Breaking The Chains Of Past Efforts

By Bruce Johnson

Leaders in many corporations have struggled with effectively leveraging analytics to improve their business and bottom line. Often times in those same organizations the concepts of data warehousing and analytics get a bad rap.  These same organizations typically have information starved managers and senior managers who are dealing with inefficiencies, high customer demands, and pressures from executives to drive down costs. 

In the healthcare industry in particular, demands for access to information are at an all time high.  Many healthcare organizations are realizing that once they get their data into an EMR, they now have the challenge of getting that data out to provide many of the information benefits that data capture promises, but cannot alone deliver.  After spending a significant amount of money on those efforts, most organizations are displeased with their inability to fulfill their demands for information.  Some of these common demands include:

  • Pressure to produce quality reporting to satisfy consumer and external requests
  • Business pressures – increasing costs of healthcare, decreasing pool of qualified personnel, increases in volumes and percentages of patients with Medicare as a primary insurance source (lower profits for providers), and an increase in the volume and percentage of uninsured patients, etc…
  • Operational management – leveraging information to properly plan, manage, and grow all operational aspects of the business.  Today, this is mostly done without access to factual statistics unless they are manually gathered and consolidated (again hire lots of people to pull data together).
  • Broad need for access to significant amounts of information for research purposes.  Currently many individuals are hired to gather and pull data – due to complete inefficiencies in data management and architecture, medical research has become an exercise in finding data wherever they can and hiring whatever researchers it takes to go find that data and curate it for their own purposes (every time this is done it satisfies one need and is repeated over and over).
  • EMR adoption statistics – it is one thing to implement an EMR, it is quite another to know that it is being used properly and the potential value of the information captured will have the desired impact that caused you to implement an EMR in the first place.

In recent discussions with a good friend, he reminded me of an old saying “when you are a hammer, everything is a nail”.  While in the right context this is good for a laugh, compared to the challenges of data management in healthcare it is more concerning.

This article will investigate some of the root challenges behind this dilemma.



In order to understand why the combination of information demands and pressures combined with minimal results of successful analytics efforts continually frustrate leadership with a lack of value or return on their investment, we need to look at what is behind the end result we are achieving.  Some of the pressures to produce data / information in and of themselves drive leadership to pressure for quick solutions or answers.  Executive leadership has challenges and demands that require them to respond to internal and external pressures quickly and firmly.  If those resources responsible for designing and building solutions were more in tune with the demands on these executives, they would be better positioned to come up with appropriate long term solutions with short term value, not just fighting fires.

Here are a few examples of current solution drivers:

  1. Needs – Individual needs of high profile business leaders.  Key leaders who have specific needs typically leverage their position to highlight urgency not for the need, but for a solution.  If the needs were truly separated from the solution it would allow the business and IT leaders to see all needs and come up with solutions that can satisfy many needs with targeted solutions.
  2. Trust – Lack of good examples of solutions often has non-IT resources coming up with designs for solutions, figuring that if IT cannot build solutions that satisfy all their needs, they can certainly tell IT exactly what to build themselves. This is merely the diminishment of IT into coding, not recognizing that intelligible system design is not something you invent, but you acquire through years of IT experience and education.
  3. External Pressures – there are several external collaboration or reporting pressures that many healthcare organizations are forced to address.
  4. Vendors – Vendors that pitch technology tools that will solve problems.  The desire of many hardware or software vendors is to drive sales by diminishing any problem to the application of tools.  The end result of this is an expensive mistake that most companies will make in implementing what appears to be a silver bullet.



The end result of many of these factors is that businesses will continually focus their resources on projects or efforts that have minimal impact on their business and continue to build on their frustration of realizing little real value.  The repetitive process only continues to sink efforts further down and invariably organizations turn to fighting the fires for who screams the loudest or has the most powerful voice.

Unfortunately, many organizations see this as a lack of technical skills and try to change the technical tools and resources without addressing the real drivers with sound technical approaches.  Many reach out to extremely large software vendors for the promise of solving all of their IT problems. 

Let’s look at some of the real drivers that should be behind our systems priorities and designs: 

  1. Leverage data and information to support corporate mission, goals, and strategies
  2. Fiscal responsibility of our systems.  Do more with less – intelligibly designed systems will reduce hardware and software costs significantly.
  3. Increase value and drive down costs
  4. Manage corporate operations effectively


Breaking The Chains

So our goal should be to define a proven approach and direction that WILL lead to success in the short term and long term.  The reason most organizations forego a long term strategy is invariably their immediate demands are causing them to move quickly.  What they fail to recognize is that if you take a proven approach you can both leverage success in the short term and long term, but it requires a change in your approach and a willingness to leverage expertise that goes against a culture that has been engrained in your organization. 

Some key areas you will need to address include:

  • Implementing a combined business and IT oversight of all IT efforts.  IT needs to report formal status on all projects and not miss dates.  Is this possible?  Absolutely, with adequate analysis and planning it is an expectation every executive should have of their IT leaders.
  • Having a plan – roadmap for the future.   The organizations that claim to have this usually have a diagram of tools, technologies, and infrastructure.  Here we are talking about the business needs being tied to data collection and analysis in a planned, comprehensive manner.  Handled in this way infrastructure costs will come down radically (the opposite direction most organizations see this headed).
  • Having a data management program – Data should be your most important IT asset and yet hardware is where most focus is put.
  • Implementing Governance over your data and processes – having business oversight of the processes and data they need to be successful help insure that IT is working on what is important to the business, not working on technology for technology’s sake.



 Most organizations would deny that they need to reinvent the way IT and the business interoperate.  If your business is wildly successful and its leaders are happy with the data and information they have access to then you may not need to.  If you have business challenges mounting while costs/budgets skyrocket and business leaders become more frustrated with the value they are receiving, take note.  You don’t need to reinvent the wheel, just try shopping at a different tire store.

About the Author

Bruce has over 20 years of IT experience focused on data / application architecture, and IT management, mostly relating to Data Warehousing. His work spans the industries of healthcare, finance, travel, transportation, retailing, and other areas working formally as an IT architect, manager/director, and consultant. Bruce has successfully engaged business leadership in understanding the value of enterprise data management and establishing the backing and funding to build enterprise data architecture programs for large companies. He has taught classes to business and IT resources ranging from data modeling and ETL architecture to specific BI/ETL tools and subjects like “getting business value from BI tools”. He enjoys speaking at conferences and seminars on data delivery and data architectures. Bruce D. Johnson is the Managing director of Data Architecture, Strategy, and Governance for Recombinant Data (a healthcare solutions provider) and can be reached at

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