It's a common problem: Two medical groups merge or a hospital acquires a physician practice and suddenly there's duplicate information and disparate data sets that lack the ability to communicate with one another.
That creates a real mess and common issues to avoid include patient tracking, ensuring that physicians are doing what they should be, miscommunication, and a general lack of organization. Because it impacts downstream revenue, it's important to get data management right to avoid common missteps.
It's becoming increasingly clear that there are 3 V's of data management in these deals: volume in terms of the types of data and their respective formats, and there's significant velocity as well -- appointments happen all the time, so there's authorization and scheduling that need to be in real time. And then there's variety, the third "V" in the healthcare data hat trick.
"Mergers and acquisitions have contributed to the variety," said Graham Gardner, CEO of Kyruus. "You're jamming together lots of hospitals and physician groups who are often on different databases, and they have different languages for how they describe themselves. One group calls themselves cardiology, the other calls themselves cardiovascular services. It sounds trivial, but there needs to be some consistency."
Duplication and miscommunication are the unhappy side effects of this phenomenon, and both finances and clinical quality can suffer as a result. It's about organizing things properly. Providers make money by scheduling appointments, and they should be the right ones. It makes sense for a brain surgeon to perform brain surgery; it doesn't make sense for her to tend to a headache.
"The information required to book with someone requires understanding their credentialing," said Gardner. "Then you have to know what insurance I take. Then you have to know my registry. So what we find is that the information that's required to pull together a profile of physicians requires over 200 data elements."
With that many data elements, it's almost impossible not to have some waste. Oftentimes the systems won't realize tha Graham Gardner, G. Gardner, and Graham H. Gardner are all the same person. If the system doesn't understand that, then it's not utilizing the physician properly, and the healthcare organization isn't realizing the downstream benefits.
Matching a physician to their true specialty is another obligation the data must fulfill.
"There needs to be a common language to describe what everybody does," said Gardner. "What's happened over the last several years in medicine is that people used to train in orthopedic surgery, and Dr. Jane Smith, I'd send her all my orthopedic services. There's no such thing as one go-to orthopedic surgeon anymore. There's a spine person and a hand person and a foot person, etc. When someone says, 'I'm a hand surgeon,' you can enable that proper routing, and it creates a common language."
Duplication and miscommunication occur when the data is siloed, which is the key to unraveling this Gordian knot. Streamlining something as simple as a physician's address is a good place to start. Dr. Gideon Spencer's address might be in multiple places, including marketing databases, which might update the address every six months. But Spencer's billing system has the exact same information and is much more current. Ultimately the more trustworthy information, it's best to go with that, said Gardner, and eliminate the rest.
"There's value in organizing the data because you're going to see clinical and financial ROI based on that," he said.
Increasingly, data is king in healthcare, empowering patients and providers both with heretofore unprecedented amounts of information. When harnessed correctly, it's a powerful tool -- which makes it important for any provider to get their data organized in meaningful and actionable ways.
"What we've really seen is that this is a multi-stakeholder issue," said Gardner. "It's not just the data guys in the basement who care about this stuff. It's the marketing manager, it's the COO who's trying to run the call center and match supply and demand. Every single stakeholder at an organization should care about data and getting it right."
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com