Using Business Intelligence to Create Better Health Decisions

With IT’s leadership, Blue Cross and Blue Shield Association is harnessing billions of data points to improve outcomes and freeze costs

Senior VP and CIO Doug Porter and President and CEO Scott Serota discuss Blue Cross and Blue Shield Association's business intelligence tools.

Scott Serota Healthcare in America is rapidly becoming an information-based business. Experience-based medicine, evidence-based, whatever terms you use, it's all based on information. Part of our mission is to take the raw data from our 38 Blue Plan affiliates, who serve one out of every three Americans, and make that information acceptable and accessible for decision making.

We're the logical source for that information, and the organization we've formed to collect, protect and process it—Blue Health Intelligence (BHI)—will be a principal focus.

Creating a warehouse with 3.5 billion pieces of data was the easy part. The hard part is turning that into actionable information and insights that will improve the quality and delivery of care, ultimately bending the cost curve in America. For example, we have found insights about the efficacy of knee and hip replacements and how they vary by protocol, and what could be done to improve them.

Doug Porter Understandably, there was an insatiable demand placed on this asset. The answer to one question seemed to trigger 10 more. We had engineered a pretty robust system, but we started to fail the expectations of the end users because of the complexity and volume of the queries. We turned our technologists loose on the problem, and the solution was essentially a columnar search appliance that gave us exponentially larger capacity.

Serota We've also created an environment where the affiliates themselves can access and ask questions without coming to us. This ability for technologists, analysts, business executives and healthcare professionals to all come together to solve a problem is really the power of this tool.

Porter It's almost like a social network, in some respects, in sharing the insights and garnering the next set of questions that lead to insights that have a material use in the business.

Serota I hired Doug as our CIO to shore up our infrastructure and our transactional processing. As we got better acquainted, and as he got better acquainted with our organization, it was clear that he brought a unique set of skills that made it a logical extension for him to run the startup of BHI.

The role of a CIO in healthcare is radically different than before. It used to be that you were support, making sure the transactions worked. Now you're becoming a vital business partner as an information provider and a co-owner of the business processes. It's a very aggressive leadership role that I expect from Doug and his folks, and our transformation efforts wouldn't work without that.

As told to CIO Executive Council Editorial Manager Diane Frank. View a video interview with BCBSA's CEO and CIO at www.enterprisecioforum.com.

NOTE: Subsequent to this interview, Blue Health Intelligence (BHI) became an independent licensee of the Blue Cross and Blue Shield Association. BHI continues to leverage Blue data representing the healthcare experience of more than 110 million individuals nationwide to improve the delivery of care.

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This story, "Using Business Intelligence to Create Better Health Decisions" was originally published by CIO Executive Council.

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