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Unified Data
A concept is alive and growing in the workers' compensation system. It is driving innovation in many precincts of this $80 billion industry, sprouting sugar plum fairies in the dreams of entrepreneurs, spooking those mentally chained to old models of doing business.
It is the concept of Unified Data. We see it nowhere because it has no center, and everywhere because for so many today it offers a path to business and personal career advancement.
The common themes are data sharing and integration. We see it when insurers harness deep geo-coded databases to make more subtle underwriting decisions. Claims payers buy precise information from third parties on their doctors, allowing them to track how doctors treat their patients in three different settings. Electronic interfaces can send medical invoices and attachments to claims payers. Policy management systems can link to employee databases. At a single portal on the cloud, brokers can submit one underwriting application for many insurers. Databases are being harnessed to work together. This may require competitors to cooperate. An embarrassing survey report in 2011 revealed more gaps between utilization review and medical bill review than top claims executives realized and their vendors let on. The value proposition for sharing databases typically focuses on error reduction and its incremental cost savings, such as in closing "leakages." But that's what the street lamp shines on, not where the keys are laying. The bigger payoff is better lenses through which to see ways to improve medical care, underwriting and other critical decisions. In sum, improvements in operations in workers' compensation are increasingly related to data sharing. The data can come from within, like the injured worker's claims activity, or without, such as demographic databases. Getting the data correctly integrated across multiple sources can be difficult, with the target never staying still. It can also be very expensive. Short-term payback mentality, complacency and paranoia about data loss can kill. Sharing data can also trigger booby traps, such as violations in using personal health information. Jerry D. Poole, president of Acrometis, a data technology firm, helped me come up with the concept of United Data. He told me that in the workers' comp industry, data integration has always been an "unsolvable" problem. Systems were built around specific functions but were not connected, resulting in isolated pockets of data existing throughout the enterprise. "Data that is not captured cannot be integrated, and data that is not integrated cannot be mined," he said. There is something familiar about this upheaval in expectations and proficiency. Since the early 1990s, in part enabled by managed care laws, claims operations built up their medical intelligence. Today some insurers have a competitive advantage due to their medical management. In like manner, Unified Data has become a persistent force in business advances. It elevates the value of women and men who are competent to promote data sharing. Where are you in this picture? PETER ROUSMANIERE is an expert on the workers' compensation industry. He can be reached at riskletters@lrp.com. October 11, 2012 Copyright 2012© LRP Publications |
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