The benefits of Big Data

Using real-world patient outcomes data

Big Data is big business. As technology advances and more information about healthcare is recorded and stored, the opportunities for turning information into insight to improve outcomes have never been greater.It is no surprise that it is those most able to collect and, crucially, interpret this data who are pushing the boundaries of what is possible in market access. In the new health economies, biopharma needs to work much harder to meet the demands of stakeholders for robust evidence of exactly how a product will lead to better patient outcomes in the real world. Compelling data lies at the very heart of this challenge.

Turning a buzzword into real value

There is one major barrier that currently stops biopharma realizing the full potential of Big Data: at the moment, there is no consensus on exactly what it is, nor how to effectively use it. It is a buzzword that is high up on every company’s agenda, but as an industry, we are perhaps two years away from understanding exactly how it can deliver improved commercial and clinical outcomes.

There is an unprecedented wealth of information out there, be it national, such as hospital episode statistics (HES) and prescribing figures, or local, including patient-reported outcomes (PROMS), patient reported experience measures (PREMS), quality of life, patient level clinical notes and local hospital systems. When Big Data is discussed in the context of the NHS, the assumption often is that ‘big’ means ‘national’, implying that insight comes solely from HES and other large and structured historical data sets.

I believe the real value comes when you are able to unpick this huge volume of data and hone in on what is most relevant to local clinicians, in a unique local health economy, for a specific patient population. This would not be too much of a challenge if Big Data described perfectly comprehensive, accessible and clean data with no gaps and contradictions. If that was the case, drilling down to pull out the local context would be a relatively simple task.

However, Big Data is just the beginning of a complex process of segmenting, analyzing and interpreting. HES data can provide an overview, presenting the ‘what and when’ in healthcare, but what we really want to know is ‘why’. The latter is far harder to pinpoint, but certainly worth searching for.

Where are we now?

There is no doubt that market access already achieves a lot from data. Outcomes audits utilise in-the-field nurses and analysts to gather national and local information, giving biopharma a highly detailed understanding of the entire care pathway. It can reveal gaps in that pathway, where adherence is unsustained, where extra patient support is needed, and where clinicians need clearer communication about a product’s benefits.

Similarly, simulation modeling uses multiple sources of data to create a virtual, near-live local pathway. Stakeholders can then see how this pathway’s performance and outputs compare against national and international pathways, and test scenarios to see what impact modifications would have on budgets, adherence and outcomes.

This modeling can be hugely important for biopharma, as it allows them to demonstrate to payers and providers the potential value of their product within a wider therapy pathway and within this specific local health economy. These stakeholders want to see the impact on outcomes in their very specific geography, and modeling fuelled by this data can help them make effective decisions to change  local care pathways (perhaps supported by the biopharma company through a joint working programme), or to develop the intelligence and insight to make cases-for-change with local commissioners.

The logical follow-on from pathway analysis and simulation modeling is service redesign. If running these simulations has revealed where new approaches would improve outcomes, then biopharma can present a powerful case for change to the local providers in this specific geography. Because the proposed service redesign is informed by localised, real-world data, and considers a product’s impact on the therapy pathway as a whole, stakeholders can be confident that there is strong evidence to back-up these proposed modifications. Biopharma can then combine an enhanced understanding of current and possible future care pathways with consultancy and change implementation expertise services to help implement any recommendations, and support the delivery of new services in a local health economy.

Finally, patient outcome studies and patient services is another market access area that relies on big data, because pragmatic analysis of real-time patient outcomes data can deliver an extremely valuable snapshot of the use of treatment in a specific local health economy. Combining patient-reported and clinical outcomes with patterns of resource allocation can assist in developing a clearer understanding of current medicine use, associated clinical practices and potential impact of a therapy across the local health economy. This insight can inform the development of patient-focused services ranging from local review clinics and remote patient support, to adherence support services and the deployment of managed clinical workflow tools.

What does the future look like?

What do payers and providers want to see from Big Data? Where are the gaps, and how can the information be better manipulated and localized? Should we be expanding our frame of reference, moving from PROMS and PREMS, and delving more into quality of life? There is clearly huge potential in social media too. Do we need a shift in focus towards non-health specific lifestyle data sets so we can understand not just the clinical impact of a drug on a patient, but how that patient’s exercise levels and diet, for example, are affecting outcomes?

Patients are just as likely to blog or tweet about their health as tell their GP directly, so social media could be seen as a major source of real-world experiential information.

It is exactly these sorts of questions that I want to tackle in an upcoming webinar with Dr Junaid Bajwa, GP and board member for Greenwich CCG. Big Data is a big opportunity for every market access stakeholder, so now is the time to open up a discussion and take an active role in shaping the future.

Source PMLive http://www.pmlive.com/blogs/smart_thinking/archive/2014/september/the_benefits_of_big_data

The benefits of Big Data