December 6, 2022


The Goal for Healthcare Data Needs to Move Beyond Quality to Usability

By Minal Patel, MD, Founder and CEO, Abacus Insights

I’ve been chasing high-quality healthcare data my entire career. As a physician, a senior payer executive, and now as a health tech entrepreneur, I understand the major obstacles that health plans, providers, and patients face when it comes to accessing reliable data. Like so many others in healthcare, I also believe complete and accurate data is the key to unlocking major gains in equity, affordability, outcomes, and experiences.

But I now know that the focus on high-quality data doesn’t go far enough.

The value of high-quality data is in its usability.

Here’s what I mean: We are making progress on creating oceans of validated data, but that is only part of the formula for healthcare transformation. While consolidating and cleaning billions and billions of clinical, pharmacy, claims, social determinants, and other healthcare data are absolutely necessary, these data remain trapped in massive pools unless we do something more to them.

That something is funneling those oceans of data into useful streams of information, tailored for a wide variety of purposes including analytics and operations. Usable data empower payers, providers, and most importantly, patients to make choices that lead to healthier lives and better health outcomes, faster and more affordably.

Defining data usability

Healthcare data that are fully and immediately usable have 6 dimensions, beginning with the first two elements that make it high quality.

  1. Complete. Collecting, validating, normalizing, and integrating both structured and unstructured data from a multitude of siloed, disconnected sources presented in a variety of formats enables a 360-degree view. It requires tracking and constantly adding inputs from current sources—such as new doctor visits, changes in medications, or prior authorizations—as well as expanding into new categories, such as information related to behavioral health, telehealth, and social determinants.
  2. Accurate. Once data are consolidated and standardized, it’s critical to root out redundancies and errors. Accuracy depends on regular updates that capture the constant changes in claims, patient records, and more.
  3. Timely. No matter how complete and accurate, data that are six months old do little to help at points of need, whether that’s for patient care, making business decisions, or developing mandated reports. Up-to-date data is critical to usability.
  4. Application and Use-Case Agnostic. Most often, data is tied to a specific application, such as analytics, or narrow use, such as enabling data interoperability between payers and third parties for Medicare and Medicaid patients. Usable data can be tailored to serve any and all purposes, so it works with every application, system and business need. Data that are application and use-case agnostic provide a new level of control and freedom, delivering maximum flexibility and efficacy for both analytics and operational uses. This type of data also facilitates innovation, such as enabling testing of new member engagement strategies and care models.
  5. Relevant. Data that are germane to various healthcare needs and data that are extraneous to those needs are mixed together in various domains and source systems. It’s critical to identify and separate out the necessary data and jettison the clutter. Context matters!
  6. Versatile. Drawing from the relevant data, the next step is to extract, bundle and deliver just the right data for a specific use case, such as risk adjustment or member engagement. Data also need to be packaged in a suitable format for immediate use regardless of the application that is delivering the value.

Setting our sights on data usability gets us to better and faster analysis and decision-making, more efficient and effective business operations, innovation, decreased waste and improved compliance – each the catalyst of greater access, equity, outcomes, and affordability. Usable data are the fuel for accelerating and scaling population health management, value-based payments, and other meaningful breakthroughs. The shift in focus beyond quality to usability is the game-changing difference in reaching these goals.