Healthcare Analytics Adoption Model: A Framework and Roadmap (white paper)
portrays how medical innovation will coalesce to change clinical practice and what the coming changes mean for today’s policy debate.4 In Dr. Topol’s vision, iPhones, cloud computing, gene sequencing, wireless sensors, modernized clinical trials, internet connectivity, advanced diagnostics, targeted therapies and other science will enable the individualization of medicine – and force overdue radical change in how medicine is delivered, regulated and reimbursed.
But unlike any prior time in medicine, this revolution is superimposed on a world of social networking, omnipresent smart phones with pervasive connectivity and ever-increasing bandwidth. This great convergence will usher in the creative destruction of medicine. At the same time, consumers have an unprecedented capacity to take charge – it is their DNA, their cell phone, their precious individual information.
The resulting analytics will be applied early in the patient’s life to develop a lifelong health optimization plan. When healthcare delivery is required, the patient’s treatment protocol is tailored specifically to that patient based upon the insights gained from these new data sources and algorithms. The boundaries of evidence-based medicine are extended beyond the limited applicability of randomized clinical trials to include the quasi-experimental evidence that emerges from local and regional enterprise data warehouses. This locally derived evidence is shared with commercial clinical content providers to iteratively enhance the knowledge content from randomized clinical trials.
Healthcare around many parts of the world has been moving through three phases of computerization and data management simultaneously: data collection, data sharing and, now, gradually into data analytics. The data-collection phase, characterized by the urgent deployment of EMRs, will not have a significant impact on the quality or cost of healthcare. Numerous retrospective studies of EMR deployment have yet to reveal anything other than a very modest return on investment.5 The overwhelming failure rate of health information exchanges due to unsustainable economic models is also well documented.6 However, the investment in EMRs is fundamentally required to achieve the value that is accessible in analytics. The return on investment of EMRs, let alone impactful health reform, will not be realized until the healthcare industry invests in enterprise data warehousing and commits culturally to the exploitation of analytics – that is, to become a data-driven culture, incented economically to support optimum health at the lowest cost.
Current adoption rates of data warehousing and analytics stand at only 10 percent and just a small subset of those early adopters operate above Level 3; none operates consistently above Level 5. ln informal polls conducted by Sanders during webinars on this topic, webinar participants consistently report their organization operating between Levels 2 and 3, no higher. By observing the events and tools that encouraged the adoption of EMRs, notably the EMRAM, the Healthcare Analytics Adoption Model follows suit and provides a framework for more rapid progression to analytic maturity.
Notes 1. Healthcare Data Warehousing Association (HDWA). 2012. Retrieved October 1, 2012. http://hdwa.org/. 2. Sanders D. A Model for Measuring Industry-Wide Adoption and Capability of Healthcare Analytics and DataWarehousing in the USA. ElectronicHealthcare. Vol.11 No.2 2012. 3. Pestotnik, Classen, Evans, and Burke. Implementing Antibiotic Practice Guidelines through Computer-Assisted Decision Support: Clinical and Financial Outcomes. Ann lntern Med. 1996;124(10):884-890. 4. Topol E. The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. Basic Books. January 2012. 5. Miliard M. Hospital Execs Slow to Measure Technology ROI. Healthcare lT News. October 25, 2012. 6. Survey: Lack of lnteroperability Hinders Health Data Exchange. iHealthbeat. October 04, 2012.
ABOUT THE AUTHORS
Dale Sanders, Senior Vice President, Health Catalyst
Prior to his work in the healthcare industry, Dale Sanders worked for 14 years in military, national-intelligence and manufacturing sectors, specializing in analytics and decision support. In addition to his role at Health Catalyst, Sanders serves as the senior technology advisor and ClO for the National Health System in the Cayman Islands. Previously, he was ClO of Northwestern University Medical Center and regional director of Medical Informatics at Intermountain Healthcare, where he served in a number of capacities, including chief architect of Intermountain’s enterprise data warehouse. Sanders is a founder of the Healthcare Data Warehousing Association. He holds Bachelor of Science degrees in Chemistry and Biology from Ft. Lewis College and is a graduate of the U.S. Air Force Information Systems Engineering program.
David A. Burton, M.D., Executive Chairman, Health Catalyst
A former Senior Vice President of Intermountain Healthcare where he served in a variety of executive positions for 26 years, Dr. Burton spent the last 13 years of his career co-developing lntermountain’s clinical process models utilized within the EDW environment. Dr. Burton is the former founding CEO of lntermountain’s managed care plans (now known as SelectHealth), which currently provide insurance coverage to approximately 500,000 members.
Denis J. Protti, Sc.D., Professor Emeritus, University of Victoria
Dr. Protti was the founding Director of the University of Victoria’s School of Health lnformation Science and a former faculty member. Prior to joining the university, Dr. Protti held senior information systems executive positions in Manitoba and British Columbia hospitals. His research and areas of expertise include National Health lnformation Management & Technology Strategies, Electronic Health Records, Primary Care Computing and Evaluating lnformation Systems. Dr. Protti was also the first recipient of the Canadian Health Leadership Network’s MacNaught-Taillon Award for his contributions to Canadian healthcare. In May 2009, Dr. Protti was granted an Honorary Doctor Science from City University London for his contributions to the British healthcare system. ln 2012, he was the inaugural recipient of the Techna Health lnnovator Award.