The Challenges Of Healthcare Information Management In 2009

By Ron Schrimp

In today’s world of information overload, finding the right data strategy can be a critical and daunting task; for health plans, the challenge balloons. More so than other types of business, managed care organizations collect massive amounts of information. With that challenge, comes a commensurate opportunity to organize and use the data constructively. Healthcare IT organizations should consider the data use, access and frequency similar to retail and financial companies. Both of these industries have become experts in delivering information to data consumers faster than any other.  They have mastered the art of “just in time” data use.  Healthcare must focus on the same.  In 2009 we will begin to see more and more green field studies on clinical analytics, disease management and programs to massively reengineer both and provide better, cheaper and faster services to consumers.

Healthcare data strategies often fail. Why? No one invests in clearly establishing how the information would be used to improve the company. A good information analytics blueprint (IAB) is about more than just capturing a flood of data in a coordinated and logical process. The real key to success is transforming that data into relevant and useful information, which then can be applied to advance the organization and help consumers negotiate their healthcare decisions. Information analytics is only useful if it drives process improvement. This way, every business decision is an informed one, with real impact on productivity and effectiveness.

In healthcare, IAB is already an $8 billion industry. Increasingly, executives understand they need accurate, near time data to thrive amid stiff competition. The Sarbanes-Oxley Act, which Congress passed in 2002, holds the management of publicly-owned companies accountable for the quality of accounting reports. However, financial statistics are just one way to measure performance. Today, IAB systems are used to track both financial and operational progress across an enterprise. As healthcare transforms from a wholesale to a retail market, effective IAB solutions are crucial to achieving greater collaboration among health plans, doctors and consumers. This technology must include the infrastructure to support such a change, the environment to maintain protected information, and the accessibility of a broad range of data for the consumer.

The best IAB solution is a combination of the right software, hardware, administrative processes, and resources to ensure delivery of critical information to the decision-makers who need it, when they need it. IAB is about being able to drill down to more specific information at the speed of thought. This must include an evolving meta data platform, so that questions can be answered as soon as they arise. Without the intelligence to address them, projects or decisions can get derailed.

Ultimately, the right IAB solution is practical, fast, visionary, evolving and customizable. It also should be deeply integrated with core administrative and legacy systems. Plans extract the greatest value from a specialized BI solution, which is built specifically for transforming volumes of data into useful intelligence.

For many health plans and health information providers, this type of reengineering requires a commitment from a variety of levels within your organization.  You must start with a centralized organization like an enterprise architecture group.  This group helps to understand strategic business objectives and ensures the architecture and technology can support the organizational goals.  We have found that this approach fosters collaboration with the business and the technologists. We started with developing an “as-is” blueprint and in parallel engaged EWSolutions to assess our overall meta data state and develop a blueprint to move us to an enterprise meta data platform.  Interestingly enough, most people really didn’t understand the value that meta data would bring to their productivity. After understanding our meta data path, we then selected an enterprise architecture framework. Once selected, we began to take our “as-is” blueprint and mapped those to a technology life cycle management (TLCM) plan.  In my next article I will detail a standard TCLM model and provide examples.

Health plans face several universal issues when it comes to data collection and reporting. First, there is a need for making volumes of data accessible and useful to business users, and now, the actual healthcare consumer. Second, health plans must manage the growing demands of the business with IT resources that are often already spread too thin. Next, there is a need to identify and implement the appropriate data governance policies and finally the right software to assist in data interpretation, such as IBM-Cognos, SAS, etc. And, finally, executives consumed by day-to-day operations and immediate concerns may be focused on what IAB can do today, without investing much thought in the future.

As health plans continue to incorporate technology into business operations, there is a larger context beyond simply selecting the right software. Technology today is evolving at an exponential rate, and unless it’s your full-time job, staying current is a daunting, if not impossible, task. With multiple-year impact and the power to drive your bottom line, your IAB blueprint should be a strategic decision.

Building a full-scale IAB all at once can be prohibitively expensive and time-consuming. With massive financial constraints in our economy and our organizations, it is prudent to develop a 3-year Enterprise Migration Model (EMM) and provide an incremental ramp to an incremental approach. (See Figure 1 below)

Example EMM – Figure 1

10 Key points to an EMM.

1)      Start by bringing together a focused team on Enterprise Architecture (EA)

2)      Develop a communication plan to socialize the role and value of EA.

3)      Develop an “as-is” and “to-be” blueprint and socialize it with the business units.

4)      Develop a Technology Lifecycle management plan and socialize.

5)      Build an enterprise data governance council with representation from both the technology and business units.

6)      Develop your 3-year EMM and socialize.

7)      Develop your Enterprise Architecture Framework with the appropriate processes and exceptions.

8)      Develop and maintain the business and technology roadmaps and documentation.

9)      Monitor and improve all components of the EMM

10)  Communicate, Communicate and then communicate some more!

About the Author

Ron Schrimp has more than 23 years of experience designing and developing Enterprise Information solutions. He is Vice President and Chief Enterprise Architect for Ingenix, a United Health Group company.

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