Why Care Gaps Are Really Data Gaps

Posted by Mohamed Alkady on Jan 17, 2019 11:02:26 AM
Mohamed Alkady
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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.

Topics: Data, Interoperability, Platform