Highly Inaccurate Claims Data
"Claims data can be, depending on the disease, up to 80% inaccurate, and yet when we're doing analytics in healthcare, we are relying on rules and traditional statistics, all of which have at their base assumption the idea that the data will all be in one place, well-structured, and reliable."
D'Avolio says 20 years of research shows that machine learning and natural language processing (NLP) are capable of making sense of healthcare data that traditional business intelligence analytics technology cannot.
But after publishing more than 20 papers on the topic, speaking publicly, and releasing some machine learning and NLP technology as open source for healthcare to use, D'Avolio was disappointed by the results.
Only 300 institutions downloaded it and used it as a teaching tool. "It never jumped the fence and really made a difference in the care of patients."
So D'Avolio found investors and formed Cyft, which commercialized this work for organizations such as Senior Whole Health.
"One of the things we're doing right now is not just identifying folks that are going to be readmitted, which is sort of where predictive analytics stops in most of health care today. They've got to figure out which people in my population are most likely to end up in the emergency department in the near future, and not just anyone, because again, the high risk pregnancy is very different than the geriatric patient."
Cyft is focusing on the top five condition classes faced by organizations such as this—heart disease and diabetes are two—to try to target preventable admissions. It does this by scrutinizing nontraditional data such as nurses' impressions on notes, call center transcripts, Medicaid surveys on activities of daily living, and Likert scale functional status data.
Start with the Outcome
Cyft predictions get funneled to the appropriate person who specializes in that area, and who can now justify the cost of a $150 home visit. The results of such decisions increasingly can be shown to be more cost effective than an emergency room admission, which can cost more than $12,000 a day, D'Avolio says.
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.