The Patient Revolution
How Big Data and Analytics Are Transforming the Health Care Experience
Wiley and SAS Business Series

In The Patient Revolution, author Krisa Tailor?a noted expert in health care innovation and management?explores, through the lens of design thinking, how information technology will take health care into the experience economy. In the experience economy, patients will shift to being empowered consumers who are active participants in their own care. Tailor explores this shift by creating a vision for a newly designed health care system that's focused on both sickness and wellness, and is driven by data and analytics. The new system seamlessly integrates health into our daily lives, and delivers care so uniquely personalized that no two people are provided identical treatments. Connected through data, everyone across the health care ecosystem, including clinicians, insurers, and researchers, will be able to meet individuals wherever they are in their health journey to reach the ultimate goal of keeping people healthy.

The patient revolution has just begun and an exciting journey awaits us.

Praise for the patient revolution

"A full 50% of the US population has at least one chronic disease that requires ongoing monitoring and treatment. Our current health care system is woefully inadequate in providing these individuals with the treatment and support they need. This disparity can only be addressed through empowering patients to better care for themselves and giving providers better tools to care for their patients. Both of those solutions will require the development and application of novel technologies. In Krisa Tailor's book The Patient Revolution, a blueprint is articulated for how this could be achieved, culminating in a vision for a learning health system within 10 years."

?Ricky Bloomfield, MD, Director, Mobile Technology Strategy; Assistant Professor, Duke Medicine

"In The Patient Revolution, Krisa Tailor astutely points out that 80% of health is impacted by factors outside of the health care system. Amazon unfortunately knows more about our patients than we do. The prescriptive analytics she describes will allow health care providers to use big data to optimize interventions at the level of the individual patient. The use of analytics will allow providers to improve quality, shape care coordination, and contain costs. Advanced analytics will lead to personalized care and ultimately empowered patients!"

?Linda Butler, MD, Vice President of Medical Affairs/Chief Medical Officer/Chief Medical Information Officer, Rex Healthcare

"The Patient Revolution provides a practical roadmap on how the industry can capture value by making health and care more personalized, anticipatory, and intuitive to patient needs."

?Ash Damle, CEO, Lumiata

"Excellent read. For me, health care represents a unique economy?one focused on technology, but requiring a deep understanding of humanity. Ms. Tailor begins the exploration of how we provide care via the concepts of design thinking, asking how we might redesign care with an eye toward changing the experience. She does an excellent job deconstructing this from the patient experience. I look forward to a hopeful follow-up directed at changing the provider culture."

?Alan Pitt, MD, Chief Medical Officer, Avizia

"Whether you're a health care provider looking to gain an understanding of the health care landscape, a health data scientist, or a seasoned business pro, you'll come away with a deeper, nuanced understanding of today's evolving health care system with this book. Krisa Tailor ties together?in a comprehensive, unique way?the worlds of health care administration, clinical practice, design thinking, and business strategy and innovation."

?Steven Chan, MD, MBA, University of California, Davis

Preface xv

Acknowledgments xvii

About the Author xix

Part 1 Think 1

Chapter 1 Introduction 3

Pain Points 4

Birth of a Start-up 5

Experience Is the Teacher of All Things 7

#healthcaretrends 10

Chapter 2 Insight 15

The Experience Blueprint 17

Dennis’s Story 20

Defining My Criteria 23

Chapter 3 Inspiration 29

Learning from Banking 31

Learning from Retail 32

Learning from Healthcare 34

But How Do They Do It? 35

Chapter 4 Ideation 39

The Fun Part 40

Healthcare 2020 40

Patient Empowerment 42

The Personal Health Cloud 45

Part 2 Do 49

Chapter 5 Implementation Part 1 51

From Ideas to Reality 52

Technology Feasibility 53

Big Data 55

Analytics 59

Trends Impacting Advanced Analytics 61

Kicking It Up a Notch 74

Behavioral Analytics 75

Personal Health Analytics 77

Visual Analytics 79

Chapter 6 Implementation Part 2 85

Back to the Blueprint 86

Changing Behavior 86

Tools for Providers and Payers 87

Population Health Analytics 88

Consumer Tools 91

Consumer Choice and Transparency 97

Where Will Transparency Lead Us? 99

What Is an APCD? 101

What’s the Landscape? 102

The Key to Success: Big Data Analytics 107

Establishing an APCD 108

Why APCDs? 112

Clinical Trial Data Transparency 113

Chapter 7 Implementation Part 3 117

Why Volume to Value? 118

The Shifting Incentive and Its Adoption 119

Why Episode Analytics? 121

Constructing an Episode of Care 122

What Constitutes an Episode of Care? 123

Calculating the Cost of an Episode 124

Patient and Population: Analyzing Costs and Outcomes 125

The Holistic View of a Patient 130

Provider Performance 130

Diagnosis and Personalization 132

Machine Learning and AI 134

Natural Language Processing 136

Chapter 8 Innovation 141

Putting It All Together 142

Design Thinking Tools 143

Exponential Growth 145

Modernization 148

Traditional → Modern 152

Interoperability Roadmap 153

Chapter 9 Individual 157

Where do we go from here? 159

Build for How the Healthcare System Should Work 162

Rethink Workflows and Experiences 163

Develop Things That Work Together 165

Close the Loop 166

Final Thoughts 166

Appendix Chapter Summaries 169

Part 1: Think 170

Part 2: Do 176

Index 187

KRISA TAILOR is a Global Industry Consultant in SAS' Health & Life Sciences Global Practice where she helps health care organizations worldwide to address today's most pressing challenges in health care service and delivery. She has worked across a variety of areas within health care, including policy, product management, and consulting. She is also the CEO and cofounder of Remedy—a digital platform for chronic pain management (remedymypain.com).

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