Identifying provider data barriers to healthcare transformation

by Howard Koenig...   
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To blaze the trail for digital transformation, provider data management requires a transformative approach and technological innovation. What differentiates this approach and defines innovation is the data itself and how it is used. The architectonics of provider data need to be scalable, designed to anticipate change, consumable from many formats and attributes, and discoverable in a valuable way for both business and consumer users.

The barriers to digital transformation within the provider data enterprise include:

Data silos: In provider data management, data may be locked up in disparate applications siloed across internal departments and external resources. Stakeholders may only have access to some parts of provider information. As a result, comprehensive data may not be shared across the organization and user may not be able to “self-serve” data for their business needs.

Dynamic data: With provider consolidation, providers entering and exiting a medical practice, geographic changes, and evolving data types and demands, the amount of data grows exponentially year over year becoming increasing difficult to manage without application and resource scalability.

Quality control: Within the provider data universe anywhere from 50 to 100 percent of data may come from external sources. This data often comes in many formats with conflicting attributes, and varying levels of quality control rendering it inconsumable and prone to inaccuracy.

Data security: As the provider data universe expands, so does the need for data security. According to IDC, “more than half of the information in the ‘digital universe’ that needs protection is not being protected.” *

Increasing regulations: Demands from the Centers for Medicare & Medicaid Services (CMS) and other regulatory bodies are forcing new data management requirements and use cases that require new business models to support them.

Consumerism: The bar for derived value continues to increase due to advancement in digital technology we use in our daily life. To keep up, health plans and workers’ compensation organizations need innovations that enable better easy-of-use and intuitive data visualization for informed decision-making and optimal user experience.

Healthcare transformation: The realization of the potential to manage health by population, the transition towards a value-based approach to care, and the accelerated shift from acute care to home highlight the need to transcend traditional provider data management.