In the Clouds

One of the underlying assumptions in this blog, The Art of Medicine and Technology, is that we will continue to gather more data, hopefully learn from it, and use it to provide continually improved care. Most of this data will be gathered using electronic medical record systems and other information technology systems that are increasingly finding their way into physician practices and hospitals. In our day-to-day lives, we use all kinds of tools that store messages, documents, websites and photos on servers outside of our physical control. We’re growing increasingly dependent on services in the “cloud” of connectivity to store, maintain and move our information. In the field of medicine, the growth of EHRs, and their eventual connectivity as part of the Nationwide Healthcare Information Network (NHIN) will add new dimensions to this concept. What they are talking about moving around however, is data about patient care, quality reporting and payment for services. What about the “knowledge” we will gain from research done on data? » Continue reading “In the Clouds”

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Timely Article on Data Sharing

Almost forgot to point out the interesting article in last Friday’s New York Times about a large data sharing project that led to some discoveries about Alzheimer’s. One of the study’s most interesting principles was that there would be no “ownership” of the data, and that it would be shared freely among several groups. The full article is here. Just days before this article, I posted questions about data ownership and intellectual property rights concerning medical discoveries, so it was great to discover that this was being addressed. Let’s see what influence it has on the “market” for knowledge.

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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Pay Yourself First

Financial advisors will often tell you to “pay yourself first.” That is, if all of your paycheck goes to pay the bills, you’ll never have any savings or build any long term equity. Set something aside for yourself right off the top; then pay everyone else. The same concept works with data. In the US, the new rules for ‘meaningful use’ of EHRs require physicians and hospitals to report quality data in order to qualify for incentives through Medicare and Medicaid. In a paper-based environment, pulling quality metrics for reporting purposes can be time consuming. In an electronic environment, there will be all kinds of data collected during the course of providing care, and some of it will be used for quality reporting. The bottom line is that in theory at least, technology will make it much easier to collect the kind of data that agencies currently require. If you look at the meaningful requirements as nothing more than a checklist, you may miss a great opportunity to learn something about your organization and the community you serve.

Remember that it is first and foremost, your data. Certain elements must be reported of course, but here is the chance to “pay yourself” by thoughtfully planning how to analyze the data you will be collecting by asking:

  • What are the missing pieces of information about your practice or hospital that would really help improve efficiency, safety, patient satisfaction, etc.? (This is not a question you ask the IT department.)
  • Does the information exist?
  • If it does, who has it? If not, can it be captured?
  • Can the EHR capture the data? Is reprogramming required? (Now you’re talking to the IT department.)
  • How can the data be accessed?
  • How will the data be validated and analyzed?
  • Who should do this?
  • What will be done with what is learned?
  • How have you prepared everyone in the organization to accept the analysis as 1) valid and 2) contributing to the overall success of the mission?
  • What else can be discovered?

Welcome the flood of data; use it to your advantage. While the requirements for meaningful use will be met through federal reporting requirements, your organization will see the immediate benefits of this “self reflection” because you had the foresight to pay yourself first.

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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String of Questions

I’ll admit I don’t have an answer to this question: We talk about “data ownership” related to data that has been collected and stored. Some argue it is the patient’s data, while others claim it belongs to the institution that collected it. But as we get more and more information flow among various organizations, and as data in aggregate becomes more available to researchers, will there be such a thing as ownership of “discovered knowledge?”

I suppose the answer to that depends upon whether or not the analysis of collected (anonymous) medical data remains an academic exercise. Cynically, I would say that it really depends on who paid for the research to be done. So the question here is, if a private enterprise analyzes data in such a way as to learn something completely new about how the body works, or what causes a disease, is the enterprise obligated to share its knowledge as a contribution to the greater good? Or can that knowledge be withheld while a unique drug or treatment is developed for profit? I’ve just been thinking about this one, as our ability to collect more and more data will have been provided as the result of a huge public investment in EHRs through HITECH and other health reform legislation.

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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