There’s nothing like a week in the hospital and 10 more days of home rehab to reset your compass. This was my very recent experience after a still-unexplained infection appeared suddenly in my left leg and managed to stump my doctors for a few days.

I’m doing fine now, but it was my first institutional encounter with health care in 35 years, and it reminded me a lot of my last, at age 15 for a bout of pneumonia. I’m sure the treatment and machines and drugs are better now than they were in the 1970s, but the rest was rote, right down to the stunningly bad food. I interacted with a dozen nurses and at least five doctors whose names are lost to me along with whatever they told me about my condition. I was asked to recite my name and date of birth each time I was given a drug, which is more tedious than you think when you’re on seven medications. I filled out forms and releases for admission, copayments, insurance and aftercare, reprinting my name, address, medical details and next of kin again and again. I signed other forms in which all the information had been mysteriously prepopulated.

My notes are all mental, but I was told I can access these records if I want, which will surely be a big stack of paper copies. For whatever I anticipated about electronic health care, the people who manufacture clipboards are going to be in business for a while.

I am recounting all this because I was just finishing a paper on the future of BI and health care when I fell ill. The timing couldn’t have been better (or worse), but it tested a lot of what I’d just learned and still don’t know about health care. After 16 interviews and 80 pages of notes, I was just scratching the surface. There’s simply no way to put a bow around health care data management in a few thousand words.

But one thing is clear. The two critical bookends of health care – how we deliver individual care that improves lives, and how we build and run the system as businesses and society – are going to be measured and managed in the middle. You don’t need to have a political bone in your body to stand in awe of this challenge and how short we are of expectations.

It is even difficult to find an entry point to the big picture of data management in health care, so I won’t try here. I spoke to nine CIOs, CTOs or CMIOs along the way and heard some inspiring stories, but these people will be the first to tell you their work has only begun. There is a lot of technology ripping and replacing going on in hospitals that reminds me of the platform wars that took place in other industries six or eight years ago. There is plenty of good technology in the wings and a competitive war to be fought. But there are so many layers of standards across practices, outpatient centers, hospitals and integrated caregivers, and so many disintegrations between departments that the challenges replicate, and worse, seem to start over at every point of progress.
 
It is also a huge change management problem where processes are optimized in a cash-strapped industry facing price and cost challenges from every angle.
 
It is one big fat ugly architecture.
 
I can’t think of an industry that needs a greater end-to-end focus or one where outcomes and customer satisfaction are more important. It is going to take a lot of talented people a long time to make a dent. And maybe I’m a bit more altruistic for having seen health care up close for the first time in a long time, but it does give me a different perspective on data management. It’s going to be a vibrant and rewarding career where people’s work can make a real difference in others lives.

Sorry I missed all my friends at our last MDM Summit, but I received some good feedback. Thanks to the people who helped me get well and all of you who sent along good wishes. For a lot of good information on this topic, have a look at our excellent sister publication Health Data Management .   


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