How healthcare organizations
can unlock value and insight from
the information they hold.
A PwC report in conjunction with
A Focus On Healthcare
Data is the lifeblood of the healthcare
economy. It is the driving force behind
the industry’s transformation and is
essential to achieving the triple aim of
improved patient experience, improved
population health, and reduced costs.
There is a clear need to unlock the value
tied up in information, and many
healthcare organizations are confident
they have the capability to do so. However,
our analysis shows that this confidence is
largely misplaced. Close scrutiny of the
150 interviews that we conducted with
senior leaders in the US healthcare
industry shows that very few healthcare
organizations are able to mine information
to its full potential, and fewer still can
realize the resulting benefits.
Our research also found that, in common
with most other sectors, the majority of
healthcare organizations are deficient in
the required skills, technical capabilities
and culture to truly gain the greatest
advantage from their information. This is
reflected in our first Information Value
Index for healthcare which scores 55.8
out of an ideal 100.
Despite the deficiencies, pockets of good
practice do exist. We have identified a
small group of healthcare organizations
that are the leaders in the field: the
‘information elite’. These organizations,
which make up just 7% of our sample,
have quickly worked out what it takes to
deliver value from the information they
hold. The rest of the healthcare industry
can learn from the elite by taking heed of
the good practice exhibited by these front
runners with regard to their information
governance; their culture of evidencebased
decision making; the way that they
balance managing information for both
risk and value and their understanding of
the need to employ and embed analysts,
using fit for purpose tools, across the
This paper outlines the findings of our
study and highlights a number of key
practical steps that healthcare
organizations should adopt if they want to
truly seize the information advantage.
The Information Conversation
The evolution from fee-for-service to payfor-
performance and the rise in digital
health have been two of the most important
disruptors to healthcare organizations of
all sizes. Many organizations have been
agile and innovative in their response and
the disruption, therefore, has been positive.
Many others, however, have not responded
so positively and risk being left behind.
During this period of disruption, the
amount of health related data being
generated has grown exponentially.
Whether it be information from electronic
patient records, health data from
wireless, wearable devices or new imaging technologies, providers and
payers are being swamped with data.
This growth has created risks and
opportunities that require significant
change in organizational culture,
governance, strategy and ways of working.
In the age of big data, the information
conversation has shifted. Where once the
key concern was information risk,
discussions now embrace the idea that
healthcare organizations must make the
most of their information to improve
patient outcomes, use resources more
effectively and gain competitive advantage.
The quest for the information advantage
is influencing strategic goals. There is now
a growing awareness in the healthcare
industry that failure to embrace the
changes required to manage information
for its value is no longer an option.
University Of Pittsburgh
Medical Center, Insurance
UPMC is an integrated payer/provider system with over 2.7 million covered lives in its insurance products, 21 hospitals,
and over 3,500 employed physicians. The payer/provider organization creates a perfect laboratory to learn with data.
UPMC Health Plan undertook an exploration of readmission using big data modeling techniques and developed a
conditional readmission model that produces a readmission risk prediction score that does not require any
information from the index admission and is produced each month on every member. That score is available to
the hospitals at the point of admission. Additional modeling uncovered optimal post-discharge clinical follow
times. In conjunction with the provider system, UPMC blended a publically available readmission model that
creates a readmission risk at the point of discharge with the conditional readmission model using machine
The blended model guides patient discharge activities. Additionally, routine physician reporting metrics now monitor
the percent of discharges seen within the optimal post-discharge follow-up window. The impact has been a reduction in
readmission rates (and thus costs) and an increase in optimal clinical follow-up post-discharge.
Source: Big Data Healthcare Analytics Forum
The Information Advantage
What Is It?
So what is the information advantage
and what are the core capabilities
required to capitalize upon it? In
essence, this is about effectively
managing information – in new or
novel ways – that can change how
healthcare organizations interact with
their key stakeholders, support new
business models, predict customer/
patient behaviors, find opportunities to
improve operating efficiencies and
enhance patient experience.
This is about re-purposing data to create
information, whether it is born electronic,
in original paper form or digitized, and
applying innovative processes and tools to
analyze the data and share it with those
who have the interpretive skills to convert
insights to meaningful clinical and
However, this is not easy. It requires new
strategies and changes to traditional ways
of working, investment in people, tools
and technology and a vision with
executive-level endorsement to drive
acceptance and implementation.
Seizing the information advantage must be
approached from a continued understanding
of, and robust approach to, managing
information risk. In our view, most
organizations have two potentially
conflicting priorities: the first is security to
protect against data breaches and loss; the
second is value extraction.
It is hard to get the balance right between
protection from the damaging impacts of
data losses or breaches and in being bold
and sufficiently confident to embrace the
opportunities and advantages that can be
gained from utilizing health information in
different ways. Striking this balance will
become an increasingly pressing priority
for organizations of all sizes.
With a core focus on understanding the
extent to which the organizations are
currently seizing the information
advantage, PwC – in conjunction with Iron
Mountain – surveyed 1,800 enterprise and
mid-market organizations across Europe
and North America. This paper focuses on
the sample of 150 US based Healthcare
organizations that took part in the study
and reveals the healthcare industry still
has a long way to go to fully seize the
The information advantage allows healthcare organizations improve clinical outcomes,
enhance patient experience, and lower cost through an ability to:
- predict patient behavior and utilization patterns
- segment populations based on individual needs and preferences
- make effective decisions around treatment options
- optimize utilization of assets and clinical programs
- design ideal networks of providers for the population served.