Dr. Dowling is president of Dowling Medical Director Services, a private health care consulting firm specializing in quality improvement, clinical informatics, and health care policy affecting specialty care. He is the former medical director of a large,
Early adopters of health information technology have been creating electronic health records for over 10 years. With the creation of the Health Information Technology for Economic and Clinical Health (HITECH) Act and its incentives, the pace of clinical data accumulation is accelerating.
To be sure, some of the data is stored in proprietary systems and is not easily accessible; interoperability standards are immature; meaningful health information exchanges are in their infancy; and much of the data is still unstructured, especially as providers make the disruptive transition from a narrative medical record to one based in software. Nevertheless, stakeholders in the health care marketplace are beginning to demand access to "their data."
Stage 2 of EHR meaningful use will likely sharpen the focus on issues like data ownership, consents, security, and privacy. But the larger question looms: How will the data be used and by whom? What exactly is the promise of unlocking the information within health care databases, and who will benefit? As this article discusses, some early experience with use of data may inform the answers to these and other questions.
The tectonic forces shaping health care today may be the key to understanding the promise of data. Health care organizations are facing narrower margins as revenues trend downward and expenses increase. Rapid consolidation of medical practices large and small is occurring to realize perceived advantages of scale, sometimes by merger and often by acquisition. The pace of regulations and oversight of health care delivery is increasing. The complexity associated with implementing systems and managing large organizations is challenging human and technical resources. The emergence of new payment models, some of them based upon value and involving partnerships with different stakeholders, is transforming markets.
At the center of the transformation are the information systems that house health care data. The promise of data lies in the ability to ask the right questions and use tools to organize the data into accurate, actionable answers.