Mother Jones magazine recently published a critical piece about EHR vendor Epic. It reported: 1) "There is no interoperability."What does this mean? It means the information remains in silos. 2) "Epic focuses on Epic-to-Epic data exchanges."What does this mean? No interoperability and more silos. 3) "Is the government fed up with Epic?" What does this mean? I'll bet they wish they would have selected only one EHR vendor for all 5,000 hospitals. Sure, I understand free market and capitalism, but healthcare doesn't have the time it takes for mergers and acquisitions to end up with only a few solutions. It's ironic that we currently have hundreds of technology solutions in an industry that doesn't have technology skills.
My email's auto-signature is a quote from my healthcare hero, Dr. Atul Gawande. Dr. Gawande says "We have one opportunity to leverage technology to improve care. That opportunity is data." Fortunately, the hundreds of technology solutions that foster non-productive "silos" are not our savior. So now what?
Last week, I read a cover story on big data. The author wrote: we need "smart people to analyze our data." I agree and disagree. The majority of our healthcare management leaders are smart, educated and experienced clinicians. Yes, they are smart, but they do not have the right skills set to analyze data. We built "IT departments" in hospitals to bridge that gap. I don't believe that solution works for the long-term big picture. So the question becomes, how do we provide data analysis tools to our smart clinicians? The answer is so simple.
My true confession starts now. As a self-proclaimed "Data Diva" who provides almost 100 percent of data analysis performed at my facility, I have never received any IT education. Sure, I've been using Excel for years, but let me repeat myself. I have never received any IT education. It was simple enough to acquire skills through practice. Working with data means working with Excel spreadsheets. And data analysis means sorting Excel columns over and over until you notice an outlier. It doesn't take a smart person to do what I do.
Here's a case from last week. Our medical records department reported it had a "severe delinquency" issue with physician documentation and asked for help. Medical records knew it had a problem because it had a huge pile of incomplete charts. What it didn't have is a huge pile of meaningful data, therefore, I asked the department to create a simple list. I knew this was another case of emotion versus evidence. I sorted the list by physician and immediately found four doctors who were responsible for 80 percent of the delinquencies. As always, the 80-20 rule applies in any big data set. I quickly created a data illustration using a simple bar chart and publicly posted my findings. This task took me three minutes to complete at most. Luckily, I've never met a physician who doesn't panic when they see their name on the "worst list." Without any twisting of arms, our "delinquency" issue disappeared.
Lord Kelvin, a physicist from Belfast who died in 1917, said "without a numerical understanding, we have no understanding." Unless we manage with metrics and data, what do we actually manage? Data teaches us that emotional anecdotes, although interesting and dramatic, never get resolved. Data is the greatest single tool for compliance I've ever met.
Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey.