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Health Care Industry BI Groundhog Day

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  • Errors abound! Information Management Systems and CPOE (Computerized Physicians Order Entry) applications account for a staggering 84% of 43,372 USP MEDMARX Computer Technology-Related Harmful Errors (2006) 
  • Proprietary, closed architectures still rule. Hospital information management applications are often based on hierarchical databases that do not speak common query languages like SQL or MDX — the basis for all modern BI tools (even though some BI tools are beginning to roll out XQuery language functionality capable of reporting from XML data structures). Even worse, most of these applications are not architected with separate data and application logic tiers. Sounds familiar? 
  • There is no data transparency. Applications with proprietary, hidden data models do not allow for a plug-and-play interface with ETL (Extract, Transform, Load), CDC (Change Data Capture), or other standard data integration technologies. Such an environment breeds a swarm of small consultancies founded by ex-developers of these proprietary, closed hospital information applications. They take advantage of the insider scoop on how the guts of these applications work, and make a living building custom interfaces for their clients. 
  • Standards are incomplete. Data exchange standards like HL7 only work for about 80% of the content (and that's for administrative, but even less so for clinical data) — the rest must be custom integrated every time. 
  • Huge chunks of MDM are missing. MDM (Master Data Management) — a key to effective BI applications — works mostly for patient information, and maybe billing codes, but not for anything else, like drugs (good luck trying to find a standard code for 200mg ibuprofen gel coated caplets), conditions, and treatments (there is no such thing as a “standard treatment” for a particular ailment — it is all subjective). For example, one senior Healthcare IT manager tells me that Glucose test is coded differently in every single lab system she looked at, so her team spent countless hours coding mapping tables. 
  • The world is very vendor-, not user-centric. True, most of the state-of-the-art (translation for those unfamiliar to the world of Healthcare IT: state-of-the-art = proprietary) healthcare IT applications are very powerful and function rich, but few of the vendors I talked to seemed to care about integrating with other vendor applications. 

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Comments (1)
The healthcare industry it seems is a never-ending headache for some. An open SOA is easier to use with "plug n play" connectors. There are many companies that boast the "out-of-the-box" connectivity, should that be a red flag to anyone looking for compliance standards? Maybe I have a narrow view, but it seems to me that there are vendors fighting for to provide the "best" software will throwing around words that they really don't understand to attract attention.
Posted by Charlotte L | Monday, June 22 2009 at 12:59PM ET
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