Abacus Insights, Leader in Health Plan Data Solutions, Raises $28 Million Series C Financing

Nov 30, 2021

Blog

Developing a Resilient Data Management Strategy in a Shifting Market

By: Minal Patel, CEO of Abacus Insights

Over the past 15 years, the healthcare industry has experienced a data explosion of voluminous proportions. Of all the world’s data, across every industry, over 30% is generated by the healthcare industry. In the next few years, that figure is estimated to grow at a rate exponentially higher than any other industry. This proliferation of data is happening concurrently with dynamic shifts in the healthcare system — a boom in remote monitoring technologies, the growth of data-driven alternative payment models, a flurry of new interoperability regulations, and the emergence of third-party digital health apps and devices, to name a few — all of which place unique pressures on healthcare organizations’ data modernization initiatives.

These seismic shifts occurring in healthcare have two things in common: First, they are focused on enhancing the patient experience and improving health outcomes. Second, strategic data management is key to their success.

I had the opportunity recently to discuss all of this with my colleagues Mudit Maheshwari, SVP of Data Strategy and Analytics at Magellan Rx Management, and Dr. Mark Friedberg, SVP of Performance Measurement and Improvement Blue Cross Blue Shield of Massachusetts. During our AHIP panel discussion on “Data Modernization in the Age of Digital Transformation,” moderated by Healthcare Dive reporter Rebecca Pifer, we discussed how to solidify a robust data management strategy. Mudit kicked off the conversation by breaking down data management into four pillars, and we discussed:

  1. Data centralization. With healthcare organizations ingesting vast amounts of varied data, it is increasingly critical to have a thoughtful strategy for bringing it all together without duplicating efforts.
  2. Data curation. The purpose of data management in healthcare is to create a single source of truth for each patient. But this is not enough. Once a single source of truth is achieved, healthcare organizations must continue to curate and enrich this data.
  3. Data utilization. This is where flexibility becomes key. Healthcare organizations need to ensure multi-stakeholder data utility. This becomes complicated as stakeholder needs and revenue models shift — sometimes in what seems like the blink of an eye.
  4. Data community. Important and often overlooked is the need to form a trusted and open community of varied stakeholders — “data masterminds,” as Mudit puts it — to ensure your organization’s data platform is continually meeting the needs of its users. Without this pillar, it is exceedingly difficult to ensure your organization is on the right path toward digital transformation.

There’s an important caveat to note here: every one of these pillars is impacted by the fact that healthcare data is ever-changing. We do not know today what the demand for data will be in the near future. Two years ago, for example, nobody in healthcare could have predicted that COVID-19 lab testing would be such an integral part of how we think about everything — from data consumption to data utilization. Moving forward, healthcare organizations need to ensure their data management strategies are not only scalable, but flexible. Otherwise, the work we’re doing today may be obsolete tomorrow.

The key to doing this successfully will be the transformative interoperability regulations already implemented, and those coming down the pike. For Abacus Insights, the interoperability mandate has been another use case for our data management platform, which, at its core, incorporates much of the basic structure needed to comply with the regulation. This allows our partners to not only begin innovating, but to start developing a comprehensive strategy for what comes next — namely, education around consent and preparation for payer-to-payer data exchange.

As Mark mentioned during the discussion, the interoperability mandates have energized the industry. There is a lot of optimism and excitement for the future of healthcare data. But we also need to move forward carefully, keeping patient safety top of mind. There is a serious need for healthcare plans to begin proactively educating members on consent. When a member agrees to share their sensitive information with a third party, they must be aware of the risks; substance abuse data, when in the hands of nefarious actors, could result in ads that put a member’s health in jeopardy. A situation like this, while hypothetical, is not out of the realm of possibility, and could have a detrimental impact on patient outcomes and cost of care.

It is conversations like these — in-depth and open discussions with health IT leaders like Mudit and Mark — that give me hope for the future of healthcare, and faith that Abacus Insights is on the right path. At the end of the day, doing data transformation for the sake of doing data transformation never ends well. As we advise all of our partners, a productive and successful data management strategy begins with prioritizing business needs. Know the problem you’re solving for your members, understand that this is a long-term endeavor, and surround yourself with partners that understand your needs and can help you navigate your roadmap to results.