Vijay Venkatesan: Make medical records more like music

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Vijay Venkatesan, Vice President of Enterprise Data Management, Sutter Health

Vijay Venkatesan, Vice President of Enterprise Data Management, Sutter Health

When Vijay Venkatesan took on the role of Vice President of Enterprise Data Management at Sutter Health, a California-based not-for-profit health network, he transformed the organization’s culture of data from a Balkanized system of historical reporting to a self-service, storefront model where everyone—including patients—has easy, instant access to the most up-to-date clinical information. His new model is cutting costs while raising the quality of healthcare delivery.

Patient data that is as easy to consume as a song on Apple iTunes will greatly improve the quality and affordability of healthcare. That’s the bet of Vijay Venkatesan. Just one year into his position at Sutter Health, his bet is paying off. Venkatesan is already helping the company reap big savings and better patient outcomes.

Organizational convergence to this vision is gaining traction. Big Data and predictive-analytics use cases are beginning to expand, such as the ability to create self-service dashboards that make predictions with external and clinical data. The realization of the self-service vision required a remarkable cultural transformation within Sutter Health. The culture had to slowly move from Information Independence to Information Interdependence—a vision initially met with heavy resistance across the various reporting and analytics functions of the enterprise. Each group believed they had been meeting their customer needs within their silos, so the case for enterprise centralization was not evident.

“The most common question I was asked was ‘What exactly is your job?’” Venkatesan says. “There was not a burning platform for leveraging data as a strategic asset.”

Venkatesan overcame this resistance not by mandates or coercion, but rather through enlightened buy-in. After all, everyone ultimately wants to deliver better quality healthcare for patients. He was able to show how his new storefront model could help them do their jobs even better by making real-time information available to everyone—including patients—on-demand and on any device.

“The best way I describe my role to them is to say that I figure out how to create connections among the data so that we can create better quality care for our patients,” he says. “Data that was once fragmented, siloed and managed locally within each department could be so much more powerful if it’s converged, standardized and delivered like a service.”

Moving from hindsight to foresight

Venkatesan recognized early on that his “challenge” was the practice of old-fashioned reporting. Each department got accustomed to generating a few standardized reports based on historical information. His plan was to shift the discussion from reporting, which is based on hindsight, to a foresight-driven culture.

Better healthcare can’t come from a retrospective view of information, he argued. If Venkatesan could show them how their data could be integrated in real time with things like electronic health records and predictive models, it could be acted upon in much more meaningful and tangible ways.

“I convinced them we needed to change the paradigm from a reporting culture based on data warehouses to an app-based culture with simplified, instant access to relevant information. We needed to think like a startup. So I was able to win the hearts and minds of department heads and executive leadership by showing them the wonderful possibilities of an integrated, interoperable ecosystem of on-demand, self-service data.”

Sutter Health’s storefront system—called “We Connect You” to play off the organization’s “We Plus You” tagline—works like a catalog of information in the same way iTunes works as a catalog of songs, movies and podcasts. Just as one can search iTunes and view relevant metadata about a song or movie, the We Connect You app provides a searchable, easily consumable catalog of clinical information in a standard way.

He was able to create a case for shared values and accountabilities department-wide by showing them that they still control their data. The storefront system simply enhances its value and distribution.

“Steve Jobs went to all the movie studios and record labels and showed how iTunes would improve their revenue streams by putting their digital content on his storefront, rather than losing revenue to Napster and BitTorrent,” Venkatesan says. “So we said to the department heads, ‘Give us your data and we’ll catalog it for you to share with the enterprise.’ We’ll help create all the relevant metadata. And we’ll apply all the necessary regulatory governance for data, like the way Apple applies strong governance principles to iTunes content. The only thing we require is that once you put your data on our storefront, you have to cut its ties to your old data warehouse and reporting system so that we can ensure standardization.”

Change actually does happen

As a network of hospitals, doctors and caregivers, this data integration and governance is also critical to Sutter Health’s goal of becoming a more integrated healthcare delivery system. Affordable Care Act (ACA) mandates are pushing the organization from a fee-for-service to a value-based or outcome-based business. The organization now has to focus on managing new healthcare models like Accountable Care Organizations as well as manage multiple populations of patients across multiple healthcare delivery systems.At the same time, patients are taking a more active role in their own healthcare delivery. They, too, are becoming data consumers.

And as a whole, the nature of data is changing. Structured data stored in database rows and columns are giving way to a new diverse universe of unstructured digital information in forms like telemedicine video, texting and social media. Sutter Health risks falling behind the industry if it cannot accommodate these new changing data forces.

The storefront app supports integration with external data sources to enhance healthcare quality in new ways. For instance, in the future, a We Connect You app would help emergency room caregivers foresee when they can expect a spike in asthma attacks by integrating with the U.S. Government’s EPA data to monitor air quality and high pollen days, as well as social media to monitor discussions.

Enhancing the data with predictive modeling is helping the organization reduce readmissions by identifying high-risk patients who tend to miss follow-up appointments or fail to follow discharge instructions.

The storefront’s governance capabilities are also critical. A new Advanced Illness Management app is enabling Sutter Health to figure out better models of at-home comfort care for terminal patients in their last months of life. The program was funded through a Centers for Medicaid and Medicare services grant, which required significant reporting and regulatory oversight. “We used this opportunity to figure out how to meet all the regulatory requirements on the new platform while still giving nurse managers and caregivers at home the self-service capability to access the most up-to-date information on their patients,” Venkatesan says.

Based on the early success of these use cases, Venkatesan’s vision turned adversaries into ambassadors, and made a significant impact on the nonprofit’s bottom line. Connecting silos of information while letting departments keep control of their data has created what Venkatesan calls an “information value chain” that delivers data that can be instantly consumed, analyzed and acted upon to actually make healthcare better.

On transforming culture through data

“The role of a data officer is not a data role, process role or technical role,” says Venkatesan. “It’s really a cultural-transformation role. Part of the role is to evangelize, part is to converge data, and part is to standardize it across the organization. Most organizations see data analytics as a path to insights. But it has to be more than that. It has to lead to action. So a big part of the cultural transformation is getting people to believe that their data can be acted upon now in very positive ways.”

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