Geisinger's Nicholas Marko: Why health systems need chief data officers [Q&A]

While data and technology in healthcare have a synergistic relationship, by no means should they be considered the same thing, according to Geisinger Health System Chief Data Officer Nicholas Marko.

"It used to be that the limiting step for using and accessing your information was the technology that it's stored on," Marko (pictured), who also serves as director of neurosurgical oncology at the Danville, Pennsylvania-based provider, tells FierceHealthIT. "But this is where the idea for an information technology department came from; we said that it's about the infrastructure and also about the information that's on it, but the technology part of things is really the central focus."

In part one of this exclusive, two-part interview, Marko shares his thoughts on the buzz and origins of "big data," as well as the importance of chief data officers for provider organizations.

FierceHealthIT: Many in healthcare say the term "big data" is overused; what do you think?

Marko: I agree. I think big data has become a buzz phrase and that, in many ways, it misses the point of what we are focused on.

The interesting thing about big data is, I feel like it was a term that was really popularized because vendors in all industries--not just healthcare--like return. It makes a lot of sense if you're someone who happens to sell large-scale data storage or data management platforms. It's particularly attractive to someone who happens to sell devices that store and move raw data--ones and zeros.

It sounds funny, but if someone who was an end user or consumer of the information had coined the term, it would probably be something like "big knowledge" or "big information." It sounds awkward coming off the tongue, which is probably why they didn't do it.

The idea of focusing on the word "data" makes it less about the information content and more about the raw stuff being stored on the disk. I think that's why people like myself find the term "big data" to be a little bit misleading. What I'm more focused on is the insight to be gained from utilizing that data.

FHIT: What's the difference, then, between big data and other data?

Marko: A concept that everyone can agree on is that information is being generated at a progressively faster pace. There's also a cultural change around information, which is, it used to be that we threw away a lot of information that was created or generated as a secondary part of our transactional business. There's a lot of metadata and secondary information that is created as a byproduct of primary functions.

It was always expensive to store that stuff, and so people just threw it away. But now that it's cheaper to store that information and it's relatively easy to use that information, people are keeping it for longer periods of time. I think that's the concept that underlies the big data revolution.

FHIT: How do the roles of chief data officers (CDOs) differ from chief information officers?

Marko: Saying that data executives and technology executives are the same is like saying that cars and highways are intimately associated, so the same person should build and manage cars and highways. But there's a whole science to building highways and there's a whole science to building cars; they're two different things.

The idea of a chief data officer comes from the notion that organizations are realizing they need a technology infrastructure and an information infrastructure, and that lumping those things together is becoming a game of diminishing returns.

Over the last decade, we've evolved to the point the where technology is becoming more and more commoditized. That doesn't mean that it's not impressive and not getting better, but we're focused less on the backbone and less on the architecture because we know we can reliably feed whatever scale of data we need and move it from point A to point B. There's always a way to do it.

So we're less about the technology now and more about "OK, great, we've got all this information, how can we use it?" As both of those domains have become more specialized, we're starting to see a divergence in the typical information and technology spaces. The technology people are very focused on the latest and greatest tech that the information is flowing on, but they don't have the same skill set as people who are focused on how you interpret the data that is flowing on those things.

FHIT: Should more organizations put an emphasis on hiring CDOs?

Marko: I think that five to seven years from now, there will be a lot more places that will have a technology expert managing the tech side of things and a data information expert managing the data information side of things. That sort of dual role of the CIO will become progressively split because it's really managing two domains that are more and more fundamentally dissimilar, especially in healthcare. Care delivery and treating patients really have very little to do, fundamentally, with the technology infrastructure. While the former depends heavily on the latter, it's not as though we're in the business of building servers or writing software; we're in the business of using those things.

The reason why the CDO merits being an executive-level position is because there's a very strong strategic component if you're doing the job right. It's not just about how do you compute information; it's not just about who gets what information put in their hands.

You want the person who's figuring out how to use your information most effectively to be at the same table with the person who's figuring out your business strategy, your marketing and product development strategy, your budget, etc. It's all different pieces of the same thing going on. CDOs aren't just guys who deal with databases. 

Editor's Note: This interview has been condensed for clarity and content.

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