All the noise brought about by changes in the healthcare industry is now a part of normal business folklore. Yet the resounding IT drumbeat of “Know the Business and Thy Business” grows consistently louder and more persistent. An accountable and successful leader must recognize and react to this trend. My survival mantra in times of change is to follow the IT drumbeat and I feel this is what separates the grain from the chaff. Technologies like Big data and Cloud computing are transformational--they cannot be implemented too late or too soon. Both these approaches are fraught with the dangers of misalignment with the drumbeat. As an IT leader, one must align with the business vision, business maturity and customer expectations. The maturity level of both the industry and the vendors in present and future dimension sends an essential message.
"Patient management and clinical participation define branding and patient loyalty. While a patient portal is the most significant IT patient-facing platform, marketing should be involved in communication and education campaigns”
Big Data is big
Big data will enable population health in a significant way. Population health merely opens the door to knowing the business. After all, insurance companies have used big data for years to become one of the wealthiest industries in the world. If healthcare delivery can use Big data to execute as much change as the insurance companies have done in profitability by managing wellness and preventing sickness, the cost curve will shatter–not just bend. Population health analytics will help decipher the business costs and population risks if Big data and enterprise data warehouses are integrated. Decision rules or algorithms cannot exist without system and process integration. Big data cannot exist in a vacuum. Delivery mechanisms include multiple platforms and multiple devices. Services that provide data from wearable, mobile and smart machines, mobile apps, and analytics for self-tracking are the next wave that must be integrated with the enterprise business model, IT infrastructure and community education strategies.
As patients become dominant players in their own care, where patients evaluate their diagnostic and treatment options, Big data will be both actively and passively involved. Patient management for health and illness by Big data is not an exclusive domain of IT-even though IT plays a pivotal role. Enterprise operations, informatics and marketing must be involved at the earliest stages of conceptual design and educational modeling. Informatics governance must be embedded in operational care delivery levels, where frontline people can take actionable steps on the data provided. The data miners need to reside in IT but the enterprise leadership must disseminate the analysis deep into the organization to gain traction and effect change. As new care models become acceptable, physicians’ buy-in for patient engagement cannot be ignored. Patient management and clinical participation define branding and patient loyalty.
While a patient portal is the most significant IT patient facing platform, marketing should be involved in communication and education campaigns. Marketing can significantly influence behavioral and societal patterns especially for chronic diseases like obesity and diabetes. Well-coordinated marketing efforts across multiple layers of the community must be executed in lockstep with care coordinators and Big data analysis. Marketing communications and focused campaigns become the educational force within the community behind the power of big data and new care delivery and wellness models. IT and care coordinators will need to focus on and manage the content of the population health marketing efforts.
There exists a gap between research and commercial adoption in the informatics domain, but I see widespread adoption in healthcare. Using real-time clinical data in a horizontal view has no limits. It is only limited by the skills of the informatics. My concern is having local level accountability and conforming to regulatory standards for user privacy. Very often while dealing with regulatory compliance, we tend to ignore controls at the way data is handled by the IT team. Another concern I have is nurturing of core competencies for Big data and enterprise data warehouse which may require restructuring of IT skills. My mantra for Big data is to manage the technology, information and data governance, and information delivery that supports the clinical operations, the informatics role, and the needs of educational marketing. How IT will manage this will be critical?
Of late, I have been reminded of “shadow IT”–where the user department’s application needs are met by circumventing IT processes. This phenomenon is growing rapidly and is expected to gain strength. We have departments that have their own local databases and homegrown applications. They exist within our network and the data is used for internal departmental purposes. With the prevalence and affordability of Cloud Computing, it is becoming harder for IT to control data security, accuracy, and reliability.
Two factors made this “shadow IT” movement happen: cloud service providers selling directly to the users and the slow response of IT in meeting departmental needs. Shadow IT impacts enterprise risk strategy and enterprise architecture. My IT management team has been proactive in preventing the risks involved in shadow IT. My team built a maturity level framework for cloud engagement. We collaborate through education and sometimes through vendor management. All SaaS applications have to pass muster through a thorough due diligence process driven by IT data security.
The due diligence process is founded on the evaluation of the vendor and the SaaS offering and the validation/remediation of the security and risk exposures. Recently, we had an instance where an application rollout was delayed as the Saas vendor did not comply with one of our security requirements. The cloud vendor had to make changes to their security controls in order to meet our security requirements. Both Big data and Cloud Computing will continue to explode. My position is to determine if these trends maintain their velocity and will the marketplace respond accordingly and consistently and not in jumps and spurts. My job as CIO is to translate the uses of these transformational technologies into business alignment with the enterprise goals which is founded on providing cost-effective, quality care to anyone regardless of the ability to pay. My responsibility is to follow the tried and true drumbeat for healthcare IT–“Know the Business and Know Thy Business.”
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