I read any story on healthcare reform with interest because the complexities and cost of reform will be significant.  One hopes that the benefits will be significant too, but that remains to be seen as reform is implemented.  I am also firmly convinced that technology will continue to change and improve the quality of care, while reducing the cost of care.  This combination is desperately needed, and integration will help us better manage change.

As mentioned in a recent Healthcare IT News article, “three forces are driving the transformation of the healthcare industry: regulatory reform is changing the industry structure, technology is creating a revolution in healthcare delivery and personalized medicine is disrupting the practice of medicine.”

Data is at the center of all of this change.  Reform will cause the healthcare industry to view patient data differently, and will require new connections that haven’t occurred in the past.  New, innovative connections between patient and doctor, and provider and insurer are already happening.  Where there are data and connections – there needs to be better integration.  Integration technology works behind the scenes and is critical to “make stuff happen” and to enable people or communities to connect with one another. 

These three transformational forces have caused healthcare providers to become even more concerned with coordinating and synchronizing results for their patients, for staffs and partners.  If everyone has one comprehensive view of patient data, for example, better care happens naturally with better communication and connectivity.  Mistakes are reduced, redundant tests are no longer needed, and entries of information go away.  In short, everyone’s on the same page.  I argue that this coordinated view is possible with better integration, and that integration doesn’t have to be difficult.  Incremental approaches to comprehensive integration can happen today. 

Integration provides connections between various disparate systems and applications to provide this single view of data.  Today, integration isn’t just about tracking and reporting on past events.  Real-time integration is about routing data based on the content of the data, applying rules to the data, causing things to happen based on the flow and content of information and how others react to the data.  On top of this dynamic mix of data and rules is a real-time view of data and the impact that data is having or showing on the enterprise.  Do I have enough inventory, staff, and information to make the right decisions?  If not, where do I go to get the information I need?    This one view of data helps organizations improve care, lower risk and increase revenue. 

The time to revisit integration is now.  Connected and synchronized healthcare data combined with the ability to manage it in real-time, will help healthcare organizations face reform, connect new technologies to old, and handle the future of healthcare, whether care happens in a hospital, clinic or at home. 

Technology has always made the seemingly impossible possible, and integration technology is no different.  In fact, while it’s addressing the “impossible,” integration technology also protects the investments you’ve already made and helps you adapt to reform and other mandates.  Integration technology is back in the limelight as the critical application to pull it all together, and the healthcare industry only stands to benefit from better integration.

With today being tax day in the U.S., many of us are focused on what we have paid in taxes, and what we get for our contributions. As our budget balloons to levels that some in both the White House and the Congressional Budget Office call unsustainable, many are thinking about how the country can lower healthcare costs (and therefore lower our collective tax burden). The question is how do we work to control the expansion of the U.S. budget while keeping a high level of care for patients? One answer is telemedicine.

Telemedicine offers a way for patients to use today’s technology to communicate with their doctors. Existing telemedicine communication tools include simple interfaces like phone, e-mail and fax. Newer tools include self-service healthcare websites and live video conferencing such as Skype or Google Wave. Telemedicine also includes home health, web-based medical decision support to self-diagnose, online PDR (physician desk reference), and direct interaction with remote medical resources via electronic collaboration tools. Armed with this technology and better information, patients take a more active role in their health. Care effectively shifts from a passive to a more proactive healthcare model.

Don’t forget that telemedicine isn’t about the technology, however. Technology is the enabling tool that allows patients to play a more active part in their healthcare. Telemedicine moves some patient care from traditional settings such as hospitals and clinics to that of the patient’s own home or location, saving us time and trips to the doctor. Today we are already using telemedicine tools such as phone, fax and email. But new more interactive self-service tools are being created all the time to help patients communicate with their healthcare providers easily and quickly, making us better informed and more in charge of our healthcare. Doctors use telemedicine to have access to the latest medical information available, and use aggregated data and baselines of care from a large collective of patients with the same health issue. This gives our doctors better information so they can provide us with the best care plans.

As access to telemedicine tools becomes more ubiquitous, patients will be able to communicate with their doctors on their iPhones, for example, no matter where either party may be located. In essence, telemedicine represents a patient revolution. It is on the path to becoming the leading way patients communicate with their doctors and doctors communicate with other healthcare providers to provide us with better care. Telemedicine holds promise for producing huge time and cost savings and improving care and outcome for patients. We can all benefit in the adoption of telemedicine, by the reduction in costs (which should help control the overall healthcare budget).

