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Posted by Boris Evelson on April 7, 2009
I am writing this blog on my way back home from www.himss.org show in Chicago, while a tingly chill crawls down my back. It’s a creepy feeling of déjà vu. Even worse, it feels like the movie Groundhog Day where the main character keeps waking up on the same day, same date, never able to get to tomorrow. Everything he was able to achieve during the day is erased, and he has to do it over, and over, and over again. This was the feeling I got as I walked the show floor and kept asking myself questions such as:
I thought we addressed all these basic truths decades ago? Ah, forgive me, I must’ve been thinking about the wrong industry. I was talking about the Financial Services vertical, where after the dark ages of 70’s and 80’s, we finally entered the renaissance age of enlightenment, standards, openness, and transparency. Well, while we may be past the King Arthur times in Healthcare IT, we are not too far from it, probably just approaching the days of Charlemagne trying to unify Western Europe.
As I explored the Healthcare IT show I found the state of industry BI where
As a result, all of the healthcare IT execs I managed to pry away from listening to yet another pitch from a vendor that was all about “Me! Me! Me!” named three top challenges that they all face every day: integration, integration and integration. Another Healthcare IT executive tells me that it took them about 3 months to write database, application and GUI logic for their hospital EMR system, but it is taking them years and years (still going strong) to integrate pharmacy and lab data even within their own hospital network! She defines standards like HL7 purely as communication standards, not content standards, the lack of which is the real culprit. Until this status quo changes, I do not see a bright future for such noble and highly needed industry initiatives as:
There’s no rocket science behind these initiatives and drivers, but they will not materialize until the ice of proprietary and closed architectures is broken. What will it take to change all that? Surely not the $19B of questionable spending that the Obama administration is throwing at the problem (which is really just an extension of http://www.hhs.gov/healthit/ initative started by the Bush administration back in 2004). Just look at the $22B that UK allocated in 2002 to similar initiatives to transform its National Health Service information infrastructure. Proving once again that federally managed projects seldom work, in January 2009 the British Committee of Public Accounts (similar to the US GAO) released a less than stellar progress report citing four to five year delays, major contractors bowing out of the projects, and, most importantly, eroding support from the key stakeholders — physicians, dissatisfied with “essential systems that are late or when deployed, do not meet the expectations of clinical staff”. Surely, we should learn from the mistakes of others, not our own.
No, nothing short of free market competition and an IT practitioners revolt will change that. And there’s hope and light at the end of the tunnel:
What can you, a Business Process and Application (BP&A) professional, do? While I could write a series of epic novels about everything you could do you improve the state of Healthcare IT, I have to get onto my flight in a few minutes, so I will be merciful and just share my point of view on a few BI specifics:
BI is not a panacea, but it's a start. True, BI is useless until data is clean, integrated and aggregated. But you should not wait for that to happen before implementing your BI solutions. Just the opposite. Use BI as a perfect tool to start exposing your data problems, and demonstrate to key stakeholders what data issues you have and how you can start addressing them. Results from BI reports are a great supporting evidence for justifying data integration project budgets.
Leverage our BI related Waves. Use and leverage Forrester's BI Wave, ETL Wave, and DW Wave when evaluating Healthcare BI solutions. If data integration, data cleansing, data warehouse, reporting, OLAP, and dashboard tools are not built on one of these standard and open technologies, that’s a huge red flag! At the very least, use the criteria in our Waves to evaluate, score, and rate the BI vendors you are shortlisting.
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