Trust is a barrier to embracing informatics

HEALTHCARE STAKEHOLDERS tend to see the potential of clinical informatics in discrete pieces. If clinicians, payers and pharmaceutical companies are to advance the field and realize some of the benefits clinical informatics has to offer, they need to find common ground, according to a new survey on the subject by PricewaterhouseCoopers' (PwC) Health Research Institute.

For example, there's a dearth of resources and skilled data analysts able to work comfortably with clinical information. Most of them must manage a mountain of imperfect data, conflicting priorities, integration issues and ongoing interoperability struggles. But at the heart of many of the problems is a core issue of trust, says John Edwards, director in PwC's Healthcare Strategy and Healthcare Business Intelligence Practice.

"Providers have been beaten up by managed care before, and they're wondering if they really want to give them a stick that they might use to beat up the providers again?" says Edwards.

CLINICAL DATA IS MESSY

For their part, pharmaceutical companies, accustomed to working with the clean data of clinical trials, are uncomfortable with messiness of clinical data: 87% of pharmaceutical/life science organizations expressed concern in the quality of data within EHR systems in the survey.

Overcoming these issues of trust is essential for all parties to move forward, Edwards says, and depends upon their ability to find common ground, identify shared goals and launch targeted initiatives.

"When people have different goals and they're motivated by different things, it's hard to find common ground to make progress," he says.

He believes stakeholders will make the most headway if they tackle medication compliance.

"Drug adherence is a great place to start because it affects all three stakeholders and there are common goals to be celebrated when they're reached," Edwards says. "The stakeholders need to work together to come up with a program design that enables everyone to see their progress and goals."

While leading-edge organizations are already making headway with successful, targeted informatics programs, no one has devised a perfect model. To date, the ability to leverage informatics to engage and interact with patients has produced mixed results. Only 13% of providers and 15% of health insurers responding to the PwC survey believe they have been able to impact patient behavior through their informatics efforts.

But Edwards insists trial and error are an essential part of the learning curve and managed care organizations that "wait on the sidelines because they lack certainty" will fall behind. Perfection is often the enemy of progress when it comes to data leveraging in healthcare. However, most observers believe new government regulations to create administrative standards will drive progress.

The time for action is approaching. As new payment innovations take root and population health becomes a driving issue, stakeholders are going to quickly discover ways to tap the power of healthcare informatics. At that point, companies that haven't established relationships based on trust and made forays into the field are going to be left behind.

"Managed care organizations can build their programs over time," Edwards says, "but they have to get their feet wet."