We don’t have a shortage of data – we’re often drowning in it – what we lack is a way to structure and organize it so that it’s useful across the entire healthcare continuum.

It’s about healthcare information, not information technology.

Information technology, while an enabler, is only a tool. What healthcare needs is data that supports its primary mission – patient care – and can be communicated among healthcare partners: Providers, payers, suppliers, distributors and manufacturers, all of whom share a symbiotic relationship.

All of these entities are connected in a data network, each relying on the others to provide meaningful data that facilitates 
collaboration – collaboration that requires
data standardization, unification, normalization, accuracy, and completeness to be effective and beneficial. Data unification enables hospitals, group purchasing organizations, manufacturers, suppliers and related entities to streamline their supply chain, analyze and collaborate global spend and improve analytical accuracy. Unifying or synchronizing data helps achieve a common definition of an entity’s customers, products, suppliers, and employees – an accurate, up-to-the-minute view of their business that they can share throughout their enterprise and with trading partners.

Interoperability and collaboration among healthcare partners is hampered by a lack of data synchronization (as is interoperability among the multitude of in-house information systems: Legacy, Laboratory, Cath Lab, Pharmacy, OR scheduling, Order Entry, etc.) As Peggy Brody of the Coalition for Healthcare eStandards (CHeS) points-out, "bad purchasing data is causing some serious issues in healthcare. Hospital budgets are being hit hard due to dirty item masters and money spent tracking down mismatches in accounts payable. Wasted clinician time, inaccurate pricing, inaccurate rebates, returns and credits..."

These are things that budget- and labor-strapped providers cannot afford – either in patient care or financial terms. Clinically speaking, data and its collaboration make the difference between acceptable outcomes and marginal or unacceptable outcomes. Financially speaking, data and its collaboration make the difference between profit and loss. 

While all parties recognize that there are significant benefits to be realized by data synchronization, and we see article after article and many conference sessions identifying inaccurate, incomplete, and inconsistent data as a leading cause of many of today’s healthcare maladies (e.g., in supply chain management), the "hard" benefits can be difficult to quantify, and it is this lack of ROI that is causing reluctance on the part of various members of the supply network to lead in the adoption of standards and data synchronization (unlike the role that the DoD took in demanding use of the Universal Product Number (UPN), or that Wal-Mart took in requiring its suppliers to use bar coding). Early electronic data interchange (EDI) adoption saw the same chicken-and-egg scenario: suppliers were reluctant to invest in EDI technology until they knew that their customers would use it, while the customers were reluctant to invest until they knew that their suppliers would use it (and adoption of subsequent technologies – e.g., XML – have met the same resistance to first adoption).

Besides, the problem of data synchronization is incredibly large and intimidating. What can be done to overcome it?

Fortunately, several organizations are engaged in the adoption of standards to help address this problem (with thanks to Peggy Brody, director of communications, CHeS):

• The Coalition for Healthcare eStandards (CHeS) are promoting the adoption of standards, such as Global Location Number (GLN) to identity customers and trading partners, United Nations Standard Product and Services Code (UNSPSC) to standardize product classification/categorization, and a Product Data Utility (PDU) that provides a centralized industry resource for standardized and synchronized product data. AHRMM supports these three CHeS initiatives.

• The Eastern Research Group Inc. proposed the use of the UPN for medical device identification, use of a Product Data Utility (PDU) to maintain accurate product data for EDI, and use of identification systems in hospitals that can read UPNs and capture data or link UPNs to a PDU database.

• The Healthcare Supply Chain Standards Coalition (HSCSC) is proposing the use of uniform supply chain standards for business transactions with consistent use of clean data and product information in standardized formats.

• The Strategic Marketplace Initiative, a consortium of healthcare providers, medical supply chain companies, and other related businesses, is working on adopting a customer identification standard to identify trading partner locations.

• HIMSS has created the Integration and Interoperability Steering Committee to guide the industry on allocating resources to develop and implement standards and technology needed to achieve interoperability.

