Health and human service organizations are spending a tremendous amount building the infrastructure to gather more and better consumer health data – and to do it faster. From electronic health records (EHR) to health information exchange (HIE) capability to patient registries and referral tracking tools, the investment numbers are up (see Health Care Provider Organizations To Double IT Services Spending By 2020, 30% Of Large Non-Profit Senior Living Facilities Have EHR With HIE Capabilities, and 96% Of Acute Care Hospitals Have Adopted Certified Electronic Health Records). The reasons for the investment are clear and we’ve written about that before in In The Land Of The Blind., The 3 Market Challenges We Aren’t Prepared For, and Technology Makes ‘Lifetime Learning’ A Leadership Must.
But there is no competitive advantage and no return-on-investment (ROI) for that investment if organizations don’t have the ability to put that information into use. Is your management teams ready to use the data they have? One sure way to tell is to answer another question – does your management team think that using data is primarily about “what has already happened” or about “what is going to happen.” That is my short-hand diagnostic assessment of data reactive versus data predictive management teams.
And this dichotomy was the theme of the session, “Shifting From Reactive to Predictive: Harnessing Data To Create Positive Change In Growing Provider Organizations”, at the recent 2017 OPEN MINDS Management Best Practices Institute. The question and answer session featured Heather Rudolph, President, RCI; Grayson Kelso, Director of Data Services, Hillsides; Jegan Anandasakaran, Chief Information Officer, HealthRIGHT 360; and Dawn Vo-Jutabha, Chief Quality Officer, The Guidance Center.
The take from our experts? Many health and human service organizations have a long way to go in leveraging their existing data for competitive advantage. And, key impediments of many organizations are organizational cultures resistant to data-driven change and “information illiteracy.”
“We see the technology supporting your staff and clients as a continuously evolving process,” said Ms. Rudolph. “Your EHR needs to keep up with quickly changing times, and your agency needs to have the internal support structure (staff, technology and tools) to keep up with the technology. To be successful, it’s imperative that your agency culture supports the need to move forward with these resources.”
Organizational cultures are often resistant to change – data-driven change in particular
Attempts to move decisionmaking from reactive to predictive means addressing the change resistance common in many organizational cultures. Staff is often invested in old processes that “work” in the old way of doing business, but are often complicated, difficult to unwind, and contribute to bad data. And changing them is seldom popular because staff get defensive when they think the process “works.” Mr. Anandasakaran explained:
We’ve had eight mergers in seven years so there a lot of subcultures and we found that we can do a better job at true integration of those differing cultures. Two years ago we brought in a CHO that really believed in data transparency. There was pushback. Sometimes it was legitimate opposition and sometimes it was defensive. There was a legitimate argument about what the right thing was to measure in each program. The data driven culture change is something we are still trying to work on. The cleanness of the data can be argued, but once you start measuring something and people care about the information, then the quality of the information really starts to change.
Mr. Kelso also explained that it’s important to help staff understand how data can be used to improve their performance and not just to identify it as bad performance.
Clinical staff always want to show off what they do well and that’s great, however, clinicians also fear their productivity will be pulled apart. Remind them that this is not set up to just identify their poor performance, but to help them do their job better. Then after they have done something new for a couple months, then we want to pinpoint what changes they then need to make.
Organizational culture is often “information illiterate”
Information illiteracy is also a problem and that problem starts at the top. Is the executive team able to use data to manage strategy and organizational performance? There is also fear of data transparency. Managers fear data, how that data will be used, and what it will mean to teach staff about what it takes to be information literate. Mr. Anandasakaran explained:
Generally the strategy is to help meet people “where they are.” It’s not just about helping staff read a chart. We are really talking about dashboards, and that needs to be some kind of clearly actionable information where the chart has built in analytics that have a reason for being there. It’s about changing the language – natural, actionable language, or numbers – and changing how the data is presented.
Dr. Vo-Jutabha shared that information literacy should also have a “more basic” function – helping the staff to do their work effectively. She explained:
It’s really more basic for us. We really want to help staff understand how to do their job, and it was also about asking them what they needed to actually complete their work. It was also important to let supervisors know what to expect from staff. If we say, had a clinician that hated to meet consumers a certain way and the data shows they are avoiding that scenario all month, the supervisor can see that. There is also the common belief that “our clients” are much more complicated and the data doesn’t accurately represent what is happening to them. And then there were the fears around “what does this mean about me if everyone can see my performance?” I want to use the information and help the agency grow in that way.
My takeaway was that this highlights the importance of a “measurement culture” – one that can eliminate “best guess” decisionmaking and replace it with measurement and analysis driven, insightful decisionmaking. For more on using data, join OPEN MINDS Senior Associate Joseph P. Naughton-Travers, EdM, on November 7 for his session, “‘Moving From Big Data To Smart Data: How To Integrate Clinical & Financial Data To Manage Performance”, at The 2017 OPEN MINDS Technology & Informatics Institute.