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Surprises from the health data trenches

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Sean Gallivan says he knows that he has to fight to keep your eyes from glazing over when he tells you what his company does.

Gallivan is the chief operating officer at Healthentic, a 6-year-old company that sells a “population health dashboard” — a system that employers, benefits brokers, benefits consultants, insurers or other customers can use to monitor the status of a group of people, such as an employer’s employees, a doctor’s patients or a health insurer’s policyholders.

Gallivan says many actual and potential customers are burning out on population monitoring systems because too many systems focus on indicators that are relatively easy to get but have too little to do with improving people’s health or lowering the cost of their care.

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The Healthentic dashboard is a little like a Google Analytics summary dashboard for people. It shows a population summary panel that indicates the size of the population, the population’s total health care costs for the reporting period, and the population’s per-member-per-month costs.

A second panel shows the percentage of the enrollees who appear to be healthy and their costs per month; the percentage who have preventable conditions and their costs per month; and the percentage who have chronic conditions and their cost per month.

A third panel shows trends in the percentage of enrollees with diabetes, high blood pressure, depression or low back pain who appear to be managing their conditions according to generally accepted standards.

Users can click through to get anonymized care utilization details. Healthentic tries to link information from different databases, so that analyzers can look at people in the population who have both diabetes and periodontal disease, or who are taking both drugs for depression and drugs for back pain.

Gallivan acknowledged in an interview that some of the indicators depend on baked-in assumptions about whether, for example, the generally accepted standards for treating depression or diabetes are correct and whether the estimates of how much generally accepted care will save are reasonable.

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But he said the way Healthentic collects and displays the information helps users test those assumptions, and that the company now has almost as much experience data as the U.S. Centers for Disease Control and Prevention (CDC). Because the Healthentic database includes data on workers, and the CDC databases reflects the experience of Medicare and Medicaid enrollees, Healthentic believes its assumptions about the effects of various care management strategies may be more relevant to a worker population than CDC estimates, Gallivan said.

So, what are the surprises that have popped out?

“The biggest surprise is the prevalence of depression,” Gallivan said.

Healthentic analysts have found that about 16 percent to 17 percent of workers at a typical employer are taking drugs for depression, and that those workers account for 40 percent of a typical employer’s medical costs.

Healthentic has also found that the results of health risk assessments and wellness program participation rights have little correlation with users’ population costs.

To reduce the risk that employers’ minds will wander when they hear about population health data analysis, the trackers should be focusing more on biometric data and less on whether people in a population are filling out questionnaires, Gallivan said.

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