Data management unlocks clinical advancements for the decade
Over the past decade, a shift has occurred within the healthcare industry. Patients have become empowered as cultural changes, increasing care options, and policy adjustments enable populations to make informed decisions about their care. The 2010 Affordable Care Act ensured that patients were protected while pressing payers and providers to move into technically advanced systems. Payer and provider groups then began combining to offer new innovative care options, while life science professionals experienced a surge in treatment advancements.
The upcoming decade will continue to build on that progress, using the most robust data management and governance model. Here, we look into future healthcare trends in the ’20s, the Decade of Data.
Changing Regulations Keep Healthcare Guessing
As Meaningful Use regulations crossed the 10-year mark in 2019, the next decade of regulatory requirements remains undetermined. For the United States, the 21st Century Cures Act currently dictates many policy changes. Amendments to the Cures Act will continue to impact providers, payers, life science professionals, and patients alike. The Cures Act currently touches many vital issues including cutting-edge research priorities and community research trials, as well as privacy protections and reducing the administrative burden. Perhaps the most critical legislative regulation from the Cures Act is the use of big data.
“The promise of big data cannot be overstated for finding patterns of disease and health and targeting therapeutics to sub-populations. The Congress, in the Cures Act, wisely recognized both the potential and the risks inherent in sharing data sets and NIH has moved quickly to get the appropriate protections in place.”
Upcoming proposed ONC rules focus on the support of seamless and secure access, exchange, and use of electronic health information. The new rule revisions are aimed to encourage innovation and competition, allowing patients and their providers to secure health information and new tools for satisfactory choice in their care and treatment. The healthcare industry will adopt standardized application programming interfaces (APIs), grant patients free access to their health data, and limit information blocking.
For the full healthcare ecosystem, these rule changes require entities to step beyond their current EHR or data capture system. The past decade has required billions of dollars of investment by healthcare companies worldwide to capture the abundant health data from numerous data sources. However, the availability of data does not translate into knowledge, business insights, or meet the ONC proposed rules. Companies need to look closely at their current data strategy to accelerate business goals, develop strategic initiatives, and ensure compliance with upcoming standards.
EHRs Are Out, CMRs Are In
Although the term electronic health record (EHR) will not be removed from the healthcare lexicon anytime soon, expect to see the growing idea of the complete medical record (CMRs) take flight. While over 96% of acute care facilities are using a certified EHR, according to HITECH, a true CMR—a full patient record from all locations the patient has received care—is still largely unavailable or may take several days and excessive coordination to obtain.
Ancillary patient care records, such as those from pathology, images, consult notes, pre and post-op notes, and even home health equipment, are largely siloed in their individual EHR system. Outside of a clinical care summary record, the CCD or CCD-A document limits the information available to the providers. Moving into the Decade of Data, caregivers, payers, and researchers will have access to all relevant health history (de-identified when applicable), not just medications, allergies, problem lists, and care plans.
With interoperability standards like HL7, FHIR, and HIEs, data sharing is currently underway, but vast improvements will be made during the ’20s to ensure the full medical record is accessible at the moment the patient or a member of the healthcare ecosystem needs it. For payers, providers, and life science professionals, this begins by ensuring incoming data accuracy, access, and overall security.
As with any personal health information (PHI), the risks from mismanagement of data, especially patient data from disparate sources, cannot be ignored. Companies will define and implement an organization-wide data strategy to integrate data silos, introduce master data management, and govern metadata. Begin with the assessment of data quality, reconcile gaps, and then define data quality rules. Once completed, a healthcare facility will be able to use the complete medical record (CMR) to make informed research, care, and reimbursement decisions. To expedite and ease the transition to a true CRM, companies should implement accelerators, such as the Human 360 accelerators and Consumer Platform, in conjugation with a company’s current standing EHR, saving both development time and overall cost.
The ‘Minority Report’ Effect Emerges
Identifying risks before they happen will be a goal of healthcare moving forward. With the increase in healthcare costs, an aging population, and an expanding opioid crisis, the healthcare industry is ready for solutions to manage patient populations with chronic conditions before they start.
For example, opioid abuse is exploding worldwide, leading Canada to label the epidemic as a ‘national health crisis’. World leaders, such as Barack Obama, during his presidency, earmarked billions of dollars to combat the situation and President Trump has passed two major funding bills to combat the epidemic. One possible solution is to understand the risk factors for someone abusing narcotics and address the problem before it begins. One major US insurance company has been working with data scientists to analyze years of insurance and pharmacy data.
Together, they have identified over 700 risk factors that predict a high degree of accuracy when someone may be a possible abuser. The care provider and payer can then work with the person to develop methods to prevent additional misuse before it happens.
Although risk pre-identification and rectification is a delicate undertaking overall, the ’20s looks to be a time where researchers and developers can use the data gathered from the previous decades and create solutions based on the data. However, an enterprise data strategy is a requirement to enable the ‘Minority Report’ effect. Payers, providers, and life science companies will enable resilient data and leverage information technology to introduce these new capabilities, improve effectiveness, maximize their competitive advantage, and ultimately generate new revenue streams.
Clinicians Are Needed—Stat!
2.3M healthcare workers are required by 2025 in the United States alone, according to a CNN Business Report. As the Baby Boomer population ages in the ‘20s, so does the age of the healthcare workforce, many of whom are retiring. Add to that the increase of chronic diseases with comorbidities and a limited number of new graduates to fill the open positions, and it’s easy to understand why there is not enough care to meet the needs of populations.
As healthcare needs quality employees in all areas, from payers and providers to researchers, the upcoming Decade of Data will present many innovative solutions. Advanced facilities are implementing the first solutions, including the use of patient trending data to uncover staffing needs. Data management solutions eloquently analyze data from the previous year’s records to leverage patterns across multiple sites. A model is developed to reveal estimations on holiday increases, flu patterns, and other metrics that impact the needed staff. Big data and analyzation lead to better staff planning, reduced wait times for patients, and better overall quality of care. One hospital in Paris had success in 2016 implementing a system using big data and machine learning to do just that—and initial reports showed improvement in staffing needs.
Using remote staff via telemedicine will be another initiative that is going to continue to boom throughout the ’20s. Reports show that 91% of mid-to-large employers will offer telemedicine services by 2020, but only 2% have used the service as of 2018. However, as finding care becomes more difficult, and healthcare costs continue to rise, increasing geriatric and millennial populations are expected to turn to telemedicine options for their care.
Although a virtual visit and staff planning seem simple enough, the ability to ensure that all involved parties have the correct access to the needed data remains a central struggle. Using this information is not only going to be vital in care, research, and reimbursement decisions, but business leaders must have better visibility on available data sets and analytical views, reports, metrics, and KPIs. Access to consolidated and trusted data in one location, focused on specialized problems without IT dependency, becomes crucial to enable leaders to make appropriate decisions to impact future generations and populations.
Healthcare in 2020 and beyond holds the promise to advance medicine in ways never before imagined. With the data capabilities formed in the previous decade, the ’20s are promising to be an intense period of growth for new healthcare innovations, treatments, and care measures.
To realize the full potential of new healthcare initiatives from the Decade of Data, companies must begin with a comprehensive analysis of their data structure.