This is a topic I touched on a couple of months ago in my blog “EHRs, Analytics, Utilization and Population Health.” Health Systems have been on a tear over the last several years with the deployment of technology to enable the transactional or tactical execution of business activities and delivery of care. With the diversity of the business process needs, no one solution is able to meet them all. This drives a requirement for integration, with a flurry of activity around hooking one module up to another, say bed monitoring and the EHR. The “hook-up” is, typically, point to point. Organizations are now wanting to, being compelled by legislation, best practices, management needs and nearing the completion of EHR rollouts, deliver analytic solutions or Use Cases built on a collection of data, sourced from these many business process applications. What they’re now faced with is the effort to “get” the data from a dozen applications, which when done in the point-to-point context, could take 12 months of effort. So much for a timely response to a need! What to do?
Break the Vicious Cycle
To be able to respond to this continually increasing demand for timely access to data, Health Systems need to construct a service that can expedite, facilitate and manage the sourcing and sharing of data. This effort is not without its challenges; while the concept is simple, the execution is not. The underlying technology foundation needs to be able to “expose” the various business process applications or producers, providing access to the data contained therein that has been deemed as needing to be shared. The act of consumption can be a single transaction or a large collection of data representing a diverse set of activities that occurred over time. Again, the service would need to be able to accommodate and respond to the characteristics of each request. As for scope of use, such a service would handle/respond to any request, as long as at least one of the endpoints existed within the context of the Health System.
Governance is Key
Data Governance provides the background on which the service and all data utilization can occur. Two basic elements are critical to the success of the service. The first is abstraction. The producer and consumer don’t really care about the other; each needs only to know how to “talk” to the service. As long as they can do that, an exchange can be made. The second revolves around the use of a common dictionary. For the exchange to be completely successful, the data element or collection of elements contained within the exchange needs to understandable by the consumer, and if the exchange was in response to an original request by the consumer, the consumer needs to be capable of asking the question appropriately.
The Long-Term View
The effort to establish a service as quickly presented here requires an investment in time, money, resources and a willingness to temporarily keep at bay many of these major data usage and analytics (ie., integration) requests that are beating at your door. The short-term effort is great and painful, but the long-term impact will generate an ROI many times that of this initial investment. The initial effort should focus on the necessary technology foundation, governance, management, education & awareness and the exposure of common/frequently utilized producers and their oft-consumed data elements. Moving forward, through the work on new initiatives and a systematic re-provisioning of legacy, point-to-point exchanges to the service, the breadth and depth of data elements available for consumption will quickly grow. This richness will provide for a quicker delivery and lower cost for each successive use, not to mention being able to say “ok”, when someone asks “I need data, now!”
