Are you a Scandinavian pop fan? Yes, there is such a thing. It ranges from groups like Abba and Ah-Ha (who can forget their “Take on Me” video), to Ace of Base’s “The Sign”, which represented the most recent popular zenith for the sub-genre when the song reigned supreme on Billboard’s chart for 1994.The song, billed as techno-reggae, had a killer chorus about a couple seeing the signs leading to a break up. Who can forget the catchy “I saw the sign and it opened up my eyes” hook?
Not everyone sees the signs, particularly health executives, who are missing them when it comes to leveraging their data. Thisfrom the Center for Connect Medicine shows that a majority of healthcare executives feel they don't have CEO and senior management support to make needed interoperability investments. While this is troubling it's not really surprising for a couple key reasons:
1. This survey and most of the talk and coverage you see around data in healthcare focuses on the concept of "interoperability" in a narrow sense, which is the exchange of clinical information. In fact, another finding in the survey showed that a majority of those surveyed felt if you just moved to a single EHR platform in your organization you can reach interoperability. The use of data in healthcare has to go beyond only exchanging clinical data records so we have a better view of what is happening to patients in other facilities. This is an important use case, but the need to leverage disparate data goes far beyond that. There are many data sources that must be combined and harmonized to truly make it an enterprise asset including:
- Claims data
- Financial data
- Workforce data
- Survey data
- Social determinants data
- User generated data
This complexity is now larger than just combining clinical records alone for a true view of episodic care across the patient journey. This requires data cleansing, mastering, enriching, and harmonizing. That's before we come to other data issues like segmenting our patient populations with complex rules, and tracking intricate metrics. When we begin to look at data unification across and outside the organization all sorts of business impact can be gleamed through increased quality, reduced costs, and in many cases, increased market share. Tying this enhanced ROI to data management will garner the executive support organizations need rather than narrowly focusing on clinical data exchange. As one of our clients recently said in a meeting, "No money, no mission."
2. The other key issue causing senior executives to miss the signs is the EHR industry itself. The identification of interoperability in a narrow fashion helps executives cling to the hope that the large investment they made in a new EHR will figure out all this data "stuff". Once we really identify the broad and growing needs with a real set of requirements we will quickly see those advanced data management needs far exceed the capabilities of EHR vendors, which at their core are transactional billing systems. This includes the ability to:
- Handle data at scale with hundreds of applications and data sources across the healthcare organization
- Master data sources as they are combined. Not just patient but domains like physician, workforce, and facility all must be mastered for accurate information
- Harmonize and cross walk across sources to make sense of data with millions of codes spanning hundreds of code sets.
- Curate hundreds of metrics and definitions on a constant basis
One of our clients recently said in a talk that for their organization it was imperative that they leverage all their investments in a new EHR, new cost accounting system, new CRM and other applications. The investment in a consolidated, built for purpose data layer acts like a force multiplier and quickly showed a more than 5x ROI based on business impact.
Afrom Fierce Healthcare showcased the work needed to really leverage data. "We're starting to make data interoperable, but we have tremendous work ahead" to make it easier for physicians, payers and patients to access and use data, said Philip Parker, CEO of Coral Health. While interoperability will continue to improve over the next decade the possibility exists now to take an enterprise approach to managing and leveraging data. Organizations that do that now will take a leap ahead of organizations that wait for the broader industry to figure out how to make things work in a seamless plug and play manner.
What is needed is a strategic approach to pulling together business needs for information across the organization. Those needs and opportunities can be aligned with the data challenges to create a strategic approach to creating an enterprise data foundation. This will allow organizations to supply the information needed for diverse stakeholders on a continual basis. Once organizations “see the signs” they can begin preparing for healthcare's digital transformation.