Everyone needs healthcare. Young or old, sick or healthy, our bioelectric “machines” that carry us around need regular maintenance and check-ups. Sometimes we need a major overhaul or a part replaced. When I take my car in for routine maintenance, the dealership has access to every oil change, tire rotation and service my car has ever received since purchase, regardless of which dealership I visit. Why is it, then, that my doctor can’t access my personal medical history and the hospital does not have my list of medications which I provided to an affiliated doctor?
In a word, Governance.
The Healthcare Data Evolution
Healthcare has evolved since the days when a physician cared for a community of people who generally stayed within easy access to the history and records of their lifetime of healthcare. It was not unusual for a person to see the same physician or at least the same physician practice from birth through death and every life-event in between. In this type of insulated environment, there was no reason to develop, or even think about, information as data. Hand written notes in big paper files were the norm then, and unfortunately in many cases today still the norm. So, what changed?
It is a little difficult to wrap our minds around the significant changes that have occurred in the past two decades in healthcare and even more daunting to think about where healthcare is headed in the next two decades. I liken our current place in history to the computer era in 1980. Advancements are occurring at a pace that most people and few medical practitioners can keep up with.
In 1990, my office at Merrill Lynch was installing the first PCs (personal computers) replacing the mainframe terminals of green or amber text on a black background. Those PCs were state of the art technology and dramatically changed the way we interacted with our clients. Suddenly the information about their investment objectives, purchasing history, and demographic information was available at our fingertips. It was amazing! When I think back on that moment in time, using a Windows 3.1 PC and how it felt to be so “cutting edge,” I chuckle a bit. The phone I carry in my pocket now has more computing power than those mainframes that required temperature controlled rooms to house them. Instead of being connected to New York by a transcontinental cable network, I am connected to the world via Facebook, Instagram and Twitter. Just the other day I had a Skype conversation from California with a friend in Sweden. Instant access has become so commonplace that we think of it as “normal,” in fact, an entire generation thinks of it as a right.
This dramatic change of pace has impacted healthcare too. Doctors today can look at radiology imagery from their phones in rural West Virginia and telemedicine makes it possible for a doctor in London to consult on a complicated case in Hong Kong. But, there is a very important piece of the puzzle missing. With few exceptions, healthcare does not utilize a standard language, and I am not talking about English versus German. The practice of medicine is still largely paper based. The conversion of written information into codified data points has not occurred. Some attempts to standardize the language of medicine have begun in the International Codes for Diagnosis or ICD-9/ICD-10 code sets and the National Uniform Claim Code (NUCC) provider specialty taxonomy lists.
However, even in America, their adoption is not complete.
What Data Governance Brings to the Table
To truly take advantage of the information from a hundred years of handwritten notes and disparate data sources, standard nomenclature and the digitization of data must occur. This is why data governance is so critical. Data governance provides the framework and repeatable patterns to transform our healthcare information into data that can be utilized to accelerate the science of medicine. The information exists, it is just not accessible.
Healthcare organizations, particularly under the mandates of HITECH and the Accountable Care Act, have begun the journey of modernizing healthcare information systems to resemble those used by the supply chain and finance industries. This huge investment is often hard to justify, primarily because the benefits are not being realized as expected.
“Governance is not just about control and decision making, it’s how you enable the effective use of Data and Information to drive value and align it to the stakeholders which companies serve. Growth in healthcare company’s data consumption and processing continues to grow exponentially, however across the board most companies struggle with driving the value they expect to receive from this volume and investment; putting in place the right decision making and governance processes at the enterprise level is critical.” - Bill Fandrich, CIO of Blue Cross Blue Shield of Michigan in a pre-release review of the recent book, Get Governed: Building World Class Data Governance Programs by Morgan Templar.
Getting the basics of data governance right will be one of the most critical aspects in the explosion of health science. Promises such as individualized medicine based on genomic sequencing, on-demand medical diagnosis and treatments, stem-cell therapies, and even the introduction of Nano-technology to repair the human body at the cellular level are going to require access to more data in standardized ways. It is not going to happen in a paper and fax based medical environment. Good data governance is the key to modernizing healthcare information to carry us through this century and beyond.
Contact us today to see how DATUM can help you accelerate your data governance initiatives.