While telemedicine helps make patient care more convenient, effective and inexpensive, it cannot cure how we feel about paying taxes, unfortunately. But we can take solace in the fact that as telemedicine is adopted and becomes more common, it will help reduce healthcare costs, which should help reduce taxes for everyone.

While visiting the White House Health Reform website this week, I thought about a statement in a feature piece that stated:

“After nearly a century of trying, and after more than a year of extensive debate, the President signed into law a health reform bill that brings down health care costs for American families and small businesses, expands coverage to millions of Americans and ends the worst practices of insurance companies.”

“Worst practices” jumped out at me. While worst practices of healthcare insurance companies and other payers has been the focus of much of the debate over the past year, I like to look at what insurance companies need to do to focus on best practices: on reducing their costs while providing better information to hospitals and patients to improve care.

For 10-15 years, most payers have been in a state of turmoil as they deal with multiple compliance measures and increasing amounts of data to maintain, control and exchange. These changes have included electronic data interchange (EDI) regulatory mandates such as HIPAA EDI 5010, NCPDP, ICD-9 to ICD-10 conversion, meaningful use, HITECH (PHI), etc. Each of these mandates will require massive effort so that payers can meet all requirements (which by the way will come in rapid fire order over the new few years). Insurance companies and payers have started to really feel the pain that can accompany change.

Add to that the ‘burden’ of the new health reform laws, which call for an expansion of EDI standards along with uniformity of EDI usage between entities and some insurance companies can quickly go from turmoil to overwhelmed.

I maintain that it’s time to start managing the chaos. If insurance companies and payers have not begun to find technology solutions that help collect, control and manage data, they will soon be hit with penalties. The time to evaluate one’s organization’s data and practices is now.

The good news is that the additional burden is based on the CAQH organizations recommendations which press for uniformity, much like their CORE certification. Organizations can evaluate their systems now, because the test data and certification requirements are all openly published, without having to pay for certification. We at BridgeGate used their test data (Phase I and Phase II) and found that compliance is not tough at all.

The only way to solve this is massive data onslaught is to relook one’s approach. This is a business issue, not an IT issue. What will win the day for the payers is not how much money or programmers can be thrown at the problem, but how successful a flexible and business-oriented approach can be. One path to get there? Use an integration platform where the business can configure and control at the hub, and let IT program at the periphery where needed. The business side has to be actively involved in the change, or all of this burden on top of turmoil will bury the IT groups within insurance companies worse than Y2K.

Change is here, and integration helps manage change.

The Economist magazine recently produced a special report on managing information, and in it, the report outlined the struggle to keep up with loads of information.  The report details how the world produces and holds a stupendously vast amount of digital information which is getting bigger by the minute.

If it’s managed properly, data can be used as a key to unlock new businesses, provide transparency of governments and other entities, and add to scientific ventures.  With more data we have endless possibilities – we can use  the data to spot trends, adjust our business practices, inform populations, prevent disease, combat crime, and so on.  But a huge amount of data also creates big headaches when it comes to capturing, processing, storing, sharing and protecting that information.  And that is just moving the data – changing and running a business based on the information that is “in” the data is even more complicated!

Turning raw data into actionable information is a challenge that some organizations are conquering effectively.   One of the latest trends in healthcare is electronic medical records (EMR).  Digital records should make life easier for doctors, bring down costs for providers and patients and improve the quality of care.  But in aggregate, the data can also be mined (business intelligence applied) to spot unwanted drug interactions, identify the most effective treatments and predict the onset of disease before symptoms emerge.  Stand alone software applications already attempt to do these things, but need to be explicitly programmed for them.  And most software applications need information that is held in other applications, records, databases, transactions to make the best decisions.  In a world of big data, the correlations surface almost by themselves, but data integration is key to making these correlations happen.

Government entities are using big data to fight crime, improve city services and inform the public about various initiatives.  With budgets being slashed during the recession and a new emphasis on transparency, government agencies are looking for a way to use information to become more efficient.  Moreover, providing and sharing information opens up new forms of collaboration between the public and the private sectors.  Data is the driver to help these organizations solve problems quicker.

So with data becoming more abundant, the main problem is no longer finding the information you need, but finding the relevant information you’re looking for.  To be beneficial to one or many, data must be organized, and it must be shared with other people and systems looking for the same data.  Right now your IT staff is concerned about big data, and they have a right to be, given all they have on their collective plate.  Data integration helps solve these issues of relevancy, organization and sharing.   The best integration solutions do all of the work connecting the data for your IT folks, so that your business people who need to use the data can very easily access the data they need and set up workflows that help them pull that data on a regular basis.

If you have questions or comments about how data is getting bigger and how to connect your data or handle it, let us know.  We’d be happy to see if we can help.