vice president of product management, SunGard's insurance business


The healthcare data dilemma: The saga continues


Some time ago, I mentioned the overwhelming amount of data that we face in healthcare in my post – An e-Health Collage of Technology for Insurers.  And though the popular media coverage still seems pretty distant from the reality in most health plans, transitioning to an e-Health environment is still top of mind for me.  As health plans shift their focus from cost-cutting to growth initiatives, it is imperative for them to get a handle on their data.  The data dilemma will only compound as the plan grows if there is not consistent data management infrastructure and governance for that ocean of privileged information coming in every day.

And even if a plan is not in acquisition mode or aggressively expanding service areas, as people live longer and new forms of communication develop, data will continue to grow exponentially regardless.  In fact, Dr. John Halamka, chief information officer for Harvard University’s Medical School and chairman of the Healthcare Information Technology Standards Panel, estimates there are about 60,000 data elements in the average medical record.  (If you’re a math geek, multiply just one such record for each of your members and swoon with me as the data warehouse causes a brown out).  Of course, there are still questions about how much medical data a plan should have on hand, legally, to carry out its purposes. Nevertheless, the trend is towards a lot more data, especially as new business models tighten accountability (aka data quality) between payers and physicians.

Establishing e-health records has already been embraced by both hospitals and physicians.  When data is ‘electronified’ and integrated, patient care improves, risks are greatly reduced, HIPPA requirements are supported and the costs associated with maintaining paper records are minimized. In fact, the American Hospital Association found that from 2009 to 2011, the percentage of U.S. hospitals that had adopted electronic health records (EHRs) went from 16% to 35%.  A recent CDC report found that the percentage of physicians who have adopted an EHR system in their practice reached 57% in 2011.

So what can health plans do now to more fully embrace the ‘electronification’ of content and processes?  First, know exactly where you are now.  Get an assessment of all current content and records management processes and systems.  Once you understand your current state, you are in a good position to decide how to govern all the information you have on hand and design how new data becomes new information.

To find out more on this topic, visit our website and read our recent white paper – The Healthcare Data Dilemma, Part I.  You may also be interested in our Reform White Paper – US Healthcare Reform: Planning for Uncertainty with Confidence – and related blogs.


5 Responses to “The healthcare data dilemma: The saga continues”

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