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Building trust in data decisions: Leveraging the Accolade data observability framework

By Matt Wurst, Senior Director, Software Engineering, Accolade | June 07, 2024 | 3 min read

The future of healthcare requires more than traditional care delivery – it demands connection, trust, and personalization like never before. At Accolade, we believe everyone deserves to live their healthiest life, which is why we focus on care delivery, case management, advocacy and a value-based model. What our teams at Accolade understand – that many in the industry either take for granted or fail to achieve – is that the seemingly simplistic objective of seamless healthcare service delivery relies on a complex system of robust, secure, reliable data pipelines.

So, what’s that? Let’s pull it apart. Not unlike our intricate healthcare system, modern data pipelines are a complex web of interwoven connections. Any disruption or delay in those connections creates a cascade of adverse impacts on people as they try to book appointments or manage other aspects of the healthcare journey. Maintaining the integrity of these pipelines ensures uninterrupted, high-quality care delivery, case management, follow-up and ultimately the entire care and advocacy experience. It’s the hidden critical component to closing the Physician Gap.

The role of data observability in healthcare

Enter our exceptional data infrastructure and engineering teams. They play a pivotal role in knitting together disparate healthcare data sources, laying the foundation for unparalleled, personalized patient journeys, all powered by a data stack hosted on AWS (Amazon Web Services).

To tackle potential data latency, we’ve rolled out an advanced monitoring framework in collaboration with Monte Carlo. This partnership empowers us to take a proactive approach towards data analysis. Consider our utilization management (UM) and claims data – crucial inputs from health plans and pharmacy benefit managers that drive our business operations. Unreliable UM data can lead to unnecessary medical spending for customers, making it challenging to control healthcare expenses and potentially causing year-over-year increases in premiums. To manage reliability of these systems we use scenarios within the UM data pipeline as a foundation for constructing monitors.

These monitors harness machine learning models trained on past data to detect deviations from the norm and promptly alert our teams. It sounds simple, but these alerts can tell us a lot. They vary in complexity from straightforward instances like the absence of claims for a specific health plan for an unusual duration, to intricate patterns such as significant spikes in UM denial rates for a particular procedural category compared to historical data. These proactive notifications equip us to move fast, investigate, resolve issues – even with carriers – and provide a frictionless experience that members love.

Why trust and confidence matter in data decisions

Drawing on years of healthcare data experience, our teams bring invaluable insights to bear on identifying key use cases for monitor construction and understanding the drivers behind business and operational impact. Experience – and more importantly trust – is crucial in ensuring that the data we use is accurate and reliable, but confidence is equally important. Confidence in our data sources and handling methods allows us to make bold decisions and take calculated risks. Only by harmonizing these elements can we develop monitors that deliver tangible business value, driving successful outcomes and fostering innovation in our processes.

It’s time to set a new pace in healthcare. The Physician Gap is real, and if we continue to move at the old pace, that gap just grows. Better, faster healthcare relies on our ability to trust our data-driven decisions and act. Accolade's Data Observability Framework, in partnership with Monte Carlo, ensures that our data pipelines remain robust, secure, and reliable. This level of data fidelity not only enhances operational efficiency but also empowers our team to deliver personalized, high-quality care that meets the unique needs of each member. For HR benefits leaders, this translates into tangible value: peace of mind, improved healthcare outcomes, reduced costs, and a seamless experience that fosters trust and satisfaction among employees.

By choosing Accolade, you are partnering with a team dedicated to driving innovation and excellence in healthcare, aiming to enhance the well-being of your workforce.

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