Surdak: Controlled chaos comes to mind. So, too, do the 1950’s. In some ways IT in healthcare is like IT in general in the 1950’s; in its infancy and barely making an impact. In others it’s like watching the 1950’s vision of the future, from the cartoon, “the Jetsons.” That cartoon predicted telemedicine, robotic nurses, pills that cured anything in minutes, etc. And low and behold, many of these things are now here.
More importantly, I think information governance in U.S. healthcare is at a major crossroads. For a very long time the primary concern around EMR [electronic health records] and the digitization of health was around privacy. HIPAA has been used as a blanket excuse for all manner of IT sins, and all sorts of poor customer experiences by healthcare providers, all in the name of privacy. However, across society we are all developing growing expectations of predictive, preventative, and interventionist analytics. We all expect organizations to use data to actually prevent bad things from happening. This will come to healthcare, too, and will undermine much of the rationale behind HIPAA. If your organization has the data that might tell me that I’m likely to have a heart attack this week, I’m going to EXPECT you to act on that data—privacy or not.
Many organizations worry about the implications of a false positive in this instance; I tell you that you might have a heart attack, but you don’t. I’m not worried about this. I’m worried about the false negative; I have a heart attack, and you had the data to warn me, but you don’t. Are you now liable? Have you been negligent in not acting on the data under your stewardship? This question hasn’t really been asked and answered—yet. But it likely will be in the next 5-10 years, with enormous implications for all healthcare organizations.
Why is information governance (IG) important to the future of healthcare?
For the reasons stated previously. All of us in society have ever-growing expectations from the organizations with which we associate. We expect them to know us intimately, to know our ever-changing context in time and space, and to act to our benefit from all of this data they have on us.
This is being driven by what I call the Digital Trinity: mobility, social media, and analytics. The trinity is building in all of us the expectation of prediction, prevention, and intervention, all seamless and unobtrusive. As a result, we expect ALL organizations that we interact with to know us and to act in our best interest, without our direct input. Because of smart phones and apps I expect all organizations to interact with me as well as Amazon, eBay, or Starbucks, and if you don’t I’ll just ignore you. So the standard of measurement of your own performance is no longer just other healthcare organizations, it’s any and every organization that creates an app.
Additionally, there will be increasingly strident requirements for security and privacy. Security is becoming an issue of real-time monitoring and active response; firewalls no longer provide any protection. And patients will like their privacy, but they’ll like compelling benefits even more. Two years ago, if someone told you that customers would voluntarily allow insurance companies to monitor their driving habits in real-time, 24/7, in order to save 15 percent on their car insurance, you’d probably say that’s crazy. Today, that’s normal.
All of this fundamentally changes the role, value, and purpose of IG. IG used to be an annoyance. Something you did because you had to. Now, IG is rapidly becoming the enabler of entirely new business models.
What is the most important thing for health information management professionals to know about information governance today?
Your IG efforts, systems, processes, etc., need to be AT LEAST as advanced as your capital management assets. For the last 200 years capital has been the basis of wealth and power in our world. All of our business systems, processes, organizations, etc., have been designed to manage the allocation of capital.
Over the next 20 years, data will take over for capital as the basis of wealth and power. Hence, all of your methods for capital management must be replicated, and enhanced, for use in data management, and you have maybe three to five years to get it right.
If your organization still views IG as a necessary evil, or simply a cost of doing business, you’re going to completely miss this societal revolution going on around us.
What can healthcare learn from other industries that use information governance?
IG should not be, cannot be, viewed as a necessary evil. It must be viewed as the key enabler of putting data to work. Today, most organizations can track every (capital) dollar they spend, down to the penny, down to the minute or second. You better be able to do the same with data assets, and be able to do so by about 2017. The capture, sale, analysis and use of personal information is the foundation of a $5 trillion industry, which is growing over 20 percent annually. If you are similarly putting your data to work, you’re following a strategy of irrelevance, and you’ll very likely succeed.
What are you hoping that members will take away from your presentation?
Action. Movement. Do something. There is no time to assign a tiger team, subcommittee, expert panel to create yet another study, report, evaluation of yet another strategy or corporate initiative. You must act. You must do something real, something tangible. And you must get uncomfortable.
Your competition isn’t the organization you’ve been competing against for the last 10, 20, or 30 years, it’s five people who live in Lagos, Nigeria that are two weeks away from launching their first app which is about to take away 75 percent of your customers in the next 24 months. What they are doing may be incredibly expensive for you to replicate, would cannibalize your existing business, and may even technically be illegal, but they’re going to launch in two weeks nevertheless.
That’s the nature of global competition in a world dominated by the Digital Trinity. The changes that this is bringing to our world are relentless, because you and I choose to make them so. So get uncomfortable with what you’re doing, start taking action, fail small and fast, and LEARN from failure, and Uber yourself, before you’re Ubered.