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Big Data
The healthcare industry is on the threshold of a vast frontier.
The frontier? Exploiting the power of Sophisticated Analytics to reveal the healthcare "Big Data" treasure trove.
Today - Sophisticated, powerful analytic methodologies and techniques, along with massive data storage and processing capabilities are becoming available to organizations of almost any size. Certainly this includes any healthcare delivery or other healthcare industry organization.
These capabilities were once available to only a select few in any industry.
· A dramatic increase in individuals having strong competencies in sophisticated analytic methodologies and techniques.
· An abundance of accessible data - information systems and computing applications of every kind and nature are in use and gathering healthcare centric information (structured and unstructured) on individuals and groups - clinical care, business & financial operating, claims, benchmarking, vendor, customer satisfaction, healthcare user devices, social networks and conversations, etc.
· A surge in computing power and storage, while relative cost has plummeted.
Understanding and using combinations of available data - large data sets (clinical & non-clinical) generated by healthcare industry organizations, as a matter of course, in doing business or non-healthcare industry data - retail, communications, media, socio- demographic, educational, etc. We are coming to know this phenomenon as Big Data.
It is a Treasure Trove as what is found and possible to do with the information resulting from these combinations.
The significance in Big Data is the information derived from patterns, correlations, and trends detected, when looking within and across data sets that would not be revealed in single or smaller data sets, even with the same number of data records.
The information's significance is the revelation of new and/or sharper pictures of current situations than previously achievable/imaginable. These emerging pictures often make readily apparent highly actionable insights as to how things may play out in the future, including business trends such as admissions volume, disease spread, or rejected claims payment, etc.
Actionable insights mean new highly valuable decision-making power. A 'Treasure Trove' due to the shear volume and power of these insights - decision making of greater speed, precision, consistency, agility, all at lower cost.
Healthcare Delivery
Viewpoint and perspective is also important to how one views the industry layout in relation to those served.
The Healthcare Delivery Continuum can be viewed from two approaches
Provider-centric Approach
Traditionally, the healthcare delivery continuum is provider-centric; that is, the industry describes the intensity of care needed according to what services are provided and where they are rendered, as depicted on the continuum on the right. In this environment, the one being cared for is either guided one step (or provider, or facility, etc.) to another, on a path largely predetermined and/or promoted by the provider (e.g. surgeons want to do surgery, all referrals are made to the device maker that the provider thinks is 'best' without a selection of alternatives presented.) Those being served have little opportunity for true consumer oriented inquiry, dialog and decision-making; or they are left to fend for themselves, because provider communication approaches, mechanisms, or systems assume those being served are not at, or cannot attain, a 'necessary' level of comprehension or understanding about their situation.
Patient-centric Approach
In this course we will approach the care continuum by the health condition or status of the one being served, in line with industry shifts toward a patient-centric approach, as depicted in the continuum on the right. Based on the patient's condition and prospects for improvement, services are rendered in relation to their holistic situation, as opposed to only considering how an individual progresses through a single facility, service or series of facilities. (For example, what facility cares for a patient after a knee replacement, etc.)
Carrying further the idea of patient centricity, brought forth above - it's crucial to consider: who is it that is actually being served? With healthcare reform and a simultaneous consumerism movement, patients are becoming known as healthcare users or healthcare consumers. Family members and loved ones in relation to sick individuals are simultaneous healthcare users in unity with the sick (e.g. post partum depression is a family event, prostate health is a marital situation). AND -- Health care is not only about the sick; healthcare services are for the well, too! [Develop more perspective on the healthcare industry and the focus on the user or consumer - visit YouTube and lookup videos on the topic by Regina Herzlinger and others.]
Indeed, two quickly building waves in healthcare practice - user (patient) engagement and population health initiatives, along with Patient Centered Medical Home [PCMH] organizations - are embodiments of patient-centric thinking. These practices are ALL about a healthcare services approach aiming to achieve optimal states of wellness for healthcare users across the continuum, and/or an optimal engagement of services to provide highest quality of life within the possibilities of a given healthcare user's situation, especially for those at the end of life.
HIPAA and HITECH
HIPAA and HITECH are covered in this module not so much to address concerns for security, but to understand how to work with data to unlock its huge informational content, within the constraints of the security measures present. Don't let these security measures limit the exploration of new questions that can be asked.
Taken to its fullest extent, HITECH's requirement for meaningful use of an electronic health record (EHR) demands that the business intelligence or analytics consultant embrace and lead the charge to use data to find new paths forward in the creation of value for healthcare users and health plans.
The Grant: being allowed the time, resources, latitude, and respect for your opinion when you present information that points to a new direction.
The Obligation: to do more than what the basic tenets are—more than using acquired knowledge and skills only to build requested reports or analyses, perform a checklist of tasks, or provide decision support. The obligation (and part of one’s accountability) is to use one’s specialized knowledge and expertise to add value by:
Teaching and leading others in the power of business intelligence tools, and
Seeking out new questions, directions, and ways to leverage organizational data and the development of new or more powerful information and insights for action.
This accountability and obligation is recognized in the HFMA code of ethics, which asks that members foster excellence by keeping abreast of pertinent issues, and promote a greater understanding of financial issues by others in the healthcare field and the public.
Professionalism
Being part of a professional association disposes one to follow and act in accordance with a set of standards and code of ethics. Your completion of this program and attaining certification is directly in line with attaining specialized knowledge, building expertise, and competency.
What is not often written, yet must be a commitment of professionals, relates to the social exchange one makes. The exchange is an obligation incurred for a grant given
Components to Consider
Services are currently rendered differentially per patient, in a kaleidoscope fashion across an uncoordinated combination of providers and locations, influenced by a variety of components as well as cost concerns and legal liability issues. This uncoordinated system of providing care is largely a result of longstanding political and economic policy in the United States, which will be discussed after we’ve reviewed a few additional system aspects.