amount of information is not enough. It’s the combination of the three that allow data to do what everyone wants it to do – help make better-informed decisions that will improve quality and lower cost. In terms of technology, the key is making data usable to those that it impacts most. For example, reports need to reach decision makers immediately so they can then be shared with physicians. Once this happens, healthcare organizations can achieve the Triple Aim Plus One: better health outcomes, lower costs and improved patients plus physician satisfaction.
Patricia Birch, Vice President and Healthcare Consulting Practice Head, Cognizant
Healthcare organizations across the value chain do collect
hundreds of thousands of diverse data elements, both in structured and unstructured format, from across the healthcare ecosystem. T e structured data elements are collected in the form of demo- graphic and historical medical data for risk assessment (claims and encounters), clinical data as part of medical care delivery through EHRs (lab results, radiology, EHR data), and lifestyle and behavioral data (remote patient monitoring devices, sensors, personal health records, etc.). Unstructured data is collected from consumer databases, social networking sites, doctors’ notes, customer care logs, etc.
Whether the large amount of data collected per consumer is a waste or not is determined by how this data is used and what information is derived from the available data. Data collection practices need to be revised on a continuous basis to assess the usefulness of certain data types and sources. Most stakeholders are challenged by data gaps, insuffi cient data sources and data quality gaps, in part due to challenges around security and privacy, multiple data standards and inconsistency in data collection prac- tices. T is situation, though challenging, can be turned around to develop consumer and patient insights by embracing analytics, ushering in a culture of collaboration among healthcare players to contextualize the insights generated with the societal behavior and lifestyle pattern of the consumer.
Bonnie Cassidy, Senior Director of HIM Innovation, Nuance It all comes down to collecting the right data for the right
reason, at the right time. Regardless of the type of decision making, the rule of thumb is to only collect the data that you are going to use that meets your needs. So in healthcare, that means carefully culling only information that is relevant to your organization and patient population. T is requires strategic planning and goal identifi cation. In order to improve healthcare quality, we need to be able to
measure it. T e U.S. is a leader in developing reliable measures of healthcare quality, so we need to be collecting the right data. To this point, Dr. John Halamka, refl ecting on the nation’s fi nancial issues, has noted: “Given the recent challenges of Lehman, Merrill, AIG, Wash- ington Mutual, and others, you wonder just how eff ective the IT systems of these companies have been. “Of course they had great transactional systems, disaster recov-
ery, infrastructure and data warehouses. However, did they have the business intelligence tools and dashboards that could have
alerted decision makers about the looming collapse of the industry? Did the fi nancial services industry have controls, risk analysis, or a memory of previous crisis – the Depression, the Japanese banking crisis, Enron/Worldcom? Was it greed, irrational expectations or too much data and not enough information that brought down these great institutions?” To learn from Dr. Halamka’s wisdom, we must challenge the
healthcare industry to collect the right amount of information in an eff ort to meet the needs of everything from quality measures to research and more. [Editor’s Note: John Halamka, M.D., is Chief Information Offi cer of Beth Israel Deaconess Medical Center, Chair- man of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full professor at Harvard Medical School, a practicing emergency physician and a noteworthy author and blogger.]
Tony Jones, M.D., CMO, Philips Healthcare’s Patient Care and Clinical Informatics’ Business Unit
Almost no information can be hurtful to have on hand, but the storage of data and information can certainly be challenging. Aside from clinical information about a patient’s symptoms, vital signs and the treatments and procedures they undergo, think about what would happen if we introduced gene sequencing into the picture. Today, gene sequencing is used primarily to determine the course of treatment for cancer patients. As we reach an infl ection point in the cost of gene sequencing, this data will be routinely added to a patient’s health record. Imagine the kind of impact this data will have on treating infectious diseases – where hours and even minutes matter. T e next time there’s a disease outbreak, we could potentially know the genome of the infectious organism, the susceptibility of the organism to various antibiotic therapies, and determine the correct course of action without wasting precious resources in trial and error. An important factor in managing the growth of data will be eliminating redundancy to avoid storing the same data more than once. If someone receives an MRI of their knee and that data is stored and available to be shared among appropriate providers (at the patient’s direction, of course), it eliminates the need and the cost of repeating the test and generating yet another image to be stored. T ankfully, technologies to store data and information are con-
stantly evolving, and healthcare technology vendors are coming up with new, creative and easy-to-use solutions that enable healthcare organizations to access and analyze that data.
Karen Handmaker, MPP, Vice President, Population Health Strategies, Phytel
T e question is not so much whether they are collecting too much information but whether they are making that wealth of information easily digestible and actionable by their providers. If they are not, their analytical reports are not being optimized and they are likely missing key functionality that will make the diff er- ence between meeting quality and savings targets or not. Next edition: The eight members of HMT’s Think Tank weigh in on how administrators and clinicians know what to do with all of the data they collect, what data they should be collecting and how they know that the data they are collecting are right for what they need.
HMT HEALTH MANAGEMENT TECHNOLOGY December 2013 11