What is needed, however, is an overall body to coordinate these, and other, initiatives and ensure consistency and coverage of issues, and resolve overlaps and conflicts.

All supply network partners need to recognize that data is a corporate asset and can provide a competitive advantage (this already is known to a large extent on the revenue side; now, equal attention must be paid to the expense side). They need to make it a priority to protect this asset by ensuring its quality through accuracy, completeness and timeliness so that they can effectively turn that data into actionable information for decision-making. This, in turn, will lead to significant savings and productivity increases that not only will fund further IT projects (that, themselves, will lead to greater savings and productivity), but other projects, as well.

And everyone needs to become involved in the adoption and implementation of standards and data "housekeeping" to enable data synchronization (how many members of the healthcare supply network have "homegrown" classification systems and haven’t adopted UNSPSC or cross-referenced their categories to those of the UNSPSC; how many cling to outdated numbering schemas – often with "intelligent" coding that either is out-of-date or limits system use, rather than adopting the UPN or cross-referencing to it, etc.)?

For providers, in particular, this new data imperative is going to be a challenge because many hospitals don’t view data as a strategic weapon (nor do they recognize Materials Management as one, either) – IT and Materials Management are cost centers/overhead that consume resources and don’t directly contribute to revenue. Clean, accurate, timely data requires effort and money – which hospitals often are more willing to spend on medical equipment and technology. Providers must make the commitment to adopt and implement standards; other members of the supply network know when their customers have done so and then can work with them in a true partnership for everyone’s benefit – especially the patient.

Providers need to recognize that savings realized through effective IT positioning and deployment can help pay not only for IT initiatives themselves, but also for medical equipment and technology. And significant savings in materials management is the "low-hanging fruit" whose ROI has been documented in many sources. This easily-achievable success can be a springboard to successive IT initiatives that expand the savings and make a significant contribution directly to the hospital’s bottom line.

GPOs, suppliers, distributors, and manufacturers (hereafter collectively referred to as "suppliers") expect that providers/customers be able to clearly communicate goods and service requirements so that the supplier understands what is required and can properly provide them under the terms of their agreements (and this includes the technology to do so – whether it be EDI, XML, bar coding, supplier portals for collaboration, RFID and others). If the supplier is expected to provide reporting to their customers and/or perform specific functions (e.g., order acknowledgements or ASNs, supplier-managed inventory, consignment, drop-shipments, spend analytics, recall notifications, RFP quotations, etc.), then data provided by the customer must be consistent and synchronized with that of the supplier. Similarly, data synchronization is required for reverse logistics (i.e., from the customer to the supplier – e.g., returns, exchanges, etc.)

Software companies expect that providers implement their solutions properly (including sufficient implementation team and user training) and, when appropriate, with guidance from the software company (which, after all, always has "skin in the game"). In a recent survey, it was discovered that hospitals implement, on average, only 30 percent of the materials management functions provided in a software package; one can only wonder then of the quality of the data that was loaded from legacy systems or manually added. Material, service, and supplier master files seem to be especially vulnerable to inaccurate, incomplete, and incorrectly structured data, and accurate historical data may be completely lacking. In such cases, providers should consult with the software company (who, after all, knows best what’s required to realize maximum benefit from their system) and follow their advice.

As we continue to see this shift towards increased collaboration among healthcare providers, payers, partners, patients, suppliers and manufacturers, thus creating a more complex web of information-sharing, the problems posed by data inconsistency grow even more acute and it becomes even more of an imperative for all members of the healthcare ecosystem to work together to define and adopt standards that facilitate communication and data transparency.

At the beginning of information and 
knowledge is data. Decisions and processes based on synchronized and accurate/complete data lead to positive outcomes, reduced risk, increased productivity and patient and employee satisfaction, and lower costs. When you’re dealing with decisions associated with patient care and underlying financial issues, those are exactly the results that you want to see.

Mark Biviano is vice president, healthcare, SAP America Inc., Newton Square, PA.