How Aetna uses patient data to prevent diabetes and heart attacks

With 30 million customers and more historical and new data information coming in all the time, Aetna (s aet) has big data. Under a new initiative, Aetna Innovation Labs, the insurer is trying out several approaches to use all that data to keep patients healthy, lower customer costs and decrease the company’s own spending on health care.
Speaking with my colleague Ki Mae Heussner at GigaOM’s Structure:Data conference on Wednesday, Aetna’s head of innovation, Michael Palmer, opened up about the Innovation Labs’ initiatives, the challenges they face and the neat opportunities ahead.
The Innovation Labs has focused on a few conditions since starting last year, including cancer, heart disease and metabolic syndrome. There are five telling signs to metabolic syndrome, including a large waist circumference and high blood pressure. Metabolic syndrome is a sort of gateway for diabetes, cardiovascular issues and other conditions, so Aetna wants to prevent patients from getting metabolic syndrome in the first place. It has started using data on 18 million of its customers’ employees to tell doctors which of the five signs of metabolic syndrome their patients are likely to get in the next year, Palmer said.
Aetna appears to want to pull in more kinds of data for patients and physicians to examine to provide better care. Asked if Aetna will start working in genomic data, Palmer said the Aetna Innovation Labs are running a pilot with some companies to allow patients to get their own genetic information and receive genetic counseling. “That will drive a wellness program driven around genomics,” he said.
And social information from patients could provide much-needed feedback to show how effective a medication is in real time, for that patient and for others. “Some companies are doing that,” Palmer said, referring to incorporating social streams into health care. “The challenge is, a lot of HIPAA laws prevent the ability to connect those two in a way that would be ultimately useful,” he said.
Aside from regulatory compliance, patients simply might not want to share as much data as insurers and doctors want them to, as it could get out to the wider public. Keeping health data out of employers’ hands, for example, is playing out right now, as Ki Mae mentioned, with media outlets reporting on Wednesday that CVS employees provide health information or pay up. But Palmer said Aetna has been working with large patient data sets for many years, though, and is cognizant of complying with HIPAA laws.
It’s ironic, but Aetna — and probably others in the health care community — finds a challenge in getting people to work on their own health. Companies want to see that, so their employees will stay healthier and work more, Palmer said.
Toward that end, Aetna is looking to work with other companies, mainly small startups, on what Palmer called “medication adherence” — texting, calling or otherwise contacting patients about taking their medications and doing other things to improve their health. It’s not easy, though, because, as Palmer said, what works for some patients doesn’t necessarily work for others.
Check out the rest of our Structure:Data 2013 coverage here, and a video embed of the session follows below:
A transcription of the video follows on the next page