The data remains just that – data – and is not converted to intelligence, i.e., a comprehensive collection of patient and provider data organized and presented in a way that enables clinicians and others to make accurate, effective decisions in a timely fashion.

The lack of actionable patient and provider intelligence sets off a cascade of miscommunication between physicians, patients, clinicians, administrative staff and other stakeholders. The result of such inefficiencies: preventable medical errors and billions of dollars a year wasted on duplicate tests and unnecessary treatments.

The lack of patient and provider intelligence not only hurts healthcare systems internally, but hinders their relationships with their patients and business partners. It introduces unnecessary complexity to strategic initiatives such as clinical information sharing, provider management, claims processing, fraud reduction, tracking beneficiary identification, analyzing business contract information, and ensuring compliance with regulatory requirements.

Increasing business intelligence in healthcare requires a foundation for true patient intelligence. This idea has moved to the forefront of information technology priorities because of intense pressure from governments, employers and patients to increase the quality and accountability of care services. Modern healthcare systems realize that they need a broader perspective; they need “interoperable” data to transform business processes and achieve patient and provider intelligence.

A patient centric health system starts by building an agnostic foundation to connect data between silos and to make data interoperable. Interoperable health means sharing data from legacy systems, as well as newly deployed applications to enable organizations to interoperate with new sources of healthcare data with minimal disruption. Patient and provider intelligence relies on the ability to locate and relate information across boundaries – departmental or geographical.

A major driver of the movement towards interoperable health is a concerted effort to reduce the number of lives lost due to preventable data errors and to manage chronic disease populations – the root cause of a burgeoning healthcare crisis in a growing number of countries with costs growing at an unsustainable rate.

For many, improving data quality and reducing administrative costs is considered a “Holy Grail” of healthcare reform. But poor data quality within a system has always been kryptonite to success and it still threatens attempts to achieve significant reform. That’s because poor data becomes exacerbated when it is linked, matched and shared between healthcare providers at any level. This has consequences for both the patient and the physician’s office, starting with:

Threats to patient safety
Jane Smith arrives at an emergency department and the clinicians administer a medication to which she is allergic – because the clinicians were referring to the medical record of Jane E. Smith, a completely different person.

Reimbursement problems
Jane E. Smith’s insurance is billed for Jane Smith’s treatment, resulting in a refusal to pay. The healthcare facility’s initial claim submission is denied; resolving the error involves extra administrative costs.

Decreased patient and staff satisfaction
Jane loses confidence when the information she gave to the emergency department is not available at their imaging center and physician office, thus she is forced to repeat herself. This also decreases the staff’s efficiency and increases the risk of error.

Increased administrative costs
When Jane has duplicate records her clinicians have inaccurate data, which may pose safety issues, causing Jane concern and costing your organization money to find and resolve.

On the other hand, when a healthcare enterprise does have effective access to comprehensive and accurate patient data and provider information, the office benefits because its healthcare systems are able to protect market share and grow its business by:

Increasing physician retention – making it simple for physicians to do business with a healthcare system; providing incentive for those physicians to continue to serve patients via that system. Recruiting physicians and all clinical staff – reducing the time to get access to information makes it easier for nurses and other staff to do their jobs and can be a powerful recruitment tool.

Improving the patient experience and establishing patient loyalty – Patients increasingly “shop” for healthcare services, and organizations that provide the best experience have a distinct market advantage. Providing “patient-centric services,” such as providing patients with online access to their treatment history or those of family members (such as a child’s immunization record) as well as other customized services. Tracking the loyalty of VIPs to ensure the organization is providing a seamless transition to these customers as both patients and donors.

The data collected across healthcare systems continues to grow exponentially due to the increased use of clinical software, more complex regulatory reporting requirements and the increased size of health systems as more facilities – and clinical business lines – are consolidated into single corporate entities. The recent stimulus bill signed by President Obama providing funds for electronic health records within healthcare reform will only add to the data intensification.

To deal with this, the healthcare industry needs to enter an “Age of Interoperability”, so to speak, and organizations that do not strategically plan to provide the level of data sharing required will find themselves at a disadvantage in the marketplace. The innovation in the healthcare information technology market in the past few years has provided healthcare systems with a wide array of choices for enterprise and niche applications. The foremost challenge for clinical and I.T. leaders is to optimize their future and past technology investments to ensure the patient information collected and stored in those systems can be used quickly and intelligently by all authorized stakeholders.

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About the Author: Lorraine Fernandes, RHIA, is vice president and ambassador for Initiate Systems (www.initiatesystems.com), a leader in enabling healthcare organizations to strategically leverage and share critical data assets. Lorraine is a nationally known expert on electronic health records in association with regional health information organizations (RHIO), health data exchange, patient identification issues and best practices for master patient index (MPI) clean up. Initiate Patient™ and Initiate Provider™ are two interoperable health solutions used by healthcare organizations to transform critical business processes by delivering higher quality information. Lorraine can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..