Is healthcare at its Wal-Mart moment?
Barry Mason thinks so. IBM’s vice president of global healthcare payers sees an entire industry – insurance companies, hospitals, medical devices, pharma and beyond – getting behind concepts like convergence with more than just words. These previously siloed sectors are not only breaking down their walls but looking seriously at collaborating through sharing data, restructuring their business to encourage collaboration, and even forging new business models together (due in large part to the move to accountable care organizations).
“There’s a tone around convergence” at this week’s World Health Care Congress in Washington, D.C., Mason said on Monday (he was one of several IBM executives attending the event).
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Mason compares the next step for healthcare convergence to what happened when Wal-Mart in the 1990s gave its vendors information on sales data and inventory levels. “Opening up that kind of data lets the transparency flow out,” Mason said.
So where is healthcare when it comes to managing data? When it comes to health insurance companies, Mason said the tech sector is now able to integrate clinical and administrative data in ways they previously could not. For example, analytics tools will marry details from those two areas, which allows health insurance companies to extend their business services further to health systems and improve better collaboration and increase revenue opportunities.
What’s next? Mason said tech companies are still grappling with how to better integrate older claims systems: “20- to 30-year-old systems” that are have old, customized policies that haven’t been digitized (and which keeps anyone from truly establishing a national network).
But that’s just one sector – and there’s plenty of unprocessed data. Mason said the true definition of convergence is about sharing so much data between sectors that they can integrate business processes together.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
So what kind of healthcare data needs to be openly shared to create the Wal-Mart moment? Here’s Mason’s list:
- Supply chain data (specifically, opening up the clinical side with claims data)
- Complete sharing of clinical data from the providers
- All remaining consumer data
That’s a short list with a lot of bureaucratic land mines left over from the siloed era of healthcare. But without that kind of commitment, it sounds to me like true convergence may still be just words.
