The ‘application-centric’ approach no longer works. In fact, it is harmful because you lock up your data and thus make innovation and open communication impossible. While regional cooperation, a smoothly running care chain and preventive care are essential for affordable, good and future-proof care. In this article we will show you how to take steps towards a data platform and how that improves chain care.
“You will never get to the point where everyone in the healthcare chain wants to work with the same system. There is simply no ‘EPD for the whole country’. And you don’t have to. We need to get rid of the silos. We no longer need to use people who are already over-demanded as robots for data input and we need to build data transparency and a network of care. Regionally, nationally or even internationally.”
That’s what Cedric Steenbeke, Healthcare Industry Technology Strategist at Microsoft, said when we asked him for his vision on the role of data in organising and delivering care differently throughout the chain. At Rapid Circle, we share his vision. The care process within the hospital is already too complex and dynamic to implement 100% in the EHR, so you will never be able to accommodate the entire care chain in a single system. The best way to make collaboration better, more effective and more efficient is to free and securely share data, so that every partner in the chain can continuously improve its own processes with that data.
The importance of good cooperation in the healthcare chain
Care processes do not start and end at the door of the hospital. On the contrary. Regional cooperation and good chain care are essential for keeping healthcare affordable and of good quality in the coming decades. Better cooperation in the chain removes inefficiencies and duplication of effort from the process and thus ensures improvements and savings. But the exchange of data is also an absolute prerequisite for making the step from curative to preventive care. Preventing or identifying health problems more quickly will ultimately make healthcare both better and more affordable.
But in order to better organise processes throughout the chain, all healthcare providers need more information than they currently have. Most of the necessary data is already there. For example, we have devices in people’s homes, biometric sources and research data. In addition, all chain partners have extensive data about individual patients. Yet all those data sources usually don’t come together. Sometimes because insight into which data can actually be found where, sometimes because choices about data and innovation strategy are delayed and often simply because there are not enough people available on the IT side. In addition, data is often unstructured and difficult to exchange.
The challenges faced by hospitals and chain partners are not unique to healthcare. These are issues that we see in all industries. But the care as a process is unique. And complex, which means that innovations from other industries cannot always be applied one-on-one.
But healthcare also has a huge advantage: because there is hardly any competition and because the people in healthcare have a great drive to deliver the very best care, there is a great willingness to work together and exchange data.
And that it can also be done practically, we see, for example, at the Zeeland care group, and Rapid Circle customer, ZorgSaam. They realised a data platform on which both chain partners and patients can organise their own information provision.
Taking steps towards a data platform
How do you take the right steps towards a data platform, and therefore towards the future of healthcare? Wilco Turnhout, co-founder and Chief Strategy Officer at Rapid Circle, says this: “As far as I’m concerned, you do that by starting with data management in Azure. Then you can make data more transparent from that data platform, combine it and then make it interchangeable. In parallel, you work on good data governance. We are now doing this for various hospitals. After this first step, you can start looking at innovations, new technologies and applications that will use the data and enable new ways of delivering care. With an open data platform, you can also connect to exchange platforms such as CumuluZ, mPlify from the mProve hospitals, the Health Intelligence Platform Santeon (HIPS) and the care information building blocks of Nictiz. This is all possible without having to immediately switch to a complete cloud solution.”
Extracting value from data: choose the right use cases
To first give you a better idea of what is possible with data in healthcare, we also asked Louis de Roo, data strategist at data management specialist and Microsoft Gold Partner E-mergo, about his vision. Together we came up with a number of basic rules for finding maximum value in data and innovation for healthcare:
- See where you already have a lot of data. There is already an awful lot of information available in the healthcare chain. Often, generating that data has taken a lot of time and energy. After all, most data has been manually put into systems by an employee. So initially look for value in data that you already have and only then start looking at collecting more data.
- Get to know the process better. Organisations usually do not have a complete picture of their processes. In order to find where the profit is, IT professionals and data specialists must therefore join healthcare professionals on the work floor. This way you gain a lot of useful knowledge.
- Change the creation of data. How useful data is largely depends on how it is structured. The well-structured recording of data, preferably automated, ensures that you can innovate faster and deliver more value.
- Find processes with plenty of room for improvement. So don’t start with finance, because processes there are often already far automated and optimised. So there is little profit there. The same often applies to logistics processes.
De Roo, an experienced data specialist, says the following about that last point: “Preferably start in the heart of the operation. Because that’s where innovations have the most impact. Use data to help people make better decisions. Don’t focus on management or planning and routing. There can be profit in them, but only if they are really very inefficient. “
Better decisions: how it works
“Caregivers look at lists very often,” De Roo also said. “What medication does a patient take? What treatments have been done? Lists of appointments made, contact moments or checks. Based on such lists, professionals make decisions all the time, sometimes on life and death. They have a lot of logic ‘in mind’ for that.”
