Hundreds of billions of gigabytes of health information are now being collected in electronic medical records, and three-quarters (76%) of more than 700 healthcare executives recently surveyed by PricewaterhouseCoopers LLP agree that the secondary use of this information will be their organization's greatest asset over the next five years. The data that could be mined from the health system can improve patient care, predict public health trends and reduce healthcare costs, but PricewaterhouseCoopers finds lack of standards, privacy concerns and technology limitations are holding back progress.
According to PricewaterhouseCoopers, the healthcare industry won't see the full value of investments in electronic medical records and other health IT investments until it finds secondary uses for the information being gathered. Yet 90 percent of executives surveyed feel the industry needs better guidelines about how health information can be used and shared, and 76 percent feel that national stewardship over, or responsibility for, the use of the health data should be regulated.
In its newly published report "Transforming Healthcare through Secondary Use of Health Data," PricewaterhouseCoopers calls for public-private collaboration and a role for government in creating incentives for the private sector to collect, share and use health data; to establish standards; and to redefine technical architecture to allow interoperability.
Secondary Use of Data Expected to Grow
PricewaterhouseCoopers found that the secondary use of health data is still in its infancy but is expected to grow exponentially as health IT implementation is fueled by federal stimulus funds. The research found:
- Nine in ten healthcare executives believe that the secondary use of health information will significantly improve the quality of patient care and offers the promise of even greater benefits in the future.
- Nearly two thirds (65%) of health organizations say they expect their secondary data use to increase significantly within the next two years.
- Among organizations that already are using some form of secondary data, 59 percent have seen quality improvements, 42 percent have achieved cost savings, 36 percent have seen patient/member satisfaction improve and 29 percent have increased revenue.
De-identified and aggregated health information - collected from electronic health records, insurance claims, clinical trials, lab and radiology results, employer benefits data, disease management companies, even third-party lifestyle data providers - can provide valuable insight to doctors, researchers, manufacturers, and payers. Analysis of the information could identify patterns to improve health outcomes, reduce medical errors, predict health trends, demonstrate the comparative value of drugs and treatments, identify new markets and revenue opportunities, detect fraud and help achieve the huge cost savings promised by the Administration as part of the health reform agenda. PricewaterhouseCoopers' research found:
- The biggest current users of secondary health information are providers, such as hospitals and physicians. Not surprisingly, they have the greatest access to patient health information.
- Those providers who are not currently using secondary data say the number one reason is lack of EHR implementation, not because they are opposed to the concept. Ninety-five percent of providers are not opposed to the concept, though they are clearly considerate of the sensitivities around how the information should be used.
- Health plans are farthest behind in their secondary use of data despite their vast repository of comprehensive claim information from physicians, hospitals, pharmacies and dentists. While information could be collected from personal health records, only 39 percent of health plans surveyed offer personal health records to their members and few members actually use them.
- Ninety percent of pharmaceutical companies have limited or no access to health information contained in electronic health records. They are heavy purchasers of secondary health data, but this is typically not derived from electronic health records. Nearly half (45%) of pharmaceutical companies buy third-party health data, and 17 percent sell aggregated health data.
According to PricewaterhouseCoopers' research, most health organizations that use secondary data now do so for their own quality monitoring and reporting and for identifying areas that need quality improvement.
Five Case Studies
The report provides case studies of five organizations that are using secondary data. They include Aetna, the American Heart Association/American Stroke Association, MedMining - a Geisinger Health System business, Massachusetts' Partners HealthCare and Wellpoint. In addition, executives from these five organizations participated in a roundtable discussion, featured in the report, about the opportunities and challenges that exist around the secondary use of health data, the need for greater collaboration among the larger health community and the role of government in creating standards and guidelines.
"The implementation of electronic health records is an enormous investment for healthcare providers and for the industry, but the bigger challenge will be in trying to make use of the wealth of information within the U.S. health system that has been trapped in paper silos, just waiting to be unlocked and leveraged," said Daniel Garrett, partner and leader of PricewaterhouseCoopers' health industries technology (HIT) Practice. "The potential of this information has yet to be unleashed. Healthcare organizations need to work together to overcome barriers and foster collaboration and innovation."
Barriers to Adoption
When asked about the barriers to secondary use of data, the majority of survey participants cited problems surrounding data, including access to electronic health records, transparency, quality and management. Fewer than half of providers, for example, have fully implemented all but the most basic functions of electronic health record. An insufficient level of detail and integration tied with data timeliness were cited as the next two biggest problems in using secondary data. Variability in data entry makes many stakeholders, especially doctors, question the quality of the information being generated by the IT system.
Though not considered insurmountable barriers, legal implications were cited as the greatest concern by healthcare executives about their organizations' use of secondary data, followed by privacy implications and public relations ramifications. Nearly two-thirds (62%) of executives surveyed agreed that individual and/or identifiable data can be re-used if it is in the best interest of the patient.
A full copy of the report as well as charts and case studies are available for download at www.pwc.com/secondaryhealthdata.
Methodology
The survey was completed in June 2009. The results are based on e-mailed survey responses from more than 732 executives, from 482 providers, 136 payer and 114 pharma/life sciences organizations evenly distributed by size, organization type, focus, geography and ownership.
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