John Walton is Solutions Manager, Technology Services, CTG and Hamish Stewart-Smith, Managing Director for the North American Healthcare Business Unit at CTG recently took time talk with Health IT Outcomes about all things enterprise information management.
Q: There are several frequently-discussed reasons organizations are turning to enterprise information management (EIM) – compliance, reporting and improved patient care are just a few. What are some of the other lesser-known benefits of becoming data driven?
Walton: Consistency and confidence in your decisions. Time and again we see that healthcare organizations have a multitude of algorithms for computing KPIs and measurements. As a result, various departments may all track for the same performance metric but measure success differently – it’s akin to each department speaking a different language. We’ve all been in a meeting where two individuals come up with different answers to the same questions – that’s a result of bad data or bad data governance.
By implementing EIM principles like data stewardship and accountability, each department will look at the same data, use the same algorithm and ultimately speak the same language. As a result, organizations no longer second guess their decisions, or run the same report multiple times to confirm information.
Stewart-Smith: A strong EIM program also creates a basis for crystal clear accountability. A healthcare client recently developed a dashboard around population health with data showing how to drive improvements and refine operations, that also tracks how the organization is improving. With well-defined goals and insights into where the company stands against those goals, the organization was able to hold its leadership team accountable for promised improvements. The dashboard also provided the leadership team with a mechanism through which they could demonstrate how refined operations impacted the healthcare organizations’ outcomes.
The key to making dashboards actionable in this manner is ensuring that they move beyond static reporting and enable users to drill down into relevant metrics and derive true intelligence. This allows leadership to dig into the data when they see an issue, assign a task, and then see how those actions impact the problem. It’s much more valuable that seeing an issue, guessing what the underlying issue is, and then waiting for another report to confirm or rule out your suspicions.
Q: What segment of the healthcare industry is benefiting the most from EIM? And what segment has yet to realize its full potential and why?
Walton: Life sciences has historically been ahead of the game. They’ve leveraged master data management since the late 1990s – way before other industry segments. The payer market is also notable when it comes to acquiring data warehouses and investing in analytics.
The provider market is behind. In recent years, they have focused on nascent issues like addressing meaningful use, converting to and integrating electronic health records, and so on. Needless to say, there have been several competing initiatives that have prevented providers from implementing and reaping the benefits of a strong enterprise information management initiative.
Stewart-Smith: I completely agree. Healthcare providers have lagged in adopting full-fledged EIM programs. As they get started, they should consider smaller initiatives rather than trying to “boil the ocean.” For instance, instead of trying to obtain a wide-ranging view of data across the entire healthcare system, it can be very beneficial to analyze specific disease state problems. For example, if your system is experiencing an issue with hospital acquired infections, perhaps it makes sense to have a laser focus on C. Diff.
This approach allows organizations to leverage the different disciplines of EIM to determine what is going on—whether it’s a clinical problem or data issue—and hone in on the workflow, how information is collected, and if the training is adequate for everyone involved. By looking at a tangible and tightly defined problem, hospitals and healthcare systems can begin to see results around important issues.
Q: What are the biggest challenges that healthcare organizations face when it comes to their data? And how are they overcoming those challenges?
Walton: When EIM initiatives fail, it is most often due to a lack of a long-term C-Suite commitment. In reality, there are a handful of subject matter experts that are involved in multiple strategic initiatives, including EIM. Without buy-in from the top-down, the project will die on the vine as other initiatives come along.
I once met with the entire C-Suite at a healthcare payer around their EIM project and they were not engaged. I asked the CEO, “How many members are you responsible for?” I then proceeded to ask every other executive the same question and received different answers from each. At that moment, the lightbulb went off. It’s imperative that your entire organization is on the same page about fundamental metrics. And while the executive sponsor doesn’t need to be the CEO, it’s critical that he or she consider data to be a strategic asset.
Of course, executive leadership is not the only stakeholders critical to the success of an EIM initiative. To keep the momentum going, individuals from a host of disciplines including finance, operations, and customer service must be involved and engaged. Essentially, you want to establish an EIM operating committee that will become the linchpin of the entire program. What you don’t want is an IT-only driven initiative. Just having a committee isn’t enough though. Everyone needs to have buy in, they need to be incented to participate, and there must be a charter in place to guide their work.
Stewart-Smith: Another common reason these initiatives fail is a lack of focus on the business issue. From the outset, the committee needs to identify the strategic plan for the organization and how they intend to use data to support it. All too often companies go overboard and implement a project with the goal of finding the problems in the data. While it’s difficult to step away from the daily rush and tactical decisions involved in running a healthcare organization, it’s essential that the committee slow down to ask high-level questions as they begin their EIM journey.
Q: We’re seeing an increase in technology within patient care, what role will EIM play in the digitization of the field? What should healthcare players be considering now as they prepare for the future?
Walton: It’s hard to have a conversation about EIM without touching on big data, which is where the future lies. We’re increasingly seeing the industry tap into sources like unstructured, click stream data from social media websites. John Hopkins is doing some very innovative work in this space that underscores what’s possible as more systems are integrated. The healthcare system recently leveraged Google Flu to understand local web searches for flu symptoms and then applied that information to better understand how to properly staff their hospital.
When it comes to EIM, it’s not sufficient to throw big data into a data lake, which is often what happens. The data lakes turn into what are better described as data swamps, where information is stuck and not useful for anyone beyond a highly-skilled data scientist. EIM recognizes that data acquisition is useful but not the end all, be all. Its processes and systems ensure that data becomes valuable to decision makers and data consumers.
Q: What advice would you provide to a healthcare organization just getting started or struggling with EIM?
Walton: Create a holistic roadmap that assesses each EIM domain – not just one. For organizations that are just getting started or struggling with EIM, it’s the best place to start.
Stewart-Smith: Don’t look at EIM as a set of tools that you can simply plug in and implement. Be sure to consider the various dimensions that extend beyond the technical aspects, such as data governance and information oversight.