Healthcare professionals therefore do a lot of error-prone thinking day in and day out under great time pressure. Supporting better decisions starts with making sure your people always have the right data. But it can go much further than that. You never want to take the final decision away from the healthcare provider, but AI can complement and support a large part of the analysis process.
Apps, context and data
The next question is: can the SPD support decisions well enough? No individual application, not even the EHR, will always have all the necessary data in real time, so that people in different places are watching on multiple screens at different times. You want to unlock and combine data sources in a way that fits the context. A mobile app is perfect for that. Automated write-back to the EPD is also slowly becoming possible, although it is always important to apply the ‘four eyes principle’ consistently and to ensure good data quality.
All devices are connected
In the meantime, all devices in your care process provide data. There is a quick profit to be made by making that data available. At the patient level, this may initially raise privacy questions, but you can start with anonymous, aggregated data. For example, if you have all the pacemaker data from patients in your region, or even across the country, you can use it to see patterns. This knowledge then helps you to get ahead of problems with individual patients.
6 key challenges
There are plenty of opportunities, but there are also challenges. Exchanging data is not always technically easy, because systems often do not integrate properly and data formats do not connect. While exchanging data on an open platform is an absolute prerequisite for innovation in healthcare. These are the 6 most important things that can slow down the transformation of care, inside and outside the hospital:
First, of course, there are the EHR and other applications in the healthcare chain that lock data in their own database, where they are difficult to access and hardly usable. But other data sources, organisations and devices often pose technical challenges. Freeing that data from these kinds of closed silos is the first challenge you have to take on in order for data-driven care to succeed throughout the chain.
2. Unstructured data
A related challenge is the lack of structure of a lot of data. Entering conversation reports and diagnoses into text fields has produced vast amounts of unstructured data for decades. In their current form, these texts are not usable for other applications. Fortunately, in order to be able to free the data, you can now use AI that understands, analyses and converts texts into structured data.
3. Uncertainty about what is and is not allowed
Then there is the privacy legislation. Due to the, rightly, strict rules for handling patient data, the idea sometimes arises that nothing can be done with data at all. But in fact, within the laws and regulations, and within the modern requirements of cybersecurity, an awful lot is possible. Microsoft infrastructure meets the highest standards and all legal requirements. Moreover, a well-designed hybrid data platform usually offers more possibilities for limiting access and setting up compliance and governance. Of course, that does not alter the fact that you always have to ensure that you have the right permissions to use data.
4. Uncertainty about ownership
As soon as you set up a data platform for the entire healthcare chain, you inevitably get questions about ownership. Who owns the data? Who is responsible for engineering and maintenance? Who makes the development and configuration decisions? Ambiguities on this front can greatly slow down innovation. Good cooperation therefore starts with good agreements, also on data governance and compliance.
5. Lack of digital skills
In fact, healthcare providers are very data-driven. They continuously process large amounts of information from different systems and sources. But the skills and enthusiasm to analyse and improve the existing situation are often lacking while you need that for innovation.
6. Focus on output data
‘Data’ is often still seen as synonymous with ‘business information’. But that’s not how we look at it. De Roo’s vision: “The way we deal with data now is not effective. We mainly look at output, and therefore by definition at the past. You have to bring the data into the process to be able to work with it effectively. So use the data much earlier, where it really benefits. No more focusing on KPIs and dashboards, but using data to support better decisions. Because if you make the right decisions early in a care process, you save a lot of time, costs and work.”
Microsoft’s vision: towards an open platform
Steenbeke and Microsoft agree: “If you bring together clinical data, administrative data and data from devices such as home dialysis devices or blood sugar meters, you get a complete patient picture. This allows you to collaborate better, use AI and do more efficient research and can deploy or develop third-party solutions for this. The data is central to this and at Microsoft we are building a hybrid, open platform, with open data standards such as FHIR, OpenEHR and OMOP. Microsoft Cloud for Healthcare stems from that vision: at Microsoft, we always opt for a modular, hybrid platform. We provide Azure, Microsoft 365 and Microsoft Dynamics as building blocks. This gives you a familiar environment with proven services and infinite capacity for working with as much data as you want.”
“Of course, there are challenges in that. There are local deviations and not every system is the same, so you have to align data to be able to link. And of course you want to do this on a secure and compliant platform. If you have such a shared trusted environment, you can work towards a ‘health care USB’: a standard that ensures that you can plug in everything you need anywhere and that it just works. The subset of data you want, in the format you want. If the hospital, the general practitioner, the rehabilitation centre and everyone else in the chain can efficiently share data, care becomes real chain care.”
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