"The big challenge is getting data out of these systems, integrating it, creating information, and getting that into the hands of people who can do something about it," says Tipsword.
There is an abundance of data in healthcare, but in many cases, it's trapped in silos. That means it's important to develop a common enterprise goal—in other words, a governance platform that allows executives and clinicians to understand the organization's priorities as a whole. Tipsword calls it developing an information management master plan, and it's common, he says, to emerge with literally 100–200 needs for integrated healthcare data.
"How can we cut out nonvalue-add tasks and make sure they stay out? No two organizations are the same," he says, "but the organizations that are most successful at it have the highest levels of executive sponsorship."
Leadership at the top
Chicago-based Rush is a nonprofit healthcare, educational, and research enterprise consisting of Rush University Medical Center, Rush University, Rush Oak Park Hospital, and Rush Health, which is a network of providers including more than 800 physicians.
When the organization also owned a health plan, Rush Health's physician groups were bound together in a physician-hospital organization, and had to deal with capitation and risk on a daily basis. That required a huge amount of data processing power, but for the past 10 years, since it sold the plan, the organization has been operating largely on a basic fee-for-service model. As significant pay-for-performance incentives have been added to all of its payer contracts, says Rush Health President Brent Estes, its perspective on data management has changed significantly.
"We decided we needed to change the rules of our organization such that we required all hospital and physician members to establish data interfaces," he says. For its part, Rush Health built a data warehouse to process information coming from the practices, "so we could look at it on a holistic basis."
By integrating that data into one platform that is usable by all practices, the warehouse allows Rush to look at patient population health across every payer class, and allows it to implement P4P programs that are payer-neutral. It makes extensive use of prompts to help clinicians keep track of patients' needs based on practice-initiated treatment protocols.