Data Poisoning: A New Disease in the Information Age

Recently a professional acquaintance postponed a presentation for several days because of food poisoning.  His description of excessive and unmonitored GI dysfunction leading to excessive GI confusion and reprocessing, seemed to duplicate another disease process recently seen in our modern information age–data poisoning.

There are two groups of people that are noted to be particularly susceptible to this disorder:  high-tech providers and medical doctors.  It may seem strange that these disparate groups would be susceptible to this disorder; however, they suffer from a similar “data intake deficiency.”  Research has shown that the high-tech group suffers from a “think I can do it” malfunction.  In contrast, doctors suffer from a “think I need it” dysfunction.

The problem of high-tech data poisoning is characterized by the myth that if we just “toss” enough hardware and software in a room, we will have what is needed.  An example of this is all of the failed Health Information Exchanges (HIE) across the country.  Millions of dollars of private and public money has been “thrown” at this nationwide high-tech project, yet data poisoning remains rampant among this population of users.  Just recently we are seeing some HIEs recover and report feeling better and returning to productive activity.  Generally that means more focused data inputs and data outputs.  The idea of moderation and careful input selection is gaining traction.

On the other hand, physicians often think they need every piece of data available in order to properly manage their patient population.  In fact, doctors barely have time to ingest the relevant information needed to treat the patient in front of them.  CMS, skillfully or inadvertently, limited the data to the CMS Claims Line Feed (CCLF) with the initial Medicare Shared Savings Program (MSSP).  This move prevented many active cases of data poisoning by limiting the data needed for success to claims information.  The new CMS Pathways to Success model will require additional data to drive success such as selected clinical information from the electronic medical record (EMR), admission-transfer-discharge data, and even social determinants of health information to keep the Accountable Care Organizations (ACO) on track for success.  Even with these new data requirements ACOs should be careful not to induce symptoms of data poisoning by ingesting data indiscriminately.

Salient’s performance management tools can help ACOs detoxify the multiple data sources that are needed to generate success.  The ACO should consider starting with the CCLF data maximizing the nutritional value before moving to the next source.  Smart clinicians will know what is needed to treat the patient efficiently and successfully.  The Salient Drillable Dashboards guide the ACO along the key performance indicators creating the opportunity for financial and clinical success.  Salient’s Interactive Miner (SIM) provides an ad hoc analytical tool capable of deep data exploration helping in areas of special need or interest.  Both solutions are practical preventive measures for the dread data poisoning disorder.

Just like any dietary change, gradual introduction of new data sources should be methodical and progressive.  By preventing data poisoning one can protect data users from the severe symptoms of the disorder–burn out, discouragement, and data blindness, among other distressing symptoms.  In other words, a data nutritionist would recommend starting with the easy to digest CCLF data source, add basic EHR data elements to complete GPRO, and then ADT feeds to follow the hospitalized population.  When the ACO is ready, then add more EHR data points to fill out a care and case management platform.

This new disorder is manageable with careful monitoring on inputs with the added protection of analytical and visualization tools to make the data digestible.  After all, we live in a time when data junk food is stacked on shelves everywhere, so data discretion becomes increasingly important.  Prevention is what ACOs are all about.  Perhaps an annual “data wellness visit” will help prevent an epidemic of data poisoning in your organization.  Is there a data Triple Aim:  better data, better outcomes, lower cost?   Stay healthy!

Craigan Gray

About the Author

Craigan Gray, MD, MBA, JD

Dr. Craigan Gray, Salient Healthcare’s Chief Medical Officer, brings rich experience from private practice, hospital leadership, and governmental health-benefit programs. Prior to joining Salient, Dr. Gray was director of North Carolina’s $12 billion Medicaid program. His time as VPMA at Bon Secours Our Lady of Bellefonte Hospital in Kentucky was distinguished by moving the facility into the top-quality performance tier for Health Grades and CMS health quality indicators. Dr. Gray is a Stanford University trained Obstetrician/Gynecologist. In addition to an MD degree, Dr. Gray holds an MBA degree and a JD degree. He is a Certified Physician Executive and is published in various medical journals.

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