What Paul Revere Knew About Actionable Data

Jan 28, 2014
Individual bits of data that sparks change, or forces a decision is data made actionable.

As a business buzzword, “Big Data ” gets a lot of attention. But when it comes to helping people make the right choices for improved health, it’s not the amount of data that matters.

A single data point that sparks change or forces a decision – in other words, data that is made actionable – is one of our most powerful tools in driving better decisions among patients, physicians and payers. Though it may seem counter-intuitive to say that one bit is more useful than many, it’s a lesson we all learned in grade school.

Think Back to the Story of Paul Revere

It was April of 1775 and British Army officer Lt. Col. Francis Smith was preparing to march on Lexington and Concord. The American revolutionaries were expecting an attack, but didn’t know how Smith’s troops would approach – on foot or in boats. So Revere arranged for a signal to be made at the Old North Church. I’m sure many of us remember the code “One if by land, and two if by sea,” used by Revere’s men to signal the path of the British by hanging one lantern or two from the church steeple.

The difference between one lamp in the Old North Church or two is precisely one bit of information. But it was just that one bit that led to immediate action by the patriots and determined the outcome of the battle.

At Express Scripts we use advanced computer analytics to sift through 15 petabytes of data, drawn from processing more than 1.3 billion prescriptions a year, to find those nuggets that are actionable. For example:

ScreenRx weighs dozens of factors – ranging from a patient’s age, geography and marital status, to his prior prescription records and physician's profile – to determine with 94% accuracy whether that patient will take his medication as prescribed. By comparison when asked, patients themselves correctly predict their own future nonadherence just 10% of the time. Knowing in advance which patients are likely to become nonadherent allows us to intervene in ways that can help them stay on track and have a better health outcome.

ExpressPAth is an online portal that flags for physicians the single nuggets of data, pulled from a vast database of drug information, that help make the best, most cost-effective and safest prescribing decisions. At the moment she’s writing a prescription, a physician can see, for example, whether a medication has been tagged with a “black box” health warning, or if it will negatively interact with something else the patient is taking.

In our member call centers, we use speech analytics software to mine a continuously updating database of 2 million call recordings to spot individual words or phrases that signal the need for action. An unexpected uptick in calls about a particular medication or concern can help us spot and address trends as soon as possible.

Although it’s true that big data is the foundation for all of these solutions, they only come to life when that information is boiled down, analyzed and made actionable. Together with our expertise in consumer behavior and clinical care, using actionable data helps us make a positive difference in members’ health and drive waste out of healthcare.




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