Better, Faster, Cheaper: How Data Governance is Transforming Healthcare
By Louis J. Capponi, MD, FACP, Chief Medical Informatics Officer & Interim CIO, SCL Health
Compared to other industries, healthcare has been late in adopting advances in technology, especially in the strategic management and deployment of data assets. Like many other industries, the business of healthcare is complex. It includes the delivery of clinical care itself; the presence of multiple stakeholder groups such as independent physicians, insurers, hospitals, and patients; intricate organizational structures; and a highly regulated ecosystem. What is unique; however, are the challenges of financial constraints and tight margins brought on by declining reimbursement rates, consolidation, and other structural forces.
Data is central to good business management in any industry, and in healthcare it is needed to fulfill the care mission, drive costs down, improve quality, and keep organizations competitive. Indeed, over the last five years, the convergence of rich data sources and analytical capabilities in the healthcare setting has opened up significant data mining opportunities that can benefit both the clinical and financial sides of care delivery.
"Maintaining integrity, usability, and consistency through and across these elements can be challenging, and a good data governance program is the key"
Setting priorities for investment, or ‘governance,’ over both data and its use is pivotal to maximizing data’s impact on the healthcare organization. Strong business cases can be measured by direct returns in the form of new revenue sources, cost reductions, and lives saved. When under severe resource constraints, smart investment in reporting and analytics can help identify the levers which are most likely to improve value and increase direct returns.
At SCL Health, we approach reporting and analytics challenges within a broader mandate of information governance. Data governance falls within this wider framework. Like many businesses, we track multiple data elements, but the magnitude and diversity of elements in healthcare are much greater. Not only do we track financial metrics (dollars), but elements such as time frames (e.g., hospital admissions and discharges), features of disease, physical exam findings, and symptoms, to name just a few.
Maintaining integrity, usability, and consistency through and across these elements can be challenging, and a good data governance program is the key. This requires investment in people who understand the data, technology, and processes to make it work. For example, we use teams to approve definitions: was that an ‘admission’ as we define it? What constitutes a ‘discharge’? Our ability to make informed decisions rests, in part, on the quality and consistency of these standards.
Data also needs to be warehoused in a way that is scalable, secure, and accessible to meet clinical and business demands. Compliance with federal regulation (e.g., Centers for Medicare & Medicaid Services, HIPAA) makes data accessibility an especially sensitive function to manage.
At the information governance level, we look at how we manage and employ our data assets: who is permitted to undertake what actions with what data and when, and deploy what methods. In short, how best to use the data to drive returns. There are various models for this; some are highly centralized with a single source of truth for data and others are more decentralized.
The source data (an electronic medical record system like Epic) is built for speed. Data from these systems are transferred to other types of databases such as a data warehouse, which is designed for reporting and analytics. In centralized designs, there is one data warehouse that stores the data from multiple source systems. In decentralized designs, there may be many databases used for reporting. SCL Health is focused on operating models that strike the right balance between competitive agility – providing our business partners the information they need when they need it to drive direct returns – and maintaining consistency across data quality metrics.
We’re at an exciting inflection point for healthcare – in which data, reporting, and the application of analytics begin to take on a major role in the delivery of quality healthcare. It can drive not only unprecedented improvements in care for patients but can move the economic needle for healthcare organizations as well.
Sustained governance of our information assets, with attention to both the technology as well as the people who rely on it, is necessary to support current day-to-day decision making, both in clinical and administrative settings and importantly, to fortify the strategic initiatives of the organization going forward. The increasing pace of technological change merely underscores these points.
Finally, the SCL Health Ministry is continuously inspired by our mission to improve the health of the people and communities we serve. Espousing strong data governance policy and practice allows us to express that through our value of stewardship. Data-driven improvements in efficiency and productivity can directly impact patient care at the bedside and that is, perhaps, the most important metric of all.