Your Analytics Software Is Creating Another Silo

Data Silo

In healthcare the current hottest trend we see is analytics software that seems to have the promise to do it all. Often times Integration Engines, HIEs and Population Health Management is also thrown into the mix to confuse things even more. Regardless of which you are looking at, we are going to call these “Analytics” software.

Don’t get us wrong we are not against any analytics software, however we are against the case for yet another silo to be created, but this can be managed!

The Value of Analytics

Analytics comes in many flavors, and this post is in no means meant as a comprehensive cover of such. You have everything from Machine Learning, AI to specific needs such as SEPSIS or HEIDS measures.

The value for analytics is broad and will largely depend on your needs as well as outcomes you are looking to resolve, which is exactly what it is intended for.

The Shortcoming

However that being said there are a few challenges with analytics as they stand today and ideally you want to avoid making these mistakes as they cost time and money down the road. The major shortcomings are:

  • Since there are so many options and each one takes a major integration effort to address, its hard to pick the right analytics software
  • All of them create another silo for your data, but they have to in order to provide value to your organization

Mind The Silo

In order for analytics to function most data needs to be transformed into whatever the solution requires in order to produce the results you need. This creates a silo for your data because the data goes in as one format and only to be stuck in another, the output is merely the process of that system.

This may sound okay, where it is not okay is that then we try to use that data for other things. Such as connecting an HL7 interface, or passing along data; which many of these systems will tell you they can do.

On the surface this all works well, however as you dig down to creating near-real-time data exchanges or try to do high volume transactions you will begin to run into a lot of issues, and in the process you have created yet another dead end silo for your data.

How A Platform Helps

This is where a platform that helps direct your data in near-real-time really can show its true benefit. First and foremost it solves for the issue of which to choose. You can easily pilot 2 or 3 software systems at the same time without adding resource needs as the platform can easily manage and direct data to each system using proper security controls.

While you are still creating another data silo, you are not dependent on that one. Meaning the software can do what it does best then you can take that output and put it back into the platform to provide a full view of your data.

Which Integration Method Is Right For You?

Integration

In healthcare it seems we are always talking about the latest type of connection you can use HL7, FHIR, ADT and the list goes on; what is even more comical is it changes based on who you are talking to Provider? Payer? Patient?

It feels like the fix for integration has been to create a new type of integration standard. However it is not all about these times of connectors or integrations, we can actually reduce down all this into 3 main areas to focus on.

PointToPoint

Point-to-Point

These type of integrations are usually direct interfaces, like HL7, FHIR or ADT, that connect one system to the next. Information flows one way to share information and it is up to the Target system to decide what to do with it.

Point-to-Point is the most common type of integration in healthcare. You work with your vendors to establish a standard you will use, like HL7, and then make sure your schemas match and then test it.

This method leaves it up to each system to interact with any other systems to handle issues like EMPI or data flow or transformation. 

Major hurdles with this integration type is each integration requires its own project timeline and you have to maintain each, we see our clients have 5k+ connections by the time we get start working with them.

On the plus side they are much easier to setup than most any other integration and require the least amount of software and/or license fees.

IntegrationEngine

Health Information Exchange/Integration Engine

These types of integrations use Point-to-Point to move data to an Integration Engine that then forwards it to a target system. This is good for keeping a copy of the information, it is still up to the target system to decide what to do but in this case you can also handle a Point-to-Point reply from the target back to the Integration Engine and back to the Source.

Integration Engines are the second most popular and the most prevalent mostly thanks to the rise of Clinically Integrated Networks and ACOs as well as Population Health. However most of these systems are heavily under utilized and most clients report costs going up to maintain them as well as the team required.

This type of integration can automate the workflows required to talk to all your other solutions such as EMPI and data transformation. 

Major hurdles with this integration is the team you will have to deploy and license it also does not eliminate the Point-to-Point connections.

On the plus side you get all you’re data is sitting in one place, its stale in the sense its one way and often transformed so it can work with a data viewer, however being in one place is great to be able to manage Population Health metrics and sharing data.

Platform

Near Real-Time Bi-Directional Platform

This type of integration is the most robust it offers you a reliable way to manage data moving back and forth from a Source to multiple Targets and back, it can also handle all your Integration Engine needs.

Unlike its counterparts this requires a platform that is able to handle data back and forth and also keep the data current and not stale, meaning minimal transformations or at least real-time transformations so you always have a copy of the live data.

The major difference of a platform is that it encompass multiple other solutions to bring everything holistically into one place.  So instead of having an EMPI, Integration Engine, HIE, API platform and so on a platform handles all this for you in one single place. 

Major hurdles for this is usually cost and time to get up and running.

On the plus side most of the solutions in this space are fully managed by a vendor, cloud based, and once they are setup it is much easier to add connections and integrations by simply having your vendor follow a schema you have set in place for them.

What is right for you?

Rather than solving a need multiple times over and over it is time to re-evaluate your data integration strategy and see which option is best for you. Picking the best option will help you scale at a much more rapid pace than your competition.

And what is right for you is not right for all health systems, we still have clients that see the most value from Point-to-Point integrations. It really comes down to your needs and when is the right time to deploy it those needs.

There is also cost and scale challenges with each solution as well as implementation time. The first step to figuring out which option is right for you is to consider your current needs and your needs in the next 5 years, from there you can find the solution that fits both the needs and the budget.

Looking for a free evaluation of your integration strategy as well as which options are best for you? We are happy to help, and even if we are not the best option we will recommend one that is! 

