Actionable data from a ‘single source of truth’

BOSTON--Health organizations that strive for actionable data, or that wish to avoid being data rich and information poor, must commit themselves to pursuing a “single source of truth,” said Barbara Bartley, senior director of clinical decision support at the Health Care Authority for Baptist Health, based in Alabama, speaking at the Medical Informatics World Conference on April 28.

This requires merging disparate systems, data, departments and reporting requirements within organizations.

Baptist Health pursued a journey to foster more actionable data, but it had a number of barriers to overcome. The system utilized 10 different EHRs that did not interoperate, and operational, clinical and claims data all existed in silos. In the meantime, multiple stakeholders had different reporting requirements, which consumed considerable resources. “Everyone wanted it sliced and diced in a certain way,” she said.

Some barriers to actionable data included human error in data entry and interpretation. “For every point of entry you get a 5 percent error. We often had more than three points of entry, so we’re coming out of it with 85 percent reliability,” Bartley said.

Other barriers included lack of access to real-time data, decentralized patient health data, inconsistent sources of data and multiple data sources and interfaces.

Through a governance structure with representatives from all stakeholder groups, a team began the slow work of establishing data management principles, data structures and identifying key data elements to harmonize across systems. Baptist Health developed a number of data principles:

• Single source of truth, a clearly defined metric consistent across the organization and reported by a single source. This eliminates redundancy and enhances productivity
• Cascade/drill: A process that begins at the system level and drills down to the lowest reporting level, and vice versa
• Timely: Reporting done in an agreed timeframe that fits both the individual and departmental needs and their reporting requirements.
• Push: Data and graphs are pushed to the inbox or dashboard of the user
• Data Support: A “go to” resource for the stakeholders to obtain data for problem analysis
• Visual: Data tools that can easily be displayed in graphic form
• Electronic Focus: Strive to capture and abstract data electronically
• Data standardization: Develop and maintain a data dictionary for easier data repository matching, common interpretations and to enhance consistent reporting.

The task at hand is far from easy. Bartley said pushback is common, even from some of the younger physicians who do not want to move to electronic systems. Workflow has been “the biggest challenge.”

But these efforts are necessary to ensure quality data. “To make data actionable, you have to make them credible,” she said.

For the weekly meetings of the multi-stakeholder group, “it’s time consuming. Everyone goes away with a task. We have taken small steps, but as we look at the past year, the data has become more reliable and we’ve been able to change outcomes,” she said.