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Governance key to creating effective health data warehouse

Many people want a health data warehouse to do many things, often at a moment's notice. That's why a governance committee should oversee its use, HIMSS 2012 attendees learned.

LAS VEGAS -- If you're not involved in either hosting or participating in a health data warehouse, you will be soon, two leading CIOs said at the Health Information and Management System Society's HIMSS 2012 conference. That's because new payment models based on quality reporting -- be they accountable care organizations (ACOs), private payer incentive programs or medical homes -- require analytics run on standardized patient data stored in these warehouses.

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Implementing these giant projects can be fraught with trouble. They're giant; ergo, complicated. It's difficult to standardize data across applications and locations to get usable, apples-to-apples analytics. They're expensive. They take years to build, but people (CEOs, ACOs and other payers) need results a lot faster than that.

The key to putting a health data warehouse together? A well-built steering -- or governance -- committee, agreed Ken Gilles, associate CIO at Essentia Health, a 17-hospital health system mostly located in the upper Midwest, and Rick Schooler, CIO of the 8-hospital Orlando Health system and 2011 CIO of the Year as named by HIMSS and the College of Healthcare Information Management Executives.

"A lot of you have figured out that it's mainstream," Schooler said after a show of hands indicated that hundreds of provider IT leaders were either in the process of building or planning a health data warehouse. "Essentially, in my mind, it's the end game."

Gilles told that Essentia Health is "signing these new contracts as we speak that have different [analytics] requirements," adding, "the No. 1 initiative in our organization is quality right now, and there's all these different flavors of reports driving this thing."

Before implementing health data warehouse software, educate and get senior buy-in

Regulators and payers are pushing hospitals to be more transparent about quality-of-care and financial information, the aggregating of which is the raison d'être for the health data warehouse. Pointing to recent Gartner research, Schooler said most organizations do not have the information, processes and tools needed to make informed, responsive enterprise decisions, due to underinvestment in an information infrastructure at the enterprise level.

Part of it is education. Schooler's health data warehouse, currently in development, now employs six full-time employees, with an expectation of 15 when the project is completed in three to five years. He advised health care CIOs to hire Ph.D.s in informatics to supervise the analytics team.

"You're not going to take your report writers and say 'Let's put Joe on the enterprise analytics team,'" Schooler said in the presentation. "This is a disciplined approach -- a master's and Ph.D.-level required -- not for technology but for [analytics] methods and techniques. It takes skill sets that many of us don't have…or could have, but only with a significant level of training and development."

The other key step is CEO buy-in -- not just for the financing and resources needed to create enterprise-level data analytics, but also because he or she needs to be an active member of the governance committee.

Essentia's governance is complex across its many hospitals and states, but it starts with senior leadership and incorporates subcommittees governing infrastructure, data management, content delivery and "functional area teams" that encompass financial operations, clinical research and other enterprise uses of the health data warehouse's contents.

Incremental rollout of health data warehouse works best

What does the governance committee do, exactly, besides argue long hours about the best way to make data usable and what software and hardware will get that done? It has an even bigger job -- prioritizing what gets done first.

This is a disciplined approach….not for technology but for [analytics] methods and techniques. It takes skill sets that many of us don't have.

Rick Schooler, CIO, Orlando Health

Gilles said Essentia's governance committee helped map out the order of development of data analytics tools and content delivery. Among other things, his timeline includes creating a clinical quality dashboard and what Essentia calls a "top of hospital" dashboard that shows stats such as admissions, daily census, length of stay and other numbers across the system. While the whole project will take years to develop, rolling out new features every few months will help satisfy not only external pressures (such as mandated quality reporting) but also show progress to senior leadership inside the company.

Having the governance committee helps a health system figure out just exactly what it wants out of a health data warehouse, and in which order its functions will be built, based on order of greatest need, be it regulatory compliance, payer-based reporting to keep revenue floating in or supporting clinical research objectives.

It also takes some of the heat off the CIO when internal or external forces are demanding results, fast. A solid governance group offers a systematic way to build an enterprise data warehouse and first roll out analytics content the enterprise identified as the most needed, on a reasonable timeline.

"The steering committee has to weigh in," Gilles said. "We only have so many resources. Some things will have be put to the side."

Let us know what you think about the story; email Don Fluckinger, Features Writer or contact @DonFluckinger on Twitter.

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