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The Wonders and Headaches of Healthcare Data Management

8 Oct 2014 by Teresa Meek

Who isn’t struggling with data management?

With ever-increasing volumes of data and new apps and databases for managing it, not to mention security issues and government regulations, every industry is faced with an confusing array of IT choices that didn’t exist a couple of years ago.

But data management is particularly tricky in the healthcare industry. IT departments need to integrate data from so many different groups — patients, health care providers, insurers, pharmaceutical companies — that ensuring privacy and security can be a nightmare. Integration itself is often tough, but the health care industry has no choice: federal regulations insist not only on electronic health records must be included, but interoperable data, as well. And everything must meet the requirements of ICD-10 and HIPAA 5010.

It’s also critical for healthcare data systems to operate reliably 24/7.

As the healthcare industry moves toward a model of more accountable care and increased sharing with patients, it needs to develop systems that coordinate care not only to meet federal regulations, but to satisfy patient expectations, as well. Coordinated care is all about data management and analytics.

With so many stakeholders involved, it comes as no surprise that the healthcare analytics market is huge. A recent report by Markets and Markets estimates its value at $4,430.9 million in 2013 and expects it to reach $21,346.4 million by 2020, growing at a rate of over 25.2% from 2013 to 2020. Most of the growth will come from healthcare providers.

They will be spending enormous sums on data management in the coming years, but some think its money well spent and will lead to lower costs generally in the long run.

In his keynote speech to the Health Information Management Systems Society (HIMSS) Feb. 24, Aetna CEO Mark Bertolini said that, in the U.S. healthcare system, more than $800 billion a year is wasted on unnecessary services, hidden administrative costs, inflated prices, inefficient care delivery, and administrative costs. Cutting out the fat could pay off half of the country’s national debt within 10 years, he said. A good data management plan goes a long way toward eliminating these inefficiencies.

Another factor is accountability. Employees now pay 41 percent of healthcare costs, but their share is expected to grow to 50 percent. With more skin in the game, employees now have an incentive to drive costs down. New data management techniques allow them to do that, in part by coordinating their care with providers in more efficient ways.

Pharmacies, the go-between for patients and doctors, are leading the way with applications that let patients download and share their prescription history. Some also provide assessment tools to nurse practitioners, and even kiosks that allow video chats with doctors. Other health apps allow patients to find a provider and make an appointment using their smartphone.

Setting up and running a health care data management system that satisfies patients’ desire for convenience while coordinating with external and often-incompatible systems and managing regulations can be a real headache. But as we wade deeper into the Information Age, not doing so will be fatal.