How Health Economics Outcomes Research (HEOR) Can Help Improve Patient Care

Blog Posts  |  13 July 2022

Written by: Cheryl Reifsnyder, PhD

The healthcare system in the United States is under pressure to deliver improved patient outcomes within the framework of value-based care, and to do so under increasingly stringent budgetary constraints. At the same time, the complexity of the decision-making process required for healthcare also continues to grow. Providers are asked to deliver care that is simultaneously high quality, cost-effective, and patient-centered.

To accomplish this, healthcare providers are often required to select from treatment options ranging from biopharmaceuticals to medical devices to healthcare services. The costs and benefits of these different interventions often vary widely. Similarly, the costs and benefits can be economic, clinical, or both. They can also include costs that are difficult to measure outright, as well as benefits directly experienced by the patient, although they may not be obvious externally. This wide range of variables can make the decision-making process extremely difficult.

In the past few decades, health economics and outcomes research (HEOR) has evolved to help with clinical decision-making. HEOR helps healthcare stakeholders to generate insights that can guide the best possible treatments for patients at affordable costs. Keep reading to learn more about what HEOR is and how it is being used to improve patient care.

What is HEOR?

Clinical trials have long been the gold standard for generating data related to potential new medicines and therapies. With clinical trial data alone, however, it can be more difficult to ascertain how effective these new treatments are in everyday life. HEOR is a field of research developed in the past few decades to correct this knowledge gap.

HEOR is used to identify and measure links between medical treatments and the outcomes patients experience. HEOR helps researchers and providers to determine the value of care plan considerations.

  • Health economics focuses on determining the monetary value of outcomes resulting from medical interventions
  • Outcomes research focuses on a set of scientific disciplines used to evaluate how specific medical interventions affect patients
  • HEOR combines the two above fields to generate both economic and outcomes data for medical interventions, allowing providers to use this information to inform healthcare-related decisions

Data generated by HEOR differ from that generated in clinical trials. Clinical trials typically produce measurable clinical data, while HEOR considers a broader range of information. This may include:

  • Clinical outcomes
  • Financial impact
  • Quality of life, as reported by patients
  • Overall satisfaction with the treatment, as reported by patients

HEOR also evaluates data from sources beyond clinical trials, such as insurance databases and patient questionnaires as well as patients’ medical records. Because HEOR looks at a broader range of measures for its evaluations, it can provide insight for a broader range of medical treatments and interventions than providers can gain from clinical trials.

HEOR is especially powerful because of its ability to reveal patient-centered outcomes. Frequently, HEOR studies incorporate patients’ lifestyles, preferences, and voices in their results. Incorporating these variables is crucial because they frequently impact treatment compliance and, as a result, treatment outcomes.

HEOR can also play a key role in identifying diversity among different populations that might influence treatment outcomes. This information can enable healthcare providers to help make treatments more accessible to patients of different socioeconomic groups and backgrounds.

How are HEOR data being used?

Increasingly, healthcare stakeholders are turning to HEOR for evidence-based guidance that will enable them to deliver higher quality of care a lower cost. They use HEOR data to:

  • Help guide healthcare-related investment decisions
  • Inform behaviors of key stakeholders
  • Evaluate the relative value of different outcomes
  • Measure quality within the healthcare system

HEOR for Biopharma and Device

HEOR provides a framework to guide biopharma and device development because it enables stakeholders to clearly define healthcare issues through evaluation of a broad range of economics and outcomes data.

Life science researchers have found a multitude of uses for HEOR data. HEOR can provide powerful data and insights for healthcare decision-makers, such as:

  • Helping healthcare providers select optimal treatment options for patients while considering their individual needs and situations
  • Helping to identify gaps in treatment choices available for different patient populations
  • Promoting the expansion of a label claim with the FDA

HEOR for Payers

HEOR data are also being used by payers. They use HEOR data to evaluate how different treatments work in the populations they serve and to help guide decision-making regarding patient access to specific drugs, therapies, or services. They also use HEOR data to help determine whether specific drug or treatment costs should be reimbursed and, if so, for how much.

Payers use HEOR data to help assess healthcare providers as well. The Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare and Medicaid Services (CMS) both use patient-reported information to help them evaluate the performance of managed care plans under them, so they can reward those that are providing the best patient care.

Veradigm’s contribution to HEOR

Healthcare data are becoming increasingly abundant and increasingly diverse, primed to drive real-time modifications to treatment types, quality, efficiency, and cost-effectiveness. Much of this data is in an unstructured format, such as the physicians’ notes section of an electronic health record (EHR). Accessing this data can seem an insurmountable obstacle.

Veradigm has developed tools allowing real-world data to be extracted from free-text fields in their EHR, making this data available to help with treatment decision-making, medical research, and monitoring the quality of patient care, among other uses.

Veradigm delivered multiple data presentations at the 2022 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conference. Veradigm researchers presented HEOR data on COVID-19, Non-Alcoholic Steatohepatitis (NASH), and cardiovascular disease. Researchers from Veradigm also delivered the presentation, “Comparing Registry and Electronic Health Record (EHR) Data for Real-World Evidence Generation: Heart Failure as a Case Study.” This presentation examined how generation of real-world evidence (RWE) from heart failure patients requires clinical data elements that are not usually found in administrative databases.

Veradigm researchers isolated relevant data from these databases using custom-built analytic tools specifically designed to extract and de-identify patient data from unstructured clinical notes using natural language processing and machine learning. The custom-built tools are unique to Veradigm, allowing extraction of de-identified patient data from Veradigm EHRs and data registries. These solutions for data enrichment provide a valuable tool for life science researchers to address research questions in population health and epidemiology, as well as HEOR and RWE. They can also be used to evaluate increasing volumes of data to improve patient care and optimize clinical outcomes.

Contact Veradigm to learn more about how we can help you generate the RWE required to power HEOR in your organization.

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Veradigm   Health Economics Outcome Research   Biopharma   Payer   Patient Care   Value-based Care   Patient-centered outcomes  

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