MediCUBE: Making Health Data Actionable

Oct 15, 2015
Express Scripts informatics tools are changing the way clients control healthcare costs and increase profitability.
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  • Compound Medications

It’s no secret that the United States needs to take aggressive action to reduce the cost of its healthcare, but this should not require a reduction in services quality or positive treatment results. It is our firm belief that Big Data has a prominent role in achieving the cost and quality goals we seek. But, while the country possesses an incredible amount of heath data, not enough of it is being used to effect change by being converted into actionable insights.

Enter MediCUBE® – Express Scripts’ advanced diagnostic and data mining platform containing over 11 billion prescription claim records and 4 billion medical claim records for nearly 180 million patients linked to the most comprehensive provider database in U.S. healthcare. Although MediCUBE manages and integrates an impressive amount of data, its real value comes by enabling its users to quickly and efficiently mine its 30+ terabyte database for insights that can help solve some of the country’s largest healthcare challenges.

To illustrate the power of MediCUBE, consider this example:

Unnecessary and Costly Compound Medications

A health plan recently used MediCUBE to identify and analyze the compound drug prescriptions being dispensed by the pharmacies within its network. Within seconds, MediCUBE revealed precisely which compound prescription ingredients were driving excessive costs for the plan, and the prescribing physicians and dispensing pharmacies responsible for the unnecessary, costly drugs. The top 10 compound prescribers in its network accounted for more than $7 million in spend in just one year.

We were then able to drill-down to the individual prescriber level and view the claims associated with each of their patients. There, we uncovered useful information, such as a podiatrist who was commonly prescribing resveratrol – a plant-based compound that lacks FDA approval and is available over-the-counter for just $160.

This podiatrist was billing the plan sponsor more than $4,600 each time he prescribed this compound, and the plan was covering almost all of those costs. The plan and Express Scripts collaborated to ensure that these sorts of poor prescribing practices are no longer being covered by this plan.

Mining Big Data for Actionable Nuggets

Healthcare industry data is increasing in complexity and volume. Thus, healthcare data science professionals are challenged to integrate, control and convert these vast amounts of data into useful, actionable bits of information. They are additionally challenged by the fact that users want access to the actionable bits of information in real-time and in a format suitable for making the best possible decisions at the best possible time. MediCUBE helps Express Scripts’ clients to easily mine Big Data to uncover cost drivers and quality issues; giving plan sponsors precision in directing resources to the issues affecting patients.

Author Bio

Tom Henry
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