Sherri Zink, with a rich experience spanning over two and a half decades, has been instrumental in aiding healthcare payers to extract actionable insights from their data, thereby enhancing the accessibility and effectiveness of healthcare for the population. Currently holding the position of SVP and Chief Data & Engagement Officer (CDEO) at BlueCross BlueShield of Tennessee, she has made significant strides.
Sherri Zink’s noteworthy achievements include establishing a data and analytics center of excellence for her organization, which is Tennessee’s largest health plan, and helping craft its first Health Equity Report. This six-topic review of health disparities is aimed at highlighting issues and informing ways to improve care delivery and outcomes.
BlueCross caters to more than 3.5 million members and maintains a workforce of about 6,500 employees. It’s an independent, not-for-profit health plan and part of the Blue Cross Blue Shield Association, a nationwide consortium of healthcare plans. Furthermore, the company extends its services to other states for diverse national employer groups.
In her role, Sherri Zink is responsible for delivering data insights and prescriptive analytic solutions. These solutions pave the way for the determination of the “next best action” for internal stakeholders, providers, employers, and consumers alike. She takes ownership of the comprehensive analytics strategy spanning the entire corporation. Moreover, Sherri Zink actively advocates for data as a cross-corporate asset, effectively translating information into actionable initiatives that contribute to the well-being of members.
One of Sherri Zink’s unique talents is her ability to translate complex analyses into comprehensible narratives. This capacity has empowered customers, business partners, and thought leaders to not only grasp the insights but also implement changes that elevate their business performance.
In this exclusive interview, Sherri Zink delves into the pivotal role of data in propelling the success stories of healthcare payers. She discusses how data fuels the journey toward enhanced healthcare outcomes for the population and elaborates on her approach to striking a balance between innovation and the essential security and compliance requirements associated with healthcare data.
As the CDEO of your company, what are your primary goals and objectives for the organization?
When we look at this industry, we have Chief Data Officers, Chief Analytics Officers, and Chief Data and Analytics Officers, but rarely do you see “engagement” in that title. At the end of the day, you can have all the data in the world, but if you’re not engaging with it and you don’t have actions associated with it, then it’s not very valuable.
So one aspect I prioritize is the strategic use of data. I aim for our organization to have data ingrained in its DNA, enabling the effective utilization of data to create value for customers. While BlueCross is a health insurer, we also consider ourselves a data company.
Equally significant is the establishment and maintenance of a data and analytics center of excellence. This involves the right technology, talent, and tools to share with key stakeholders who can create value for our members.
Of course, our primary goal is to deliver value and peace of mind to our members, business partners, and customers. Providing data is a big part of that, but we also want to guide them in taking actionable steps based on the insights we provide.
Another crucial objective is to offer proactive consultation to those engaging with us on data and analytics matters.
Lastly, I’m deeply invested in fostering innovation. This includes harnessing new technologies, such as data analytics and artificial intelligence, to enhance the delivery of value and improve products and services for our customers. This focus on innovation also extends to mentoring students who have enrolled in the BlueSky Tennessee Institute are earning a bachelor’s degree in computer science and path to a job offer at BlueCross in just over two years.
I would like to gain insight into your strategy for utilizing healthcare data to enhance client engagement. Could you please provide more details on this approach?
We serve multiple stakeholders through our data and analytics services.
Some of these customers are internal. Our business partners focus on consumer engagement strategies, such as member engagement through population health management programs. We handle the identification and prioritization of patients for outreach, which may include calls, texts, or digital assets. Personalized and relevant information is crucial in this strategy, and data plays a key role in understanding member needs from a population health perspective.
External customers form the second group. We provide valuable information to participating providers in value-based care initiatives, offering a comprehensive view of patients. This helps identify opportunities for us to better serve our members by providing resources to assist with medication adherence and scheduling preventive care visits. Admit discharge transfer (ADT) data from hospitals informs physicians about patient events like hospital discharge or emergency room visits, supporting value-based care arrangements. A BlueCross care manager is also notified simultaneously if the affected patient is assigned to them for support.
Our third focus area is employer groups. By leveraging data, we guide them in optimizing benefit plans and inform them of opportunities to enhance care quality and affordability for their employees, who are in turn our members.
What possibilities does healthcare data hold for improving care delivery?
Integrating healthcare data between provider clinical records and payer claims information is crucial. This holistic view offers a 360-degree understanding of an individual’s health journey, allowing us to see the whole person and meet them where they are, pinpointing engagement opportunities when needed most. Navigating the complex healthcare system is often challenging, and healthcare data can simplify this process for patients.
Another significant point is the expansion of healthcare data beyond clinical settings. It encompasses external factors like social drivers of health, such as food insecurity, transportation issues, and economic burdens. Addressing these aspects is vital for effective healthcare.
Considering factors like weather, environment, and access to resources adds value to healthcare data. This broader perspective aids providers in tailoring treatment plans, considering the holistic well-being of patients.
Enhancing interoperability among health plans, providers, and consumers is another area where healthcare data plays a significant role. By sharing the same data, informed decisions can be made to improve both healthcare costs and quality.
Remote monitoring and real-time data exchange are notable advancements. They offer the potential to guide patients in making timely and relevant decisions about their healthcare journey.
In essence, the potential of healthcare data lies in its capacity to create a comprehensive view, simplify healthcare navigation, and inform decisions for better patient outcomes. And through all of this, part of my role is to ensure we’re working hard to protect the confidentiality and privacy of that data for our members, and that we’re transparent with our members as to with whom we’re sharing that information and why our members benefit from that.
