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FCW : September 15, 2014
tame and make effective use of the flood of data their systems are capable of collecting. That is actually a strate- gic planning issue. The solution is to first identify the problem you need to solve and the right questions to ask. You are then more effectively positioned to iden- tify and collect the data most relevant to helping pinpoint the solutions. In radiology, for example, big data can be used to help identify the appropri- ateness of various imaging modalities in different clinical circumstances. Reimbursement practices for dupli- cate images are changing, so using data in this way is more important than ever. • Work in real time to make work easier. This approach reflects two guiding principles for using big data included in Jesse’s presentation at the 9th Annual World Health Care Con- gress. The first principle is to acquire all data needed to manage patients during the actual treatment or work processes, not afterward through ret- rospective data collection. The sec- ond, which nearly goes without say- ing, is that the solution must make work easier and not impose undue burden or require rework. Indeed, solutions are becoming widely available that enable clini- cians to collect patient data in real time through the course of treatment. This is particularly true in the periop- erative suites of VA medical centers, where solutions are being used to ensure that surgical safety checklists and other measures are performed for every procedure, enabling clinicians to track procedure times and other metrics and permitting post-procedure analyses to identify and correct per- formance issues. • Foster interoperability. Solu- tion interoperability is emerging as a third major characteristic of success- ful health care delivery in the private, public and federal sectors — and not just as it applies to communication between or among facilities. The abil- ity for departments within facilities — such as radiology and cardiology, or orthopedics and accounting — to exchange patient care and billing data is becoming increasingly important to the efficiency of organizational work- flows at VA facilities. Solutions that facilitate those capa- bilities are available, and the most effective ones will enable clinicians to convert much of what works with manual and paper-based practices to the electronic realm. For example, in its transition to a new electronic system for managing chemotherapy treatment, a VA facility in Michigan has been able to retain provisions for six clinician signoffs to ensure the accuracy and safety of chemotherapy treatments. Much of health care as a whole still has far to go before it can fully realize the promise of big data to transform patient care and treatment. We remain in the early stages of figuring out what big data can and cannot do for pro- viders and their patients. But proac- tive strategies like those delineated here can be used by every medical specialty, from obstetrics to geriat- ric medicine, and they also have the power to go a long way toward help- ing the VA and other federal health care agencies make significant prog- ress toward using big data to improve patient care. ■ Mark Byers is president and CEO of DSS. He has been involved in the development of electronic health record software, specifically the VistA- based platform, for more than 16 years. DrillDown 28 September 15, 2014 FCW.COM MORE FROM FCW ON HEALTH IT Analytics could drive the future of VistA The next generation of VA’s electronic health record should see benefits from agency advances in predictive analytics. (August 2014) http://is.gd/FCW_VAanalytics Patient data is the next IT frontier at VA VHA’s Kathleen Frisbee predicts that patient- generated data will swamp electronic health records in terms of volume. (May 2014) http://is.gd/FCW_patientdata How VA is driving telemedicine The agency’s scale, vision and customer base have put it on the leading edge. But that also means being the first to face technical and operational challenges. (February 2014) http://is.gd/FCW_telemedicine Volume-based care is being replaced by value-based care, in which patient outcomes, costs of treatment and quality of treatment (i.e., treatment value) determine payments and reimbursements.
September 30, 2014
August 30, 2014