It might be every hospital researcher's dream — insurance claims data on tens of millions of patients, right at your fingertips to plumb for information, like missing puzzle pieces that suddenly appeared.
Scientists at the Mayo Clinic will soon begin living that fantasy, with the health system's recent announcement that it's partnering with insurer UnitedHealth Group to share data and tackle some of the larger problems vexing health care. Similar sharing has been attempted before, but those involved say this could be the largest such combination of records, comprising some 115 million patients and history dating back more than 15 years.
With talk of getting other payers and providers involved, and the goal of turning research into results much more quickly, leaders at both organizations are calling this a "game changer."
"It provides us the opportunity to accelerate the pace of change in health care," says Mark Hayward, administrator for the Mayo Clinic's Center for the Science of Healthcare Delivery. "As you look at the true value of care delivery, you need to have both components well-represented; you have to understand the clinical side of delivering care, as well as the cost and utilization of services over time."
Mayo and Optum, a division of UnitedHealth, have set up a lab on neutral turf in Cambridge, Mass., to serve as ground zero for the effort. The two already have worked together on projects, according to Hayward, and there wasn't the usual hospital-insurer rancor to get past. Specifics are still being determined, but the two health care behemoths are establishing an oversight committee, working out the infrastructure of the analytics and deciding what diseases to zero in on.
Researchers will use the de-identified claims data, coupled with clinical information, to find trends and common treatment pathways for complex and chronic conditions, says William Crown, chief scientific officer of the 60-employee new Optum Labs. Those patients must deal with handfuls of disparate providers who often don't coordinate or share information, and claims data can help map out and determine the optimal pathways.
"We want to align on questions that are going to have a high impact, so that we can generate results in the near-term rather than doing the perfect study that will generate results five years from now," Crown says.
But what does this mean for the rest of the industry, and is this partnership duplicable? Optum Labs is casting its net to try to find any entity — health systems, insurers, life sciences companies, universities — that might be interested in joining the effort. And there is no one-size-fits-all fashion in which others have to participate, says Mayo's Hayward. Some may bring their data to the table, while others may just analyze what Optum Labs has already done to draw their own conclusions. Evolving IT capabilities and better data standards will only make it easier for others to replicate what they're doing, he added.
The challenge will be maintaining patient privacy and jumping through all the necessary hoops put in place by HIPAA, along with getting comfy with using the unfamiliar figures, says Nilay Shah, an assistant professor of health services research at Mayo.
"We just have to be careful, but I can't imagine that being one of the things that slows us down," Shah says.