Recently, Andy Slavitt, CMS Acting administrator, wrote “Pitching Medicaid IT in Silicon Valley“. His requests are sensible and well founded, but will fail. I’m not saying he won’t have modest gains, but his gains will be held back by overly burdensome Code of Federal Regulations that regulates all regulated industries including health care providers, pharmaceuticals, utilities, etc.
I am currently working at a global Pharma company and it is embarrassing the volume of labor and the amount of paper we consume in the name of quality. We are switching to a digital system, but the effort will remain the same. Every item has to be written up for expectations, dry run testing to get 100% correct, written, printed in screen print, and then signed. Any exception such as an extra temporary file in the directory results in a hand written explanation. I’m not convinced that any of this QA work will ever add anything to quality of the pharamceuticals the company produces.
I fully get the need to test, but this test so we can’t be questioned model of micro-testing and lack of awareness of digital images will continue to hold back the industry. Cloud, at any level (IaaS, PaaS, SaaS) requires the ability to certify the template and assume all instantiations are also certified if they have no errors in the instantiation process. Again, I’m not against testing or quality, but the redundancy is a waste.
The other 2 issues that will need to be conquered for healthcare is: 1) privacy and 2) standardized data formats at least for header records. Privacy is pretty obvious in that I don’t want anyone reading my information unless required and released by me. At the same time, it is important that my “data” goes into the pool for analytics to give researchers the ability to learn from the population. There is no perfect answer for anonymizing data, but good security and good tools are well-known, understood, and can be implemented.
Data standards are not a new issue in our industry. While 80% of data is non-structured, the 20% that is structured never seems to line up so we spend anywhere from 60-80% of our analytics money messaging data. To tie together all this data, we’ll need to have at least some standards for header records.
Again, I salute the efforts by Andy Slavitt (@aslavitt), CMS Acting Administrator, for his efforts. I hope he gets his interns and can make a big impact. He’s got a big job to do.