Emerging data integration approaches and self-service analytics are already delivering benefits to patients, providers and payers. Newer reimbursement methods coupled with value-based care and population health management models that demand more insight would not be possible without the large-scale data warehouse platforms available today.
But as W. W. Jacobs' cautionary short story titled "The Monkey's Paw" points out, no great things come without a cost, or a corresponding challenge. In the case of health data, one of the major costs is an urgent need for impeccable data governance.
With all this data available someone needs to determine who can access it and how it will be used. Generally the big picture view is managed at the executive level. These executives or "Data Owners" set the overarching policies across the organization, make the tough decisions regarding many aspects of data, and are ultimately held responsible for its quality and the appropriateness of its use.
Yet these executives cannot do it alone. Their knowledge of the organization and its data tends to be broad, and their roles are more strategic. As a result, to make the best decisions about data governance they need to be able to tap into the expertise of those who have deep domain knowledge within specific datasets – clinical, financial, claims, operations, etc. These people are generally referred to as business data stewards.
Suggestions that lead to decisions
A business data steward is much like a coach on a baseball team. For example, when the manager is making decisions about the starting rotation for an upcoming series, he doesn't start performing a deep dive into the health, mindset and past records of each starting pitcher against the upcoming team. Instead, he goes to the pitching coach, who is the keeper of that domain knowledge. The pitching coach makes suggestions. But it is still up to the manager to make the decisions.
Business data stewards operate the same way. They not only know what is being done but why it is being done that way.
Here's a good example. During a meeting with the CEO of a health maintenance organization, I questioned him how many members they had. He proudly answered more than 300,000. I then asked the other attending executives the same question, and each time I received a different answer. The CEO immediately saw that the inability of his leadership team to agree on this most important and apparently simple business measure was indicative of a larger problem.
To solve the conundrum the organization identified a team of data stewards to determine why members were being counted differently in various departments. What they discovered was there could not be a consensus answer to the question "how many members do you have?" because of differing business requirements applied to each area. Instead, the business required three different counts.
Calculating such data and how is likely not a task undertaken by a company's C-suite. It required the deep domain expertise of the business data stewards who understood the regulations, requirements and nuances of each individual department. In other words, the people who live it and breathe it every day.
Ensuring data quality
One of the major responsibilities of the business data steward is ensuring data quality. In an era of Big Data and next generation analytics, the old adage "garbage in, garbage out" applies more than ever.
The warts in data are often exposed once reports start to run, particularly when the organization is using an enterprise data warehouse (EDW) that aggregates data from multiple sources to run more detailed reports. Because of their domain expertise, business data stewards are often best suited to determining the cause of data problems quickly and recommending ways to remediate. If the issues cannot be immediately reconciled, business data stewards can at least flag the data so business users know to approach any conclusions cautiously.
Business data stewards are invaluable in helping healthcare organizations build key performance indicators and streamline workflows as well. Their understanding of how things currently work versus the ideal state, and their area's willingness to change how it operates, can help set the organization on the optimal path toward improvement. They will also be able to monitor those efforts to ensure that the organization continues to progress toward its goals – and then maintains the gains it has made.
Not an IT issue
The healthcare industry is notorious for viewing data governance as an IT issue. While IT does get involved at points, its expertise is focused on the technical aspects of how data moves through the organization. In other words, IT can tell you how to integrate or secure the data generally, but lacks the domain expertise to recommend how to compute and aggregate business measures or how to ensure data quality.
Appointing business data stewards who are front-line users of the data on a daily basis solves that issue. They will understand what is needed to do the analysis being proposed and will be in the best position to make recommendations that balance organizational need with requirements for patient privacy and the security of protected health information.
Now it's your turn. Has your organization started using business data stewards? What has your experience been? Have they had a positive impact? What things would you like to see them doing that they're not yet?
John Walton, a Solutions Manager for CTG Health Solutions' Technology Services practice, is responsible for developing Enterprise Information Management (EIM) strategies. He has more than 30 years of IT experience spanning multiple disciplines and industries, including 20-plus years of healthcare experience primarily in data warehousing, business intelligence and data governance. He can be reached at john.walton@ctg.com.