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Managing Data in a Converging Healthcare Market

by Janice Young | September 07, 2017

This post originally appeared on the blog for our upcoming Convergence 2017 conference. 

In a recent blog, I observed an emerging convergence trend – that of the shared information platform. As providers and payers converge, they need to collaborate efficiently and accurately, particularly as they align on reimbursement strategies and population health management (PHM) programs. A majority of PHM vendors report that their platforms are being or will be used for shared platform initiatives among payers and providers by the end of 2017.

An astute responder to this blog noted that this will only work if payers and providers agree on what data to share. All too true. I’d also argue that data management issues rank high on the list of challenges to shared platform strategies. Neither access decisions nor data management activities are simple exercises, but Chilmark’s PHM research suggests that these challenges are not lost on those vendors with shared platform initiatives. PHM vendors, in particular, recognize that return on investment is extremely hampered without strong underlying data management.

Data services are fast becoming a core PMH vendor offering; some are evolving to “data management as a service” offerings. Vendors are investing also to extend and expand access, security, and privacy roles to enable specific access to information across expansive healthcare ecosystem roles that include providers, payers, consumers and families, third-party population health and care management organizations, and employers.

This ability to establish customizable, specific, and unique access and/or views is pivotal to executing one of the main success criteria of value-based care and population health – collaboration. With a flexible data access architecture, providers and payers can customize and revise decisions about what to share, with whom and when. It doesn’t need to be “hard-coded” which is important in a market experimenting with value based health and collaboration. Shared platform leaders will excel at both data management and flexible data access architectures.

Value-based collaboration, market convergence, and shared platform models introduce a list of new management and administration questions, not the least of which is who will manage the provider-payer and shared platform data relationship. Any large healthcare payer or provider will confess that managing data within their own organizations is an extremely challenging job. In a 2015 report, Health System Analytics: The Missing Key to Unlock Value-Based Care, Deloitte discussed gaps between health systems’ belief in the importance of healthcare analytics and actual implementation. Data management, data governance, and access were among the gaps.

Clearly, a centralized and prioritized data management strategy is needed. Enter the Chief Data Officer. Borrowed from other industries, large healthcare organizations now employ Chief Data Officers to manage one of their fastest-growing and most important assets – data. This role is still gaining traction in the healthcare market. So far, most have focused on data management programs for their own internal organizations – and, as the Deloitte study would suggest, there is enough to clean up.

As collaborative value-based and PHM programs expand and converge, these chief data officers may find their responsibilities extending beyond the walls of their own organizations. The Healthcare Chief Data Officer 2.0 job description expands to an ecosystem role, including collaborative data and shared platform initiatives with payers, consumers or other business, health or clinical partners. This role will be critical to executing policies and procedures for sharing information with partners, on shared platforms or otherwise.

Chilmark invites you to join and continue the conversation at Chilmark’s inaugural conference: Convergence 2017, Oct. 4-6 in Boston. View the agenda and register for the conference today!

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“Chilmark were one of the first industry watchers to recognize the importance of population health and are still one of the most sophisticated in their apprecition of what is going to be needed to transform health and care.”

-Former SVP of PHM at Cerner