The generation, collection, analysis and protection of healthcare data are fundamental pieces from which to build a successful foundation for value-based care models or almost any other innovative or disruptive platform for healthcare.
Such concerns have been relatively stable as predictions for areas to develop and implement within healthcare for the past few years. While progress has not necessarily occurred in revolutionary leaps, it is possible to identify incremental implementation and improvement. Incremental, or step-by-step, progress may actually be better as measured steps provide time for change to truly sink in. Despite the recognition that data creation, analytics and protection are perennial issues for healthcare, the belief that those areas will see material growth in the coming year remain well founded.
Watch Fisher talk with HIMSS TV about how HIPAA enables information to flow, but it might need some adjusting in the digital age.
The creation of this data continues to occur at breakneck speed. New devices, whether directed to consumers or professionals, on the market aim to generate data from users in everyday life and either suggest actions or feed to healthcare clinicians. Some smartwatch devices allege to capture baseline information about users that can be used to track heart issues, activity levels and other matters.
How to utilize the newly created data is a conundrum though. Some physicians and other clinicians worry that individuals will seek unnecessary visits or believe that an issue exists when nothing is really of concern.
Despite the concerns, whether proven or not, as to the accuracy, efficacy or overall value of such device-created healthcare data, it will likely be impossible to ignore such data. The anticipation is that more users will take advantage of the devices and expect clinicians to consider or incorporate that data into care decisions and plans. If demand exists and grows, then using the data will become unavoidable, or those clinicians who refuse to use the data may discover that their patient population is shrinking.
This issue underscores how new sources of data, primarily consumer-focused devices, are being put into the hands of individuals without a clear picture of how that data can be captured and utilized by clinicians. Just creating the data and expecting it to be easily incorporated into the healthcare system is not a viable solution.
No matter how much data created it, all that data will remain useless unless healthcare organizations can utilize it. That is where data analytics continually enters the picture. From the perspective of data analytics, it is more likely that entities already in the healthcare industry will have the greatest impact. That assessment may fly in the face of popular opinions about “big tech” companies being the most likely to generate that change. However, actual implementation has yet to occur or real-world evidence to be presented.
Instead, there are already many companies already in healthcare focused on data analytics and providing actionable data to healthcare clinicians. Being fully entrenched in the industry without a large degree of public attention can be the recipe for a perfect storm of making real change.
Another area to watch is how some the vertical mergers in healthcare play out. Mergers, affiliations and joint venture transactions are percolating in the background. Putting vast troves of data from different silos of healthcare into the hands of one organization should accelerate change in those organizations and the likely development of tools that will be rolled out to other organizations. The erosion of old barriers could well be one of the more significant aspects of these transactions.
While it is clear that analytics will and do make a difference, that is only true when an organization is receptive to and needing of those analytics. Even though data are becoming more available and actionable, the healthcare industry operates in two disparate worlds: fee for service and value-based care. Until more physicians, hospitals and other organizations are predominantly in value-based care, data analytics will not matter as much. That may actually be the greatest drag on use of analytics.
Aside from questionable need for all of the data and analytics, concerns about maintaining the privacy and security of all of the data is the next major concern. The vast amounts of data being created are not only attractive for the potential to completely change the care rendered to individuals, but also how that data can be exploited. Unfortunately, the data are more vulnerable that would be preferred at the moment.
Healthcare is one of the top targets for cybercriminals and others bad intentioned actors. The industry is considered ripe for attack because many legacy devices are used without up to date protections, security budgets are constrained and defensive efforts may not be top of the line. Even beyond the outside threats, insiders pose a major risk to the privacy and security of data because insiders will leak data unintentionally, fall victim to attacks like phishing, or take advantage of broad access permissions, all among any other number of concerns.
With the issues acknowledged and identified, the current state of affairs cannot remain. Regardless of the new data being created, lack of privacy and security undermines the essential trust between patients and healthcare organizations. Luckily, the tide can be seen as turning. Individuals question why privacy and security cannot be maintained and organizations are realizing that healthcare data must be protected to preserve operations. Privacy and security issues are being presented to governing boards of organizations, and organizations are investing more (though still insufficient) funds, among other changes.
The request for information issued by the Office for Civil Rights of the Department of Health and Human Services in connection with potential changes or updates to HIPAA also shows that the government is paying attention. While far-reaching and material changes to HIPAA are unlikely to occur, the request for information is at least encouraging a lot of introspection by the healthcare industry on how privacy and security interact with the goal of moving to a more value-based care system.
A wave of optimism is appropriate for the healthcare industry. Years of efforts are beginning to bear fruit and it feels like momentum has become self-sustaining. However, no one individual or organization can rest on its laurels. Instead, honest assessments of shortcomings and a willingness to push for change must continue in the coming year and for the near future.
The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.
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Originally published February 5, 2019