The case for improving health data liquidity

September 17, 2012 | Kristine Martin Anderson, Senior vice president, Booz Allen Hamilton's healthcare market

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Kristine Martin Anderson, senior vice president in Booz Allen Hamiton's healthcare market

While some disagree on the right approach to transform our healthcare system, most will agree that patients must remain at the core. In order to deliver on the promise of more affordable, convenient care, healthcare decision makers should look at every decision with the patient at the center. How patients experience health reform over the next few years will be the measuring stick of health reform success.

To date, progress has been made in a few areas but we still stand removed from a truly patient-centric healthcare system. To meet this objective, more should be done with patient data – from how it moves within the healthcare system, to how it is analyzed and presented.

[Also by Kristine Martin Anderson: 9 ways health IT helps patients.]

First, greater attention is needed on healthcare liquidity: the ability of patient data to move throughout the healthcare system securely. Liquid health information, distributed digitally through electronic health records (EHRs) and health information exchange mechanisms has potential to transform nearly every aspect of healthcare delivery. Digitized health information, and its movement, has enormous potential – it can paint a vivid, real-time picture of the patient’s experience, creating knowledge and collaboration among the patient and his or her healthcare providers. Liquid healthcare information can facilitate improvements in healthcare quality, efficiency, convenience, and outcomes while encouraging innovation and providing a foundation for a new standard of patient-centered, team-oriented care.

Unfortunately, healthcare liquidity is not rampant in our system. Patients – not exchanges or EHRs – remain the most reliable exchange mechanism within our healthcare system. Most patients can re-tell stories from their visits to their physician’s office where they've wasted time filling out form after form, trying to remember prior visits, prescriptions or procedures. Often, this information already lives within the healthcare system, stored in health records, whether paper or electronic. Unfortunately, the lack of liquidity has locked patient data, limiting patient-centricity. When we are successful in allowing this information to securely follow patients, many could feel assured that they and their physicians will have the right information to make the best decisions for their health.

Second, measures of quality need to make sense to the patient. Currently, the quality measurement system is heavily biased toward the needs of our healthcare delivery system – and does not speak directly to patients. This focus on measuring physicians and hospitals is important, particularly if you think about the types of measures that are created (measures that assess technical quality) and the intended uses of measurement, from accreditation and quality improvement to payment. However, the information that healthcare providers and payers need to assess quality and efficiency are not necessarily the same as information that patients need to make decisions about their care. Patients do not consume health information in the same way that a professional healthcare worker would consume health information. At the point of decision, they need personalized data that will help them play an active role in choosing the right treatment option, and an understanding of how they can achieve optimal health outcomes.

So, what are the possibilities for patient-centered measurement? For example, providers could translate a patient readmission rate for a hospital into a personalized calculator that physicians could review with patients and their family before admission, during hospital stay, and at discharge. This personalized information could show each patient what actions they could take to help avoid an unplanned readmission. In addition, mobile applications could be created to help patients navigate care transitions and help to ensure that they have received the recommended treatment.

The next few years will be critical to the success of our healthcare system – from continued EHR adoption, to HIE implementation and creation of Accountable Care Organizations. Regardless of the program or reform, the healthcare system stands the best chance for success when the patient is truly put first.

Kristine Martin Anderson is a senior vice president in Booz Allen Hamiton's healthcare market.

Reader Comments (2)Login to Post a Comment

Phil21841 says: Health Data Liquidity.........

September 20, 2012 | 3:34PM GMT

Great article! As an IT person for the last 20 years, and a HIT/EMR Consultant for the last 10, data liquidity can be easily accomplished! But, unfortunately, it's a highly political issue with large financial ramifications, as well! As we all know, we wouldn't have the WWW(World Wide Web)unless TCP/IP had been created as a 'standard' informational transport protocol. The same holds true for HIE, and a NHIN (National Health Information Network). While some standards have been created, such as LOINC, SMTP, SnoMed CT, for example, there is one that many have been keeping their eye on..... and that is Medcin. In order to have 'data liquidity' a computer has to be able to read, and intelligently use, "Clinical" data (And I emphasize 'Intelligently Use'). Over 20 years ago, our Federal DHHS did an extensive study on this very issue. They identified 2 vocabularies that could be utilized for clinical documentation - Medcin & SnoMed. (The providers note is where data fluidity HAS to start!) One was created, specifically, for clinical documentation. And, the other was created, specifically, for reporting purposes. But, the two were meant to work, in conjunction, with each other and can provide data liquidity! Remember, this was over 20 years ago! Politics & financial Impacts - Let's say that the ONC/PHDSC decided that 'enough was enough' and made these to vocabularies a standard for EHR's and their vendors. Within 6 months we would see vendors, large and small, falling by the wayside. Easy to say, but we're talking about hundreds of billions of dollars worth of Acute & Ambulatory vendors! This would be a larger 'crash' of the market than when we bailed out the auto industry! Vital industry standards, such as the one I'm talking about, would also make EHR's look and work the same way! And, since the health industry lobbyist's spend hundreds of millions of dollars, each year, pushing their agenda in Washington, the primary reason for this is to keep their systems segregated from their competitors. So, in a way, it's understandable why we don't have these types of standards in place. But, then again, think about how much farther along we would be if this type of a standard were in place for all EHR Vendors!?!? No more CCHIT certification process, as an example! No more wasted money on initiatives, such as HIE, where every state was provided millions of dollars to implement & create their own HIE's..... So, now we have 50 different HIE's that still can't function at a basic level! I just wanted to throw my 2 cents in there. Sincerely, Phil Albert

RightPatient says: Accurate identification of patients is key

September 19, 2012 | 12:01PM GMT

Great article Kristine, thanks for writing this. Patient centric care and the subsequent "liquid" flow of their electronic health records across a system certainly should be the key focus of healthcare transformation. It's interesting that at the heart of ensuring quality patient medical data is ensuring accurate patient identification, something I think goes unmentioned quite often. As more providers jump into the health information exchange and IDN networks, developing data integrity standards and adhering to them will be integral to ensure that master patient indexes remain clean and free of "dirty" data that could perhaps jeopardize the system. We are looking forward to seeing more providers make the connection that accurate patient identification is at the heart of patient centric care.