Real-world data (RWD) and real-world evidence (RWE) have the potential to answer clinical questions and identify interventions that can help improve health outcomes.
In the area of population health, many believe that RWD can shift care models to a more proactive "predict and prevent" approach that targets at-risk patients. Amassing and analyzing the data needed for this work, however, is not easy.
At a session sponsored by Amgen at the Becker's 10th Annual CEO + CFO Roundtable, senior leaders from Amgen and Optum Life Sciences discussed how they are leveraging real-world data and evidence to support population health. Panelists were:
- Christen Buseman, PhD, director, IDN strategy and marketing, Amgen
- Eric Fontana, vice president, client solutions, Optum Life Sciences
- Bethany Kalich, PharmD, U.S. medical director, cardiovascular, Amgen
- Bryan Powell, director, value-based partnerships, Amgen
Four key takeaways were:
1. Social determinants of health (SDoH) have a major impact on outcomes but gathering data on SDoH can be difficult. Over the past year, a Chicago safety net hospital has focused on data collection for SDoH Z codes. "Providers aren't always comfortable asking the questions to generate the correct information. However, our early results are encouraging. Some physicians took to it naturally, but we are slowly rolling out the requisite education to all employed physicians to show what they need to do in the EMR," a participant said. Although social determinants affect clinicians' ability to care for patients, physicians often don't have the bandwidth to document Z codes. A participant from a national primary-care focused multi-specialty group noted that his organization is using the Health Resources & Services Administration's Area Deprivation Index as a proxy for SDoH information. "We've begun comparing our practices based on the Area of Deprivation Index. In high areas of deprivation, we have EMTs going to patients' homes to provide care. When we grade our physicians, we don't penalize them financially if they are practicing in an area of deprivation," he said.
2. Value-based care requires data and insights across patient populations and across the continuum of care. From a population health perspective, health systems must stratify their patients. "We can't just take a singular view of one segment of the population that has a chronic condition," the COO of an academic hospital system said. "We need to be equally thoughtful about other groups, so we can take preventive measures and stop them from moving into the chronic disease space. In value-based care, you need to think about total continuum of care and articulate what it means. Clinicians want to know the metrics they will be held responsible for, but those vary based on patient segment and market."
3. Interoperability is a major challenge when gathering data across the customer journey. The more data sets that are available, the harder it is to stitch them together. "One challenge with real-world data is you find gaps or opacities in the continuum of care. Some things can be material events that get missed," Mr. Fontana said. One participant explained that the independent physicians working with her health system use different EMRs. "I have all the classic HEDIS datasets I have to report on, but there isn't a single affordable solution that brings everything together for the independents and connects the data with our EHR," she said.
4. Technology and talent gaps are leading healthcare organizations to consider data-focused partnerships. Many health systems can't afford the technologies and human resources needed to analyze their data and generate insights. On the technology front, some organizations are creating "pseudo data warehouses" to gather data inexpensively from multiple sources. Hiring data scientists is another Achilles heel because most healthcare systems can't pay what other industries offer. When Mr. Fontana asked if the talent gap was prompting organizations to think about partnerships, one participant replied, "Absolutely. We have to get out of the mindset that everything has to be done internally. We have to partner because we can't afford the overhead of doing this in-house."
Amgen and Optum Life Sciences recently partnered with a health plan and network ACO in the Southeast to launch a hyperlipidemia program. "The program demonstrated how payers and providers can use data to quickly incorporate guideline-based care recommendations with patients into daily practice processes," Mr. Powell said.
Leveraging data to transform healthcare requires more than simply executing on data. It demands interoperable systems, provider buy-in and upfront thought. "Any application of real-world data starts with a well-defined question," Mr. Fontana said. "We can't expect to put data into a machine and have it automatically generate insights. To the extent possible, we must identify the most critical questions to be answered."
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