Original map by John Snow showing the clusters of cholera cases in the London epidemic of 1854, drawn and lithographed by Charles Cheffins. (Published by C.F. Cheffins, Lith, Southhampton Buildings, London, England, 1854 in Snow, John. On the Mode of Communication of Cholera, 2nd Ed, John Churchill, New Burlington Street, London, England, 1855.)
Now that we have the assistance of computers and big data, we can do the same sort of work that John Snow did, but on a much higher level. We can focus on any procedure, diagnosis, or prescription about which we record copious amounts of data.
In some cases, we identify potential fraud, waste, and abuse problem areas by using a mapping technique known as hotspotting in combination with statistical modeling. This is a data-driven mapping process that lets us identify extreme patterns in a defined region of the healthcare system while controlling for known causes of variation.
Identifying trouble spots
It is a common practice to use road network data to analyze ambulance rides to hospitals. Sometimes, the mileage claims don’t match up with the distance between the patient and the provider. So, if an ambulance company claims that it drove 100 miles to deliver a patient to a provider, we can map the two locations and see if someone’s padding the books. We can use the same tools to analyze home healthcare claims. If a provider claims to have visited 20 patients within a 100-mile radius in an hour, that’s an obvious problem. And we can do this across thousands of claims with limited data (e.g., patient addresses missing), helping identify patterns and concerns that can then be addressed, ultimately resulting in cost savings.
Really, there’s no limit to the number of things we can analyze using these sophisticated mapping tools and algorithms. You can map the prevalence of prescriptions for certain drugs or surgical procedures like C-sections, or medical conditions such as low birth weight, and uncover meaningful patterns that can lead directly to better health care. At Cognosante, we regularly use sophisticated auditing algorithms and GIS tools for Medicaid program improvement. These tools can help businesses, government agencies, and healthcare organizations pinpoint improvements, which ultimately leads to better health care for patients.
In many cases, the answers that our clients are looking for are buried so deeply in the data that they’re extremely difficult to see. That’s why it helps to have a really great map.