Health care data comes from a bewildering number of sources and different formats, such as structured data, paper, digital, pictures, videos, multimedia and so on. Data collection and aggregation communities are equally fragmented, making the extraction and integration of data a real challenge. Providers, payers, public health specialists, employers, social network communities and patients all collect data, but there is no effort to unify the information. There is divergence and duplication of data with no single source of truth. This results in inaccurate and incomplete health care member profiles with little insight into a patient’s well-being journey and a member’s ever-evolving relationship with providers, payers, pharmacy, friends and family members. A lack of understanding, monitoring and support cause low adherence and high readmission risks. Poor communication (particularly during the preoperative phase) often results in cancellation of procedures, causing loss of revenue and inefficient resource utilization.
Patients and physicians, like everyone else, move, change their names and professions, or retire. Payer organizations may also relocate, add new locations, or go through various mergers and acquisitions. Moreover, the introduction of new treatments, new drugs and personalized care models change the service delivery and data captured, making it a challenge to keep healthcare data clean, complete and current. Stale data and information latency directly impact a member’s experience and providers’ business sustainability. The result is a delay in the adoption of new treatment options, inadequate response to health care programs and poor engagement and experience.
Maintaining patient trust is the cornerstone for building an efficient health care ecosystem. Data security has become of utmost importance to the health care industry as Patient privacy depends on HIPAA2 compliance and secure adoption of electronic health records. Also, with ever-changing regulatory requirements, keeping data sets and engagement compliant can be a challenge. Poor data quality and strategy prevent organizations from meeting new regulatory needs and result in high costs associated with audits and reporting. Until data security and compliance issues are adequately addressed, it’s an uphill task to improve the health of the broader population.
The health care industry is about to experience the same shift we saw in retail, banking and hospitality. The health care system is on the verge of a perfect storm. A silver tsunami — in the form of the aging baby boomer population – will put the system through a stress test, while pressures from millennials and Generation Z will force health care organizations to choose newer forms of engagement. Health care organizations must equip themselves for a new age, volume and type of members. The industry will need to have an understanding of members’ changing needs and their preferences and then provide solutions that align with their way of life.