Big Data and Technical Advances Can Help Employers Reduce Health Insurance Costs

At a time when the annual price tag for health insurance is topping $10,000 per employee, cognitive health systems, telemedicine or telehealth and other medical advances are helping to lower costs.

The aim of cognitive health systems is to control costs with the use of health care data and analytics.

Cognitive health systems help doctors gain access to data for their patients. Patient-level data from health records and other sources is integrated to create a better picture of patient populations, risk factors and other red flags at the individual, group and population levels to improve patient outcomes.

Watson Imaging Clinical Review is one such cognitive data review tool. It helps create a more reliable patient record for accurate reporting and billing processes.

How Cognitive Data Tools Work 

The Watson cognitive data review tool improves the path from diagnosis to documentation, eliminating data leaks caused by incomplete or incorrect documentation. It supports accurate and timely clinical and administrative decision-making by:

  • Reading structured and unstructured data
  • Understanding data to extract meaningful information
  • Comparing clinical reports with the Electronic Medical Record (EMR) problem list and recorded diagnosis
  • Empowering users to input the correct information back into the EMR reports.

“Watson Imaging Clinical Review enables reconciliation of inconsistencies between clinical diagnoses and administrative records,” said Anne Le Grand, general manager and vice president of imaging at IBM Watson Health. “Those inconsistencies…can impact billing accuracy, quality metrics, and an organization’s bottom line.”

The initial release of this cognitive data review tool was focused on aortic stenosis, a condition that affects 1.5 million Americans and occurs when the aortic valve in the heart is narrowed. This impedes blood flow to the rest of the body and causes shortness of breath, tiredness, and chest pain. If a cardiologist’s report indicates a diagnosis of aortic stenosis, Watson Imaging Clinical Review helps propagate the diagnosis into the full electronic health record, including the patient’s problem list and recorded diagnosis.

“Aortic stenosis is only the beginning of the important journey to wide-ranging cognitive medical imaging innovation we are undertaking at Watson Health,” Le Grand said.

Telemedicine or Telehealth Continues to Progress

While it’s been around for nearly two decades, telemedicine or telehealth — technologies that deliver health care via telecommunications — is only now starting to make significant strides, improving care and lowering costs.

“It’s clear that effectively harnessing the full breadth and depth of telemedicine’s capabilities, in fact, can impact health care for millions of people, especially those in more remote communities and regions,” John Donohue, associate CIO of technology and infrastructure at Penn Medicine, wrote in an article for Healthcare IT News.

Studies by the Veterans Administration and CVS revealed that some recently implemented telehealth strategies increased patient satisfaction 86% and 90% respectively, according to a post by The Telehealth Report.

Perhaps some day the same kind of dramatic reduction in costs and improvements in speed and capabilities that we’ve seen in the computer industry will have a similar impact on health care. We can only hope as we watch developments like these take shape in the next few years.

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