Analytics For Colliding Payer And Provider Worlds: Chilmark Report Explores Role Of Clinical Data Analytics In Population Health Management

Value based payment models drive demand for Clinical Analytics solutions

Evolving payment models and an influx of clinical data generated from EHRs are compelling healthcare provider organizations to seek analytics solutions to manage patient health risk, according to Chilmark Research's newly released 2013 Clinical Analytics Market Report: Analysis and Trends. The report describes a market for Clinical Analytics solutions that is just getting started, driven by the major new challenge of population health management.

The report details an immature, yet rapidly evolving market. Today, a common language across the industry has not developed, with vendors preferring to market their wares using the terms "Big Data," "Population Health Management" (PHM), and "ACO." To further complicate things, the legacy of claims-based analytics lives on. The end result, a market that creates significant challenges for those providers and healthcare organizations that seek to adopt analytics solutions in advance of payment reform driven in large part by the Affordable Care Act. These providers come from a range of payment perspectives, from those seeking P4P reimbursement, to those plowing headfirst into managing patient risk, to those that simply want to practice managing risk before they take the leap.

Healthcare organizations are now taking a variety of approaches to address their analytics needs including combining claims with clinical data. As providers increasingly seek to reduce the risk of the patient populations they serve, this claims-based legacy will be both a starting point as well as a distraction from analyzing much richer clinical data from clinically housed sources.

Going forward, providers will have a unique opportunity to leverage rapid advancements in analytics and automation to leverage their rich clinical data for more proactive population health management. Chilmark forecasts a future state wherein clinical analytics for population health (CAPH) will enable clinicians use their unique, trusted position to succeed in improving the health of the population they serve where payers before them failed.

"There is no way around the fact that clinical data analytics will play an essential role in furthering PHM efforts," says Cora Sharma, lead analyst of the report. Sharma continues: "High-touch care management processes of the past will no longer suffice as the size of the problem is too vast, resources too few, and patients too numerous. However, with the exception of payers, the healthcare industry as a whole is late to the analytics game."

There remain plenty of market challenges. Providers have never acted to manage global risk on this scale before, leveraged such complex clinical data treasure troves, nor faced such obstacles. Clinical data integration remains expensive and human-brain intensive - and HIEs are not yet coming to the rescue.

Many analytics vendors are entering this industry, seeking to align their brand with PHM by any means necessary. Competition has flared up and it is becoming increasingly difficult for vendors to differentiate themselves and avoid commoditization within this crowded field. Surprisingly, several well-known brands are still in the early process of entering the market, including some with the largest presence in healthcare, electronic health record (EHR) vendors.  

In addition to a broad market assessment, the report provides detailed profiles of 14 vendors across several categories. Surprisingly, a few startups have built strong momentum over some of the largest healthcare IT behemoths. According to John Moore, founder of Chilmark Research, "Clinical best of breed vendors had initially enjoyed little competition, but in the last 12-18 months have seen a significant increase in competition. Unfortunately, we have also found a very immature buyers' market. This has led to significant confusion as to what the true capabilities are of various analytics solutions to address the strategic needs of a healthcare organization. It is our hope that this report will lead to a more educated market and wiser purchasing decisions going forward."

Copies of the report are available to subscribers to the Chilmark Advisory Service or may be purchased separately. Inquiries should be addressed to Sean Campbell at sean@chilmarkresearch.com,

About Chilmark Research
Chilmark Research is the only industry analyst firm focusing solely on the most transformational trends in healthcare IT. We combine proven research methodologies with intelligence and insight to provide cogent analyses of the emerging technologies that have the greatest potential to improve healthcare. We do not shy away from making tough calls, and are respected in the industry for our direct and thoughtful commentary. For more information visit: www.chilmarkresearch.com.