Can UnitedHealth Group Inc. become the health care industry’s version of Amazon.com?
Well, not for a while, if at all. But the nation’s largest private payer, based in Minnetonka, is already laying the technological groundwork for a system that can quickly collect and analyze patient data from multiple sources, spot trends, and even predict consumer behavior. The result would be an Amazon-esque Internet portal that can market health care services to patients based on their personal behaviors.
Ideally, the company could generate extra revenue and nudge people toward healthier lifestyles, said Robb Webb, CEO of OptumHealth, a unit of UnitedHealth based in Golden Valley.
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“We do want them to do more of their commerce with us,” Webb said. “Can they buy [nutrition] coaching from us directly? We would like them to do that. The real motive for us is now we are part of their lives. When they are making some of these tougher [health care] decisions, I have a better chance of being a part of that decision process.”
Launched in 2008, UnitedHealth’s “eSync” system quickly collects a broad array of real time patient information, including medical claims data, pharmacy information, lab results, self-reported data, and “syncs” them in a way that offers meaningful insight into each patient. Based on the information, the company can spot “gaps in coverage,” recommend services, and provide patients with detailed personalized health profiles.
For instance, a patient suffering chronic pain may get depressed and gain weight. Using eSync, UnitedHealth could contact the patient and recommend services like counseling and/or an exercise class from a particular therapist and a local gym.
eSync can also spot potential trouble before it happens. A patient who receives two pain injections into the spin has a 88 percent chance of electing back surgery. UnitedHealth would reach the patient and offer less costly, alternative treatments before he/she chooses surgery.
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eSync is just the latest example of health care companies embracing “data mining” or “predictive analytics,” the science of using super smart software to detect patterns in data and predict outcomes. The most notable example is Fair Isaac Corp. in Minneapolis, whose trademark FICO credit scores predict the likelihood a consumer will repay a loan based on their debt ratios and payment histories.
Health care payers like UnitedHealth are particularly suited for data mining because they have a lot of it, said David Hatch, a senior vice president at the Aberdeen Group, an information technology research and consulting firm in Boston.
“These companies are in a good position,” Hatch said. “They do have the data. They are trying to be more efficient by uncovering opportunities to improve the cost and quality of care.”
In recent years, start-ups developing analytic tools to help health care companies sift through their data has drawn considerable interest from investors, said Jodi Hubler, managing director of Lemhi Ventures, a venture capital firm in Excelsior that specializes in health care. Lemhi is exploring several such deals, she said.
However, health care firms have mostly focused on using data mining to spot fraud and billing errors. The real challenge is how to proactively interact with patients the same way retailers like Amazon interact with shoppers.
For example, UnitedHealth has used eSync to develop “Healthy Notes,” a series of mailings that outlines health care opportunities to both consumers and providers. The company also create an online “Treatment Cost Estimator,” which allows consumers to compare out of pocket costs between five providers in their area. In September, UnitedHealth will partner with Microsoft Corp.’s Health Vault on a pilot project to create a personalized online health portal for each consumer.
The idea is to first use eSync to engage the consumer with personalized health information on multiple levels, including websites, mailings, portable devices, and social media tools like Facebook and Twitter, said Karl Ulfers, vice president of innovative technology solutions at OptumHealth.
The second, and more challenging goal, is to use eSync data for selling stuff to consumers, he said.
“We’re sitting on a wealth of information,” Ulfers said. “How do we maximize the number of people we engage? And how do we maximize behavioral change in each individual? The real opportunity is to push services tailored to their needs.”
Ulfers envisions a kind of Amazon.com portal in which the website automatically recommends services to consumers based on their behavior and health profiles the same way Amazon recommends books and music based on previous purchases.
“In some ways, it’s not that a big of a leap” for health care companies, Hatch of Aberdeen said. “It’s being smart about how patients interact with their health care. Some services are more profitable than others. [Companies like UnitedHealth] are interested in that sweet spot.”
