Are You Ready for the “Data Tsunami” from the Affordable Health Care Ruling?

The recent Supreme Court 6-3 ruling on the Affordable Care Act (ACA) allows health insurance consumers to receive federal subsidies regardless of their state’s role in running their insurance market makes healthcare insurance coverage. I personally believe regardless of political affiliation, having health insurance coverage for all this is a good thing for our society.  Now that the legal and political jousting is coming to somewhat a close, the real work begins as state and federal agencies gear up to handle the inflow of new enrollments and all that comes with it.

One area in particular will be the massive amounts of data generated from millions of new online enrollments, EMR & EHR records generated from health provider services for new patients, influx of medical claims submissions, and call logs generated by millions of new subscribers asking questions across state and federal call enters. Healthcare exchanges, providers, and insurers must be ready to access, govern, and protect it to ensure success. However, years of under-investment in enterprise class data management infrastructure and software by healthcare providers, payers, and government agencies pose significant risks to the health of the system.

The current state of data management processes and systems across the industry represent a ticking time bomb that needs to be addressed, not by developers, but CEO’s, COO’s, and CMO’s to ensure invalid, out of date, and unsecured data does not destabilize the health care industry.  The volumes of data will no doubt increase as well as the need to integrate and deliver clean, safe, and holistic data from new member on-boarding systems to new and existing business intelligence, data visualization, and predictive analytic applications across the provider and payer markets. Healthcare organizations must factor in the importance of these areas to the support the integration, governance, and security of all this data.

  • Data integration to help automate and streamline the process of extracting, transforming, and loading raw data from healthcare exchange enrollment systems, EHR & EMR healthcare records, patient and clinical data from legacy systems mike EPIC and others into upstream data warehouses, analytic applications, and day to day business solutions on premise or in the cloud.
  • Data Quality and governance solutions to enforce identify and repair unforeseen data quality errors caused by human data entry, data corruption in source systems, invalid and incomplete formats. In addition, delivering transparency into how data quality is performing throughout the organization and define workflow processes that require human intervention.
  • Data security solutions including data masking to help protect sensitive information including Personally Identifiable and Non-Personally Identifiable Information used in test data to support new IT projects or from unauthorized access to that information

As the saying goes, “Hope is not a strategy” and for CIO’s, CEO’s, and Chief Medical Officers hoping that existing tools, processes, and bodies will be ready to hand the volume, variety, and velocity of all this expected data, that too is not a strategy you can hope for. How Ready are You?


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