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The McKinsey Global Institute estimates that the sheer volume of healthcare data and the industry's inability to tap its potential adds up to more than $300 billion annually in wasted value. Add to that compliance with federal privacy laws, and it's no wonder patient care is often a mess.
Multiple health data sources keep information such as clinical, financial and operational data siloed and separated, a problem that's compounded by each data system's unique validation rules, formats and key identifiers. With different databases and software systems holding different subsets of data, it's difficult to get a complete picture of a patient -- so accurate analysis of all that information is tough to do.
The Health Insurance Portability and Accountability Act, or HIPAA, mandates data-handling practices, restricting access to patients' data sets; only practitioners directly involved in their care and whoever else they request can lay eyes on it. To comply with these rules, healthcare providers often maintain information silos, with clinical data segregated from billing data, for example.
Consultant Nathan Caro said that at the healthcare analytics provider where he previously worked, data such as a patient's name, address, demographics and insurance info was organized in separate tables. Rigid rules and formats governing the data sets made it challenging to link business information such as billing transactions and clinical data such as records of doctors' visits with patients. Caro said hospitals would send his company huge chunks of data, none of it structured -- billing information mixed with patient data as well as insurance claim codes. Identifying which information was relevant to which business units became a herculean task.
"You need to figure out what people can or can't see, then provide the means to be able to get it," said Rick Sherman, founder of consultancy Athena IT Solutions. "The issue once you get outside your firewalls, or when you move data out of your database, is that you have a responsibility for how the people distribute that data out. To give them online access so they can look things up, that's one thing. If you actually physically give them the data, then you have another issue."
Healthcare industry trade associations and government rule makers are pushing for standard data formats and information governance practices, but it's a big market. And until some standards are in place, analysts are on their own.
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