Data Will Transform Healthcare on Multiple Fronts Over the Next Decade

Healthcare organizations need to heed the clarion call to prepare for the coming transformational decade that will see data take center stage. We will soon see a number of articles predicting what will happen in healthcare in the next decade as we reach 2020 so I thought I would get out ahead of that.  The next decade in healthcare will be the decade of data making 2019 a critical year for organizations to get their data house in order with and enterprise strategy and data platform. Before we look ahead let’s look at the last decade which has really been driven by several major themes:

-         This decade really started in 2009 with the passage of the American Recovery and Reinvestment Act of 2009 which incented the adoption of electronic health record systems. This lead to major multiple year initiatives to select and element new consolidated EHR platforms. The end result has been a consolidation in the marketplace with only a few major players left.  A few years back the CIO of an early adopter of a new EHR platform made the statement that the EHR implementation is not the final destination just the ticket to enter the show.  By and large most healthcare systems have made their choices and completed their implementation cycles at this point. As the energy and resources dedicated to that process fades in the rearview mirror organizations will being to pivot to the “show” namely how to use data from across the enterprise to impact decisions across the enterprise

-         Population health and care management have gained momentum over the last 10 years as ways for organizations to tackle costs by segmenting their populations into groups and managing their care more proactively to improve outcomes while reducing costs. What we have learned so far from these initiatives the more data we have across the patient journey including social determinant factors the more successful programs can be with a more granular approach.  

-         The growth of value based care models has seen an increase the last several years after a slow start to the transition earlier in the decade.  A recently updated study from Numerof & Associates spotlighted some of the ongoing challenges. For the fourth consecutive year, Numerof & Associates has partnered with Dr. David Nash, Dean of the Jefferson College of Population Health, to study the evolution of population health management in the United States as a strategy for taking on risk from value based care contracts. In the 2016 survey, over half of respondents (61%) predicted they would be at least “very prepared” to take on risk in 2018. In the current survey, however, barely 25% felt they had achieved that mark.  Financial, organizational culture and data challenges abound as barriers for the successful shift to VBC models. 

So that was the last decade:

·      A titanic shift towards a few consolidated EHR vendors

·      Beginning to look at managing care for various sub populations

·      Preparing for the gradual shift from fee for service payments to value based care arrangements featuring quality attainment as a goal

We’re already seeing at the end of the decade a number of items that are going to continue to gain momentum in the years to come:

·      Providers using claims data and payers using clinical data to give more context to the patient journey

·      Patients taking control of their data through interoperability and a growing amount of user generated data through wearables and apps that healthcare organizations will want to tap into

·      New care models such as care shifting to non-traditional players like CVS, Walmart, and perhaps Amazon.  A recent CNBC story put a spotlight on how a large employer like Walmart is consolidating treatment across the country for certain surgeries to a specific provider to reduce costs. Look for more and more employers to do this on a national and regional basis. Providers are going to need the data to show they have the ability to deliver low cost, high quality care. 

·      There has been an explosion of interest in the advanced use of data through predictive, machine learning, and artificial intelligence technologies. Though there is more than a whiff of hype cycle around these technologies early use cases show promise and momentum will grow in the next decade. All three technologies are dependent on a source of cleansed, curated data which remains a challenge for the majority of healthcare organizations.

·      The digitalization of the healthcare organization which encompasses the aforementioned advanced uses of data, but also includes tailored patient experiences supported by digital technologies and personalized medicine. 

When you add the current challenges in healthcare with what will accelerate in the Digital 20s, I’m coining that first, it’ clear healthcare organizations have A LOT on their collective plates.  There is a common thread through this collection of industry shifts, technologies, and initiatives and that is their success depends on the use of data.    Healthcare has notoriously been behind the technology curve on many fronts for decades.  Healthcare data provides an outsized challenge with its complexity in sources, disparity, and volume. Healthcare has traditionally operated in application silos and executives widely hoped that a move to large consolidated EHR platforms would alleviate the data silos. In reality the scope of the problem is wider and more complex for EHR vendors to take on despite their epic ability as transactional point of care systems. For organizations that want to thrive and succeed in the coming Digital 20s they need to invest in an enterprise approach to managing their data assets in a consolidated, curated manner. 

Healthcare organizations need to consider how they will organize and leverage data not just for an individual need like population health, but across all the enterprise needs now and moving forward.  An enterprise healthcare platform needs to be able to:

·      Onboard data rapidly and without the need for complex ETL processes which require the support of talented and expensive ETL developers

·      Master multiple domains of data including patient, provider, provider practice, workforce, facility, member

·      Organize data around a centralized model with agreed upon data and metric definitions with a process and capability to support the data stewardship needed to keep data cleansed and accurate

·      Harmonize data with the millions of codes and value sets in healthcare

·      Manage the hundreds of complex metrics that healthcare organizations must execute against

·      Prepare cleansed and curated data for analytical and other downstream uses such as predictive, AI, and ML algorithms to drive new insights across the organization

For the healthcare organizations willing to make the needed organizational investments to create and leverage a foundation of data the rewards will be great in the Digital 20s. Those organizations that do not will find themselves falling behind to new models of care delivery and the target of M&A activity as the digital winners increase their scale.  We're ready to help those ready to meet the digital future with our healthcare data management platform Omni-HealthData. Let's go on a data journey together!