What challenges do you foresee in the realm of healthcare data management?
Three key challenges come to mind.
First, the increasing number of data sources necessitates understanding the healthcare journey. This includes remote monitoring data from devices like Fitbit and Apple Watch, as well as integrating information from employer groups’ onsite clinics, wellness visits, and remote monitoring.
Second, managing data security is crucial. This involves safeguarding Protected Health Information (PHI) and adhering to complex federal and state regulations governing health plan data.
Third, integrating data and analytics functions into operational systems is essential. Data and analytics must be seamlessly accessible to end-users to add real value to their work. Ensuring integration into workflows is vital for effective utilization.
These three challenges — data source expansion, security management, and effective integration — are the primary areas that pose significant challenges in the field.
How do you address these challenges through the implementation of technology?
When considering the obstacles from a CDEO’s perspective, managing the influx of data sources poses a challenge. Meeting the demands of multiple stakeholders within the organization becomes challenging as data’s value grows. Providing self-service tools can ease the pressure on the team by enabling stakeholders to access the information they need.
Showing the value data brings to operations and its role in real-time decision-making is critical to getting support from leaders and stakeholders.
Additionally, securing investments for future technology is a concern. To stay ahead of these challenges, I developed a three-year data and analytics strategy. Through collaborative brainstorming sessions with key stakeholders, we align technology needs with business goals. Around 20 prioritized business use cases are identified, assessed for technology requirements, and tied to ROI and business growth. Skill-set evaluation ensures we have the right team to implement the chosen technology.
This strategy is reviewed annually for adaptability, making it an ongoing, collaborative process with business stakeholders. Such collaboration is integral to our success in navigating these challenges and driving the organization forward.
With emerging technologies, particularly their potential to enhance healthcare plans, how do you evaluate their value and decide which technologies are worth investment?
In terms of potential technologies, a few areas stand out. Generative AI holds promise, though it’s still in its infancy. We’re considering it, but cautiously. Given our stringent PHI regulations, we’re approaching it gradually.
We’re exploring non-PHI use cases, such as content management and personalization, to leverage its capabilities effectively within our regulated environment.
Another focal point is graphical or graph databases. Traditional dashboard development can be limiting, but graph databases like Neo4j offer better pattern visualization, aiding quicker decision-making.
Of course, we’re continuing with traditional machine learning, natural language processing, and predictive analytics. These are crucial for predicting outcomes, enhancing quality, and facilitating visual analytics.
When evaluating these technologies, alignment with our business strategy is paramount. We analyze how each enhances products, services, revenue, quality, and safety. Additionally, we run proof of concepts to identify potential use cases and value for the business.
We’re exploring platforms like Microsoft Azure and Google’s healthcare AI, ensuring data security in a controlled environment. We’re stepping into these technologies methodically, ensuring alignment with our goals and maintaining data security as a top priority.
How do you strike a balance between innovation and the imperative security and compliance demands, particularly in the context of the tightly regulated healthcare industry?
Balancing innovation is indeed complex. Our commitment to client data protection requires rigorous security protocols, which limit external information sharing.
This balancing act involves managing the investment required for regulatory obligations while fostering innovation. To mitigate this, we focus on maximizing innovation with existing technology. We capitalize on the potential of our current framework, finding ways to optimize functionality and drive improvements. By leveraging what we have, we discover opportunities to enhance processes without necessarily introducing new technology.
If you would like to delve further into the specifics of privacy and security related to your customers’ data, such as how you ensure its security, could you please provide more elaboration on these aspects? Your insights would be valuable.
Maintaining stringent data access standards is a core priority for us. Data ownership and protection is an inherent responsibility. This commitment is deeply ingrained in our organizational culture and is why all of our employees undergo annual compliance training.
When it comes to sharing data externally, we’ve established an Information Governance council. This council oversees and approves any third-party data extractions. We enforce comprehensive contracts to ensure data confidentiality and security. This approach maintains executive-level involvement, ensuring data remains within our organization’s confines and under controlled agreements.
Furthermore, data de-identification and aggregation play a significant role. Even within our organization, we limit access to PHI. Instead, we often provide de-identified or aggregated datasets, tailored to specific use cases and information requirements. These strict protocols dictate who can access information within our organization, fostering data security and control.
Concluding our discussion, I’d like to ask if there’s anything I might have missed in this questionnaire.
Health equity has been a significant focus at BlueCross. We wanted a better picture of the health issues and barriers to care faced by our members and Tennesseans as a whole. This would allow us to more effectively partner with healthcare providers to address those issues. This year, we took a major step by releasing our inaugural health equity report.
This report reveals gaps in care across various racial and ethnic groups, shedding light on social drivers that result in a lack of consistent quality care, particularly with regard to chronic conditions, mental health, preventive measures for adolescents and children, and maternal health.
We’re seeking to bridge these gaps. Understanding this data helps support progress that will ultimately deliver better health for everyone, not just vulnerable Tennesseans, regardless of their background. As my colleague Dr. Andrea Willis has said, “Our objective is not just to create awareness, but to demonstrate our commitment to make health equity an ongoing priority.”
The report, accessible to the public, presents data from both our commercial and Medicaid books of business. Interested individuals can find the report at www.bcbst.com/healthequity.
In early 2024, we’ll release an updated version with additional measures.
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