Thought Leaders in Big Data: Charlie Lougheed, Co-Founder and President of Explorys (Part 3)

Charlie Lougheed: As these healthcare organizations look to those who pay for the care, which are either the private insurers or Medicare, you see a move towards value-based care. Rather than paying for all the associated services with that patient’s admission into the hospital, you instead get a flat rate for that patient to take care of them. Anything above that, they may be able to share an additional share of savings.

To do that, you have to be able to do three things. The first thing is understand what the population looks like, where the risk is in that population, and what parts of that risk can you do something about. Once you have that, the second thing that we provide is the ability to outreach those patients using the right channel and people at the right time. For instance, if a diabetic patient hasn’t been in to see a foot or eye exam in the past year, that’s a gap in care. Those aren’t always evident. It’s certainly not evident when that patient isn’t in front of you. We bring that information to the forefront, put it in the hands of the right people so they can outreach those patients and change that negative course. The last element of that is measuring. Where is this working or is it not working? Why is it not working? Where are the variations? How do we reduce those variations? That example of treating patients using the right channels, which are usually the less expensive and more effective channels, is an example of where this technology is being used today.

Sramana Mitra: I know you were trying to place this in the context of the ecosystem. Help me understand the ecosystem map. What’s happening in your market? Who’s doing what? How do you differentiate?

Charlie Lougheed: As I mentioned before, our target is the healthcare industry, which includes healthcare providers, large healthcare systems, and life sciences like pharmaceutical companies and companies that develop medical devices. I talked a little about the emergence of value-based care in the space. The other important piece of that component is those that actually pay for the care or underwrite the risk of the care. In many cases, those are commercial payers as well as, in many cases, the employer. Employers pay a lot of the healthcare cost today in America. In addition to that, it’s our Federal and State government that are paying. The ecosystem is very broad. Of course, the patient is in the middle of that.

That patient is becoming more and more a consumer of healthcare, meaning rather than not knowing what somebody was going to charge for something, that consumer is now much more involved in the decision of what care they purchase, particularly if they have a high exhaustible plan. You have this rapidly evolving ecosystem. Where we play is helping healthcare organizations and life sciences form these networks and deliver that care with shared information. Our focus is to help them derive better information. With that large a data set, you can learn a lot about how to take on risk and manage a population by applying benchmarks.

This segment is part 3 in the series : Thought Leaders in Big Data: Charlie Lougheed, Co-Founder and President of Explorys
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