According to a recent article in the LA Times, healthcare costs in the United States far exceed costs in other countries. For example, heart bypass surgery costs an average of $75,345 in the U.S. compared to $15,742 in the Netherlands and $16,492 in Argentina. In the U.S. healthcare accounts for 18% of the U.S. GDP and is increasing.
Michelle Blackmer is an healthcare industry expert at Informatica. In this interview, she explains why business as usual isn’t good enough anymore. Healthcare organizations are rethinking how they do business in an effort to improve outcomes, reduce costs, and comply with regulatory pressures such as the Affordable Care Act (ACA). Michelle believes a data-driven healthcare culture is foundational to personalized medicine and discusses the importance of clean, safe and connected data in executing a successful transformation.
Q. How is the healthcare industry responding to the rising costs of healthcare?
In response to the rising costs of healthcare, regulatory pressures (i.e. Affordable Care Act (ACA)), and the need to better patient outcomes at lower costs, the U.S. healthcare industry is transforming from a volume-based to a value-based model. In this new model, healthcare organizations need to invest in delivering personalized medicine.
To appreciate the potential of personalized medicine, think about your own healthcare experience. It’s typically reactive. You get sick, you go to the doctor, the doctor issues a prescription and you wait a couple of days to see if that drug works. If it doesn’t, you call the doctor and she tries another drug. This process is tedious, painful and costly.
Now imagine if you had a chronic disease like depression or cancer. On average, any given prescription drug only works for half of those who take it. Among cancer patients, the rate of ineffectiveness jumps to 75 percent. Anti-depressants are effective in only 62 percent of those who take them.
Organizations like MD Anderson and UPMC aim to put an end to cancer. They are combining scientific research with access to clean, safe and connected data (data of all types including genomic data). The insights revealed will empower personalized chemotherapies. Personalized medicine offers customized treatments based on patient history and best practices. Personalized medicine will transform healthcare delivery. Click on the links to watch videos about their transformational work.
Q. What role does data play in enabling personalized medicine?
Data is foundational to value-based care and personalized medicine. Not just any data will do. It needs to be clean, safe and connected data. It needs to be delivered rapidly across hallways and across networks.
As an industry, healthcare is at a stage where meaningful electronic data is being generated. Now you need to ensure that the data is accessible and trustworthy so that it can be rapidly analyzed. As data is aggregated across the ecosystem, married with financial and genomic data, data quality issues become more obvious. It’s vital that you can define the data issues so the people can spend their time analyzing the data to gain insights instead of wading through and manually resolving data quality issues.
The ability to trust data will differentiate leaders from the followers. Leaders will advance personalized medicine because they rely on clean, safe and connected data to:
1) Practice analytics as a core competency
2) Define evidence, deliver best practice care and personalize medicine
3) Engage patients and collaborate to foster strong, actionable relationships
Take a look at this Healthcare eBook for more on this topic: Potential Unlocked: Transforming Healthcare by Putting Information to Work.
Q. What is holding healthcare organizations back from managing their healthcare data like other mission-critical assets?
When you say other mission-critical assets, I think of facilitates, equipment, etc. Each of these assets has people and money assigned to manage and maintain them. The healthcare organizations I talk to who are highly invested in personalized medicine recognize that data is mission-critical. They are investing in the people, processes and technology needed to ensure data is clean, safe and connected. The technology includes data integration, data quality and master data management (MDM).
What’s holding other healthcare organizations back is that while they realize they need data governance, they wrongly believe they need to hire big teams of “data stewards” to be successful. In reality, you don’t need to hire a big team. Use the people you already have doing data governance. You may not have made this a formal part of their job description and they might not have data governance technologies yet, but they do have the skillset and they are already doing the work of a data steward.
So while a technology investment is required and you need people who can use the technology, start by formalizing the data stewardship work people are doing already as part of their current job. This way you have people who understand the data, taking an active role in the management of the data and they even get excited about it because their work is being recognized. IT takes on the role of enabling these people instead of having responsibility for all things data.
Q. Can you share examples of how immature information governance is a serious impediment to healthcare payers and providers?
Sure, without information governance, data is not harmonized across sources and so it is hard to make sense of it. This isn’t a problem when you are one business unit or one department, but when you want to get a comprehensive view or a view that incorporates external sources of information, this approach falls apart.
For example, let’s say the cardiology department in a healthcare organization implements a dashboard. The dashboard looks impressive. Then a group of physicians sees the dashboard, point out erroes and ask where the information (i.e. diagnosis or attending physician) came from. If you can’t answer these questions, trace the data back to its sources, or if you have data inconsistencies, the dashboard loses credibility. This is an example of how analytics fail to gain adoption and fail to foster innovation.
Q. Can you share examples of what data-driven healthcare organizations are doing differently?
Certainly, while many are just getting started on their journey to becoming data-driven, I’m seeing some inspiring examples, including:
- Implementing data governance for healthcare analytics. The program and data is owned by the business and enabled by IT and supported by technology such as data integration, data quality and MDM.
- Connecting information from across the entire healthcare ecosystem including 3rd party sources like payers, state agencies, and reference data like credit information from Equifax, firmographics from Dun & Bradstreet or NPI numbers from the national provider registry.
- Establishing consistent data definitions and parameters
- Thinking about the internet of things (IoT) and how to incorporate device data into analysis
- Engaging patients through non-traditional channels including loyalty programs and social media; tracking this information in a customer relationship management (CRM) system
- Fostering collaboration by understanding the relationships between patients, providers and the rest of the ecosystem
- Analyzing data to understand what is working and what is not working so that they can drive out unwanted variations in care
Q. What advice can you give healthcare provider and payer employees who want access to high quality healthcare data?
As with other organizational assets that deliver value—like buildings and equipment—data requires a foundational investment in people and systems to maximize return. In other words, institutions and individuals must start managing their mission-critical data with the same rigor they manage other mission-critical enterprise assets.
Q. Anything else you want to add?
Yes, I wanted to thank our 14 visionary customer executives at data-driven healthcare organizations such as MD Anderson, UPMC, Quest Diagnostics, Sutter Health, St. Joseph Health, Dallas Children’s Medical Center and Navinet for taking time out of their busy schedules to share their journeys toward becoming data-driven at Informatica World 2014. In our next post, I’ll share some highlights about how they are using data, how they are ensuring it is clean, safe and connected and a few data management best practices. InformaticaWorld attendees will be able to download presentations starting today! If you missed InformaticaWorld 2014, stay tuned for our upcoming webinars featuring many of these examples.