Healthcare Manage Resources to Deliver Optimal Care Worldwide, the top priority for organizations involved in healthcare is seeing that the proper care is delivered, wherever and whenever it is needed. Due to growing concern about the cost of healthcare, there is renewed emphasis on ensuring that it is delivered efficiently. Nevertheless, maintaining a high level of quality and protecting public health remain top priorities. SPSS Inc. has a long history of providing support to healthcare organizations. Our solutions include statistical, data mining, text mining, and Web mining tools, business intelligence and reporting software, and survey research products. Used separately or together, they enable organizations to: Support medical research Improve disease management Monitor the quality of patient care Improve operational efficiency Maintain accreditation Combat healthcare fraud Protect public health SPSS software solutions are well suited to healthcare applications. Our solutions use open architectures, enabling users to access and analyze data from a wide variety of sources and deliver results in a variety of ways. They are highly scalable, capable of processing the large volumes of data that healthcare organizations typically generate. Our survey research solutions meet statutory requirements, such as the U.S. HIPAA (Health Insurance Portability and Accountability Act), as well as healthcare organizations stringent hardware and firewall specifications.
Supporting medical research Medical research generates massive amounts of data. Individuals and institutions involved in research rely on SPSS solutions to efficiently manage the data collection, analysis, and reporting so that they can spend more time on the research itself. Dr. Eric Bremer at Children s Memorial Hospital in Chicago, for example, uses an SPSS data mining solution to analyze microarray data and characterize pediatric brain tumors by type and stage of development. Dr. Bremer also uses SPSS linguistics-based text mining solution to sift through the research literature in this field and efficiently monitor new developments. His goal is to create a database incorporating clinical, pathological, and biochemical information and make it available to other researchers in order to find the best cancer treatments available. Improving disease management In delivering healthcare, hospitals, clinics, and individual physicians use both individual clinical expertise and the best available external evidence to guide treatment recommendations. SPSS solutions help providers increase their awareness of the relevant evidence and evaluate the strength of that evidence so that, in consultation with the patient, they can choose the most appropriate treatment options. A study done at London s St. George s Hospital NHS Trust is typical of many that shed light on the effectiveness of medical treatments. Using statistical software from SPSS, the study evaluated more than 14,000 admissions to the hospital during a nine-year period. It found that there was a higher mortality risk when certain types of patients were moved out of intensive care units rather than being kept there longer. This helped the hospital choose the most effective treatment options for its patients and provided guidelines to other hospitals with similar patient populations. SPSS solutions also give payer organizations, such as government agencies and private insurers, the tools to identify patterns in patient care that signal the mainstreaming of new treatments and therapies. In this way, they can determine which therapeutic approaches improve patient outcomes and minimize the need for expensive emergency interventions. Concern over costs Healthcare costs are expected to continue rising, even though they already represent a significant share of gross domestic product (GDP). Share of GDP spent on healthcare United States 15.0% Australia 9.5% Canada 9.5% Japan 7.9% United Kingdom 7.7% Other EU nations (average) 9.0% Source: "Social Health Insurance Systems in Western Europe." World Health Organization, 2004.
Monitoring quality, improving efficiency In addition to helping providers evaluate treatment effectiveness and maintain high levels of patient-care quality, SPSS software also enables them to improve operational efficiency and meet accreditation requirements, such as those of the U.S. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Analytical tools from SPSS do this by helping providers negotiate appropriate payment contracts with insurers and other payers, obtain funding for research, and efficiently meet regulatory requirements. To comply with quality-control legislation in the Netherlands, for example, the Hospital of Walcheren chose SPSS suite of survey research tools. Not only did this solution improve staff efficiency in processing patient questionnaires, it also uncovered some unmet patient needs. By quickly addressing those needs, the hospital improved patient satisfaction and met regulatory requirements. A number of other health providers use SPSS reporting solutions to monitor operational efficiency according to a variety of metrics. For example, the Wesley Hospital Back Rehabilitation Centre, located in Queensland, Australia, uses SPSS products to monitor operational efficiency. Each year, the facility treats more than 60,000 patients who have had back surgery, suffer from unresolved or recurrent episodes of back pain, or are unable to return to work. It combined clinical and operational data to create key performance indicators (KPIs) that are used to more effectively allocate staff and other resources.