Why Care Gaps Are Really Data Gaps

Gap

In healthcare you will often hear, or see in the news, talks about care gaps. Care gaps is used to describe when a link in the chain along the journey is not connected. Think of care gaps as a way to address a particular path/journey/experience in the same manner every time.

Addressing journey experiences is very important for systems and providers as it provides patients with a better experience overall, reduces risks and increases the success of each visit.

CareGaps

White spaces

Care gaps live in white spaces, spaces that need to be addressed to resolve a particular initiative that is usually unique to addressing the unique population that provider/system serves. This is an important part, because you can’t have the same care gaps for every hospital be the same, although there are guides and standards people follow as a starting point most often you will see systems really take a unique approach to it which is important for them to stay innovative.

Strategic initiatives look at resolving these challenges at a high level; for example lets say a patient visits a doctor and then he is referred to a specialist and instead of making appointment on the spot the patient has to call a different number make an appointment. Then once the patient gets there the doctor does not have their information, this is a big care gap.

In this area is where care gaps work to solve the white spaces and they do this using workflows that can be followed consistently over and over again.

Workflows

Workflows go hand in hand with care gaps. Care gaps identify the challenge we need to address and workflows is how we address those challenges. So if we were to take a look at it the flow goes from strategic initiatives to care gap identification to workflows.

Once workflows are identified then operations can begin executing those workflows and then we can measure the output of those and repeat the process or adjust until we find the right formula that provides consistent results

DataGaps

Data Gaps not Care Gaps

When thinking of addressing care gaps what is always absent is the data gap. We have a larger data gap problem than a care gap problem. If we take our example of a basic referral for instance and ask the question is why is it missing? There are a few reasons that could be:

  • Provider is not inside the 4 walls of the system OR
  • Provider is using their own EMR system OR
  • Provider is completely independent and even in another location/state

When you dig into all care gaps you will find it is often, if not always, a data gap issue that needs to be addressed – and any care gap or workflow built to work around this often ends in less than desired outcome.

It’s time to look at data gaps to inform care gaps

When working through the customer journey or doing an experience map, it is vital that we use data gaps that we have to inform those care gaps rather than the other way around. Unfortunately we often come at it only from a care gap perspective leaving our IT team scrambling to identify where data gaps exist and how to fill them.

Often this results in workarounds that cause more work for providers than is needed. Instead we really should start looking at data gaps to help inform these care gaps, in fact if we look at our data gaps we can identify large gaps that we have and by solving those we would be informing care gaps about which gaps can be addressed and which are the biggest whitespace to fill.

This is where a platform comes in, platforms help you resolve data gaps quickly or at least offer a path to a solution quickly that does not require you to have to build out a team or projects with every single new identified data gap.

How is Hart Connecting the Missing Pieces of CHOC’s Data Puzzle?

Building jigsaw puzzles is a favorite pastime of many, young and old. Not only are there proven benefits to puzzle building, but seeing an image come together with each piece can be one of the most satisfying exercises, knowing you’ve reached the end as you place that one last piece. Yet, the moments of frustration when pieces are lost or are mixed in other puzzles somehow.Similarly, in today’s healthcare industry, a patient’s care team consists of multiple touch points with various specialists, imaging centers, pharmacies and beyond. Collaboration is key when it comes to continuity of care, but it does not always mean connectivity. With the various systems in place, sources from each facility often do not communicate with each other. One patient may be manageable, a handful may be as well, but for hospitals caring for thousands of patients with multiple levels of data details, there exists a complicated puzzle the healthcare industry has long been trying to solve. 

At Hart, not only do we love to build puzzles, but even more so, we love to solve them. When Children’s Hospital of Orange County shared their challenging data puzzle, we were motivated to ensure improved care for their pediatric population. Hart and CHOC’s mission is to place patients’ well-being at the center of everything we do. We couldn’t wait to get started.

Healthcare data is at the core of our mission, our day-to-day currency that feeds the healthcare engine. We ensure that hospitals that maintain a close partnership with more than a dozen prominent clinical institutions within a community work together to improve access to care and to make a difference in their patients’ outcomes.

In the words of CHOC, “This problem derives from the use of different EMR systems, forcing patient records to be spread among incompatible systems, and preventing valuable information from being easily transferred and accessible across the healthcare system.”

As an extension of CHOC, we went to work seamlessly linking the differing EMRs and clinical systems, by way of our bidirectional API platform. Occurring in near real time, the most current set of data is collected, merged and redistributed into CHOC’s population health tool (Cerner’s HealtheIntent), filling in the missing pieces of information that can potentially play a determining role in a diagnosis.

With every piece of data weighing significantly for each patient, it is increasingly gratifying to be part of patients’ paths to recovery. After equipping the immunologists of CHOC with a holistic data plan for 150,000 patients, the outcomes started to speak for themselves. Not only was there a financial impact on managing the pediatric population by saving the hospital over $1,000,000, over the course of 8 months, the data collection and reallocation helped increase the distribution of Asthma Action Plans by 30%, resulting in 18% fewer unexpected visits to the Emergency Room. That’s 27,000 children that can be busy playing with puzzles instead of being rushed to a hospital yet again.Collectively, our teams acknowledge the importance of fluid data operations and we look forward to continuing our collaboration with CHOC and completing the puzzle for each patient, big and small. We want to make physicians feel confident so communities can thrive with healthy children running around in that California sun.