CTI Healthcare blog series: A Prescription for Improving Patient and Institutional Financial Wellbeing

Creating a Healthcare Data Ecosystem – A Lesson from the Business World Part 4 of 5.

The healthcare industry has been playing IT catch-up, as the IT paradigm is already changing.    Healthcare technology, by that I mean the IT that runs healthcare (and not the bedside monitors and such) is more or less where the commercial industry was 20 years ago.   Back then, businesses were busy investing in monolithic ERP systems – the whole business would run on the ERP – and also investing in companion data warehouses for visibility into all business performance.

While this monolithic ERP paradigm was a giant step forward, albeit expensive, its time has passed – businesses now assemble software-as-a-service components and “stitch” them together to align with their end-to-end business processes – it’s cheaper, and it’s more fungible to changing business needs.   Meanwhile, the monolithic data warehouse could never meet expectations, ergo the big data “movement” was born, which has also couldn’t meet expectations — more on that topic to come.

These lessons are extremely valuable for healthcare leaders.   Healthcare today is investing in monolithic EHRs – that manage everything from the patient clinical record, the scheduling of services, to the back-office processes – and investing in companion data warehouses for visibility into clinical, patient, financial, supplier and HR operations.   Be prepared that both will end up mirroring the same trajectory within the business world.

Let’s examine why the data warehouse paradigm couldn’t deliver.    The data warehouse is akin to a metropolitan library.  It’s full of data about patients, their encounters, and many other “sections” – and just like an extensive library, the way to find something new is to ask your friendly librarian for help.   The librarians (your data warehouse IT specialists) work hard to carefully organize the data and help with customer queries.   Sometimes the “journal” you need isn’t available, and they help with getting a copy for the library (integrate new data).

There are a lot of good sounding things here (a reason why data warehouses are still being built), but the reality is there are significant practical challenges:

      • The library’s organization is predetermined, once it’s organized a certain way, that’s the way it’s going to be for a long time
      • The user’s need must be reframed to fit the way the library is organized; if you don’t know how to do this, you can’t use the library without waiting for help
      • The variety of requests and the pace of new information overwhelms the library’s, so it often isn’t able to be of help
      • As the library gets bigger, the more complicated it is to use, and the more help you need

Practically speaking, the data warehouse approach could never work. In my next blog, I’ll talk about how to overcome the data challenges in healthcare today around governed, self-service access for everyone.

References:

Read part 1, part 2, and part 3.

http://www.healthcareitnews.com/news/hospitals-use-business-intelligence-boost-patient-throughput

http://searchbusinessanalytics.techtarget.com/report/Business-intelligence-in-healthcare-Special-report

https://en.wikipedia.org/wiki/Electronic_health_record