How to meet all demands to achieve data-driven healthcare

To rebuild healthcare on the foundation of data quality, healthcare leaders must focus on information synthesis and taxonomy, data experts say.

To better treat patients, providers need to consistently have the right data at the right time and in the right format.

Components of the Quadruple Aim have been at the center of healthcare organizations’ operational improvement efforts for at least the last couple of decades.

But achieving better experiences for clinicians and patients, while simultaneously reducing costs and improving care, have also seemed to be mutually exclusive.

Two data experts understand this conflict, but they say healthcare providers will only be able to achieve the Quadruple Aim when they can consistently get the right data at the right time and in the right format.

In a presentation in a recent HDM KLASroom, John Lee, MD, senior vice president and chief medical information officer at Allegheny Health Network at the time of this presentation, and Dale Sanders, chief strategy officer at Intelligent Medical Objects, examined what role data quality needs to play in healthcare’s path to a digital revolution.

Lee’s work as a physician informaticist and Sander’s background in ballistic missiles and as a CMIO give these experts unique perspectives on the digitization of healthcare.

The right data

Sanders cited several studies showing that as much as 90 percent of the data needed to optimize patient health resides outside of the EHR. This shouldn’t be surprising, he explained, when we understand that the average American patient goes to their local clinic only three times per year.

“Three samples of data per year about me as a patient is not enough,” Sanders said. “It's time to get past the EHR and really drive a digital strategy into healthcare. I'd love to see digiticians and their staff members acting more like intelligence analysts in the military.”

The right time

Lee, with a background as an emergency physician, transitioned into information systems (IS) with the goal of making things easier and better for his provider colleagues. He gained a clearer view of the dysfunction in healthcare and how many problems could be solved if data were available when it needed to be.

“Our information-delivery system in medicine right now is comparable to unguided missiles. Data points are just indiscriminately being displayed to different people in the wrong place and at the wrong time. That creates a huge amount of friction and is causing a lot of poor decisions to be made,” Lee contended.

“My professional goal is to try to help solve the digital asymmetry in healthcare and change those unguided missiles into precision munitions,” he added.

The right format

Lee and Sanders asserted that even the right data isn’t useful to providers if it isn’t intelligible, synthesized and in a standard language.

“We need more people translating what the data is and what it actually means to the stakeholders,” Lee said. “You have to do a lot of synthesis — almost semantic governance or translating. You have to be kind of a Rosetta Stone between the real world and data.”

“At a very tactical level, if you are a C-level who is passionate about being data-driven in your organization, you should start by fixing your master data catalog behind your EHR,” Sanders urged.

“Three-fourths of our lab results and lab orders that we as patients depend on for safety and treatment have no coded vocabulary associated with them. There's no consistency in the catalogs across the country, much less in individual organizations,” Sanders added. “In terms of interoperability, we've proven that we can exchange messages. But there's garbage in those messages because we haven't fixed the fundamental taxonomy and language of healthcare.”

That kind of project may not sound very glamorous. But Lee argued that a first-world society — and a first-class healthcare system — can be built only on the fundamentals of infrastructure.

 “The care and maintenance of our physical infrastructure, even though it's very, very complex, is something that we just take for granted,” Lee said. “We have to get there with our healthcare data, too. We need that governance, that cleanliness. We need to clean up the sewage of our healthcare data infrastructure.”

The right Leaders

So what can healthcare executives do? Regulatory frameworks and payment models may have C-levels feeling that they have little power to innovate. But Lee and Sanders agreed that leaders can help their organizations make real progress by gaining deeper understanding and having “a passionate insistence on being data driven.”

“If you're an executive, be like a toddler,” Lee suggested. “Ask ‘Why?’ again and again and again. And each of those whys can then be related to a particular project and a measurable goal.”

Sanders concluded that, “What I'd love to see is a new generation of executives — maybe people who have spent some time in the military — who know what it's like to depend on data to inform life-critical decisions, and then carry that passion, independent of economic incentives, into the organizations they lead.”

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