Healthcare Data Governance: What’s the Prognosis?

by Michael Pastore       • November 15, 2018

This is the second in our three-part, industry-focused blog series. Today, we explore why data governance is crucial to modern healthcare. From regulatory compliance to mergers and acquisitions, healthcare organizations, now more than ever before, need to fully understand all aspects of their data.   

Healthcare data governance has far more applications than just meeting compliance standards. Healthcare costs are always a topic of discussion, as is the state of health insurance and policies like the Affordable Care Act (ACA).

Costs and policy are among a number of significant trends called out in the executive summary of the Stanford Medicine 2017 Health Trend Report. But the summary also included a common thread that connects them all:

“Behind these trends is one fundamental force driving health care transformation: the power of data.”

Indeed, data is essential to healthcare in areas like:

  • Medical research – Collecting and reviewing increasingly large data sets has the potential to introduce new levels of speed and efficiency into what has been an often slow and laborious process.
  • Preventative care – Wearable devices help consumers track exercise, diet, weight and nutrition, as well as clinical applications like genetic sequencing.
  • The patient experience – Healthcare is not immune to issues of customer service and the need to provide timely, accurate responses to questions or complaints.
  • Disease and outbreak prevention – Data and analysis can help spot patterns, so clinicians get ahead of big problems before they become epidemics.

Data Management and Data Governance

Data Vulnerabilities in Healthcare

Data is valuable to the healthcare industry. But it also carries risks because of the volume and velocity with which it is collected and stored. Foremost among these are regulatory compliance and security.

Because healthcare data is so sensitive, the ways in which it is secured and shared are watched closely by regulators. HIPAA (Health Information Portability and Accountability Act) is probably the most recognized regulation governing data in healthcare, but it is not the only one.

In addition to privacy and security policies, other challenges that prevent the healthcare industry from maximizing the ways it puts data to work include:

  • High costs, which are further exacerbated by expected lower commercial health insurance payouts and higher payouts from low-margin services like Medicare, as well as rising labor costs. Data and analytics can potentially help hospitals better plan for these challenges, but thin margins might prevent the investments necessary in this area.
  • Electronic medical records, which the Stanford report cited as a cause of frustration that negatively impacts relationships between patients and healthcare providers.
  • Silos of data, which often are caused by mergers and acquisitions within the industry, but that are also emblematic of the number of platforms and applications used by providers, insurers and other players in the healthcare market.

Early 2018 saw a number of mergers and acquisitions in the healthcare industry, including hospital systems in New England, as well as in the Philadelphia area of the United States. The $69 billion dollar merger of Aetna and CVS also was approved by shareholders in early 2018, making it one of the most significant deals of the past decade.

Each merger and acquisition requires careful and difficult decisions concerning the application portfolio and data of each organization. Redundancies need to identified, as do gaps, so the patient experience and care continues without serious disruption.

Truly understanding healthcare data requires a holistic approach to data governance that is embedded in business processes and enterprise architecture. When implemented properly, data governance initiatives help healthcare organizations understand what data they have, where it is, where it came from, its value, its quality and how it’s used and accessed by people and applications.

Healthcare Data Governance

Improving Healthcare Analytics and Patient Care with Healthcare Data Governance

Data governance plays a vital role in compliance because data is easier to protect when you know where it is stored, what it is, and how it needs to be governed. According to a 2017 survey by erwin, Inc. and UBM, 60 percent of organizations said compliance was driving their data governance initiatives.

With a solid understand of their data and the ways it is collected and consumed throughout their organizations, healthcare players are better positioned to reap the benefits of analytics. As Deloitte pointed out in a perspectives piece about healthcare analytics, the shift to value-based care makes analytics within the industry more essential than ever.

With increasing pressure on margins, the combination of data governance and analytics is critical to creating value and finding efficiencies. Investments in analytics are only as valuable as the data they are fed, however.

Poor decisions based on poor data will lead to bad outcomes, but they also diminish trust in the analytics platform, which will ruin the ROI as it is used less and less.

Most important, healthcare data governance plays a critical role in helping improve patient outcomes and value. In healthcare, the ability to make timely, accurate decisions based on quality data can be a matter of life or death.

In areas like preventative care and the patient experience, good data can mean better advice to patients, more accurate programs for follow-up care, and the ability to meet their medical and lifestyle needs within a healthcare facility or beyond.

As healthcare organizations look to improve efficiencies, lower costs and provide quality, value-based care, healthcare data governance will be essential to better outcomes for patients, providers and the industry at large.

For more information, please download our latest whitepaper, The Regulatory Rationale for Integrating Data Management and Data Governance.

If you’re interested in healthcare data governance, or evaluating new data governance technologies for another industry, you can schedule a demo of erwin’s data mapping and data governance solutions.

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Michael Pastore is the Director, Content Services at QuinStreet B2B Tech.

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