Am I the only person who needs a break from trying to understand insurance overhaul and its implications? Reading the two laws and juxtaposing their verbiage is numbing my brain, so I’ve decided to think about something else today. (Don’t fret if you were looking forward to my ongoing commentary on health reform; it will resume next week.)
Today’s diversion—the thought that keeps coming to mind while I ponder the new legislation—is data. Insurance overhaul and relentless evolution of medical science will compel all health sector enterprises to pay unaccustomed attention to the numbers in their many data bases. Operational success will increasingly depend on having good data and the ability to analyze them in real-time.
Quality of data has been a preoccupation throughout my career. (Google Statistical Analysis for Decision Makers in Health Care, Second Edition if you want an understandable, in-depth discussion of data quality.) Having lots of data to analyze is useless if the numbers are not meaningful, accurate, and timely—which is altogether too often the case. Consequently, we need to start paying careful attention to the validity and reliability of numbers that “reform” will impose.
Efficiency of data is a related concern that comes immediately to mind in context of the overhaul legislation. Compliance requirements will force providers and payers to handle more data than ever before, which means that spending on data will quickly become a major concern. (Data costs will be a really big headache for providers also seeking designation as “meaningful users” for HITECH funding.) Managers will need to prevent data duplication, accelerate access to useful data, stop collecting data that have no value, and halt other unproductive expenditures on information.
The overhaul laws will not force us to focus on the quality and cost of data; we must do it ourselves. However, we don’t have an enterprise structure for managing all our data as a single resource. To complicate matters, our data will continue to reside in many locations, both on paper and on disk. We need a system to manage the interface between different data resources, one that integrates principles and devices for total data management (TDM).
OK, I just made up TDM, but it has a nice ring to it…like ERP or CRM. Please give me your suggestions for a better name, but above all, let me know what you think about the need to develop a system for optimizing cost-effectiveness of the paper and electronic data bases we’ve already got. We’re never going to become paperless, and we barely have the time and money to undertake the truly essential steps in digital transformation (e.g., providing all relevant clinical information to all caregivers simultaneously in an EHR). We really need to get a getter bang for the bucks we are already spending on data. I can’t get this thought out of my mind, even with all the other things a health futurist needs to be thinking about these days. What do you think?
2 comments:
Jeff, I think you are spot on with the importance that correct data will play post reform. I spent 25 years operating in the world of health care receivables, struggling with disparate systems and being challenge to provide more meaningful information and data to my customers. I found it paradoxical that medical science could make such advanced strides in improving the health of the US population while the "back office" support of the operation was 10 - 15 years behind in having any true enterprise support system.
As I've watched EMR move along...slowly...I wonder out loud what the chances are that we will get the right data AND know what to do with it.
One final irony. I am struck that your statement "Operational success will increasingly depend on having good data and the ability to analyze them in real-time" is as applicable to those external serving the healthcare receivable needs of healthcare as it is applicable to healthcare directly. Good data (right data, timely data) available in real or near real time is essential to adequately serving the needs of the providers of healthcare AND the patients.
As usual, Dr B., you are spot on! As we move into the world of bundled payment, accountable care organizations, and the overall need for better control over the total care process (TCP -- my acronym on the spot invention), DATA will be Primus inter pares.
When addressing TDM, robust analytics will be essential and the efforts to develop the relevant metrics and thresholds will be critical to tame the data monster -- clinically a few good pieces of actionable data may be more beneficial than reams of data for which the tools or the time do not permit analysis.
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