergency department?

We want to understand the impact of a planned change in one service on the other organizations in the continuum of care, given the interactions and constraints throughout the system.

2)     What is the best way to improve proactive care services?

We want to use analytics to determine the changes that should be made, and the impact of those changes.

Recently, the Puget Sound Regional Fire Authority (PSFD) (formerly Kent RFA), CGI and River Logic collaborated on a prescriptive analytics project to understand the impact and value of FD CARES, an innovative non-emergent services (NEMS) approach to community health management. FD CARES is dedicated to transforming fire department healthcare services by providing care coordination and in-home clinical services to stabilize patients at home or direct 911 callers to the most appropriate care.

To evaluate the benefits of these services and identify future improvements in delivery effectiveness, the project team built an “intelligent model” of an episode of care. Using prescriptive analytics, we then evaluated the impact of different changes to patient care pathways through FD CARES’ services and its provider, payer and transportation partners.

The value of FD CARES’ innovative NEMS approach to community health management was measured in terms of potential savings to PSFD, savings to the health system partners as a whole, and care utilization.

For the questions we knew to ask, the analysis identified the current and future benefits of:

• Reduced costs to PSFD by up to $600,000 annually
• Reduced health system costs by up to $1 million annually
• Improved health services utilization by reducing emergency department visits by up to 200 visits annually and associated diagnostic tests

The project also prescribed the changes to make to achieve future benefits, answering specific questions we didn’t know to ask, for example, the optimum volume at which additional proactive care visits can add financial benefit and improve health services utilization.

I invite you to read our case study to learn more about our project methods and results.

*911 is the emergency telephone number for the North American Numbering Plan used by Canada and the U.S.