Research

Ties that Bind: How HCA's Big Data Transforms Care

Sheryl R. Skolnick, Ph.D.
Managing Director, Healthcare Services
April 13, 2016

MIZUHO SECURITIES USA INC.  |  US EQUITY RESEARCH

Summary

A data set by itself, even if as extensive as HCA's, is useless unless knowledge from analysis of that data is tightly bound to process change. We learned that, and a lot more, at the MSUSA Big Data Day at HCA at the company yesterday. The key point: In our view, 'only HCA' has the excellence in operations AND scale to drive improvement in both care and costs. Buy, $102 PT. 

Key Points

The promise of data mining made real: With the advent of EHRs and meaningful use, HCA's already extensive clinical database exploded, adding useful datapoints on millions of patient encounters. Then, natural language processing technology matured enough so that clinical notes could be efficiently processed, queried and analyzed to allow clinicians to understand what happened, why it happened and, most importantly, to identify and analyze those processes and outcomes that are 'good.' HCA invested in the technology and people (data science is alive and well in Nashville) to build an impressive set of real-time tools, dashboards and clinical practice change initiatives that is tightly bound to operating paradigms. In short, big data 'works' (to improve care, outcomes and margins) only because it is tightly bound to and embraced by the clinicians and operating teams and because it is implemented by more than 90 Chief Medical Officers, a position that HCA appears to value much more highly (and imbue with much more responsibility and capability) than its peers.

As a result of the investments made over the last 2.5 years, HCA has not only identified areas of cost savings, but is also able to predict which patients will be at risk for complications and implement best practice protocols that are also informed by analysis of its clinical data. Better care means better margins. It also means happier nurses and doctors (the data shows that nurses have a big influence on outcome), lower turnover and, more importantly, it drives referrals of more complex patients, a virtuous circle.

We've asked HCA before why its margins are so high (and why they are sustainable). Big Data day confirmed what we knew before: HCA's very scale makes its Big Data advantage possible - but it is only an 'advantage' because HCA's ops teams, led by CMOs, embrace and implement the tools that lead to rapid process change. Data unbound to ops is useless. Tightly bound, Big Data and operating excellence create a potentially unmatched competitive advantage. As we've said before: There's HCA....and everybody else. Reiterate Buy and $102 PT. 

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