SPSS solutions also help private sector organizations, such as health insurers, improve efficiencies and obtain the competitive advantage they need. Highmark Blue Cross Blue Shield, which provides insurance and health-related services to millions of members in Pennsylvania, uses SPSS products to identify different characteristics of customers, plan member service improvements, and compare product penetration rates by region. This enabled the insurer to identify opportunities where it could significantly expand its market. SPSS survey research tools are used to monitor feedback both within provider organizations and outside them. For example, a hospital or clinic can continually track community or legislative support for its outreach programs and initiatives. SPSS software also can be used to monitor physician and staff job satisfaction and loyalty important factors in managing valuable human resources. Combating healthcare fraud It is estimated that, in the U.S. alone, as much as $500 billion may be spent each year on duplicate or unnecessary treatments and fraudulent claims. This clearly diverts resources that otherwise would be available for treatments patients need. Private payers and state, local, and federal government agencies have a vital stake in detecting and minimizing the effects of wasteful or fraudulent practices. One state health department, for instance, processes hundreds of millions of Medicaid claims totaling billions of dollars every year. The department implemented an extensive data warehouse project that included an SPSS data mining component. This award-winning initiative saved the state millions of dollars in its first year in operation, in part due to predictive models that detected the most likely instances of fraud. Because they knew which cases to focus on, agency investigators had a higher rate of success in identifying and recovering improper payments.
While current methods typically catch fraud after payment has been made, putting payers in the position of trying to recover funds, new methods are designed to detect likely instances of fraud before payment has been made. This minimizes the need for expensive collection efforts and represents a major step forward in combating improper payments. The real-time deployment capabilities that SPSS solutions offer enable organizations to take action in the small window of time between the submission and payment of claims. Protecting public health Public health departments function as monitors, researchers, and educators. Their staff must watch trends both locally and across borders in both communicable diseases like influenza and chronic conditions like diabetes. They must understand the causes behind the trends. And they must provide healthcare providers and the public with guidance both in emergency situations, like the SARS outbreak in 2004, and on an ongoing basis. The open architectures and advanced features of SPSS solutions make them ideally suited to helping public health agencies and organizations. When surveying the public about their knowledge of and attitudes toward certain health-related topics, SPSS solutions protect individual privacy while making it easy for agencies to collect information through a variety of cost-effective channels. Another way in which SPSS solutions can be used is in syndromic surveillance. This is a process that requires agencies to analyze health data, stripped of any personal identification, to discover patterns and associations that suggest the presence of a certain syndrome and the need for a public health response. Because data comes from many different sources emergency room admissions records, pharmacy sales records, and public safety incident reports, among others openness and the efficient use of computing resources are essential. SPSS aids healthcare organizations Our customers rely on us for both reliable, innovative software and in-depth industry expertise. SPSS products are used by: Five of the seven largest healthcare provider organizations in the U.S. 14 of the 16 hospitals on U.S. News & World Report s 2005 honor roll More than 300 hospitals in the NHS Trust in the U.K. The top five private payers in the U.S., who insure more than 150 million consumers AXA and BUPA, two of the leading insurers in the U.K. Many county, state, and federal healthcare agencies, including those serving densely populated areas Medical researchers at numerous universities and public health agencies, including those conducting research on genomics and other groundbreaking therapies Leading not-for-profit medical associations and foundations
Meeting new challenges The cost of healthcare will continue to be a concern, particularly in industrialized nations as older people, who require more healthcare resources, comprise a higher proportion of the population. One way to help curb costs is to cut down on the amount of paper handling involved in every phase of healthcare, from visiting the doctor to picking up prescriptions to paying doctor and hospital bills. Already, there is a trend toward computerized physician order entry and electronic medical records, and many payers give physicians and patients the ability to access claim information online. Increased use of the Web offers opportunities for improved communication among all parties involved in healthcare. Consumers use the Web to research medical conditions, treatments, and caregivers, and to purchase medications. Physicians and other healthcare providers increasingly communicate with each other, with patients, and with payers electronically. In this area, SPSS Web mining solution can assist organizations, since it provides a clear picture of who is visiting a site, when they are visiting it, and what they do there. For medical researchers and public health officials, the trend toward digitizing healthcare information offers exciting opportunities. More data than ever before will be available some of it data that could not previously be analyzed, such as doctors and nurses textual notes. SPSS text mining can help researchers and others uncover hidden associations in these new sources of data, adding to the accuracy of current predictive models. Technology to play a key role Numerous studies show that healthcare organizations increasingly recognize that information technology improves their ability to operate more efficiently and deliver the quality of care that is required. IDC projects worldwide software spending by healthcare organizations to grow by a compound average growth rate of 5.9 percent a year, reaching $10.5 billion by 2008. (Source: Worldwide IT Spending 2003-2008. IDC, #31544, 2004.) SPSS is committed to continuing to provide healthcare organizations with the powerful yet flexible predictive analytics solutions they need in order to carry out their vitally important missions. For more information on SPSS solutions for healthcare, visit www.spss.com/healthcare or call your local SPSS office. To learn more, please visit www.spss.com. For SPSS office locations and telephone numbers, go to www.spss.com/worldwide. SPSS is a registered trademark and the other SPSS products named are trademarks of SPSS Inc. All other names are trademarks of their respective owners. 2006 SPSS Inc. All rights reserved. HCIB-0106