Data warehouses, tracking dashboards and analytic training developed by Advocates for Human Potential, Inc., (AHP) with three MassHealth provider networks to increase their health information technology capabilities can now be used as a tool in the fight against COVID-19. The warehouses and associated tools are just being launched, and AHP is training providers on how to put them to greatest use. 

While AHP had been building out these “big data” solutions for community partners (CPs) in projects originally designed to help with the ongoing shift toward accountable care in Massachusetts, they realized the data could have a more immediate impact: It would enable healthcare providers to easily and proactively identify and reach out to high-risk individuals as COVID-19 continued to spread across the state.

Dana K. Borgia, director of Long-term Services & Support Community Partner Program at Family Services Association (FSA) said, “I think it’s great to have this information, because I don’t think up until this point we’ve had a good way to judge who is in this highest risk category. I mean we know some of what’s going on with our members and a diagnosis and we can kind of guess that, but it’s nice to have data to back it up.”

The data warehouses contain aggregated and harmonized information from disparate sources such as insurance claims, case management systems, electronic medical records and outcomes management systems. Once everything comes together in a usable form, “that big data can tell a very big story,” said Patrick Gauthier, director of AHP Healthcare Solutions.

With this enhanced capability to pinpoint cases, “I can look at a mountain of data representing a population in a region of the state, and I can identify in that data who is over a certain high-risk age, and who is in a particularly high-risk chronic condition group, a sub-group of all that data,” said Gauthier. “Now I can do some prevention. Now I can reach out to those people and say, ‘We need to make sure that you are sheltering in place, that you have everything you need. Maybe we’re going to see you a little bit more often on telehealth.’”  

AHP’s data projects are part of the Massachusetts Delivery System Reform Incentive Payment (DSRIP) program, helping accountable care organizations (ACOs) and CPs in the state improve patient outcomes and quality of care while lowering costs. Sharon Ford, FSA Chief Program Officer noted, “This dashboard is a great tool that we will be able to use with our staff to help identify trends with members. For example, those high users that may need additional education and guidance to better utilize community services. This tool will also help identify trends for caseload management and performance measures.”

These types of data applications are ripe for expansion, Gauthier said. “It’s definitely something that could be used more broadly going forward.”
 

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