Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data PDF

Introduction

I have been tracking healthcare data (information) in medical environments since I was a child standing guard next to someone special. My introduction to healthcare information started at the age of 12, when I spent the summer sitting beside my grandmother in an acute care facility. At the time, I recall telling the doctor (my father) that the only people working around the hospital were the nurses. In high school and college, I worked in various healthcare facilities, and after graduation, I joined the healthcare profession as a registered nurse.

Later, these clinical experiences proved to be invaluable in developing a 30-year career managing a consulting practice. At first, my consulting business focused on auditing medical bills and helping hospitals correct their internal processes to minimize future errors. My client list grew from hospitals to include other providers, payers, insurance companies, regulatory government agencies, self-insured corporations, attorneys, and others who needed help in navigating healthcare data.

I found myself teaching classes, writing books, providing expert testimony, and advocating for patients. After 30 years of analyzing details, I can summarize in one sentence why most medical and billing errors occur in the healthcare industry: the root cause of all errors, gaps, and failed milestones at some point circles back to a data point that was unknown, misunderstood, misplaced, ignored, and/or just simply not processed.

Before I ever heard the term big data, I knew the answer to solving problems for my clients existed in the details (aka data). Leveraging technology, my internal processes started to shift to using more data mining and data analysis. Whatever question I was asked, the answer could always be found in the data. I couldn’t help myself from wondering, what if the healthcare industry could manage its data better? How would this impact the bottom line and patient care?

In the year 2015, we now know that the big data revolution in healthcare is upon us. The takeaway from this book is to identify how the C-suite revolution is impacting the chief information officer (CIO), the emerging chief information roles, the need for data intelligence, and the importance of sharing data across the organization. The data has always been there. However, as these roles emerge, it is becoming increasingly apparent that the market lacks a clear, patientcentric data policy. What is needed are new processes and people who are empowered to utilize actionable data to solve problems, increase profitability, and improve quality of care. Take this one step farther by asking your organization these simple questions: Do we have a data policy? Who is being served by the data policy? Is the policy in the best interest of the patient or the organization? I would respectfully introduce the notion that organizations need to operationalize a data policy that is patient holistic. When it comes to getting at the right data to make the right decision, simply stop, look, and think.