Healthcare runs on data. Some say it’s the oil that keeps the engine running. Healthcare Payer organizations are the stewards of an abundance of this data and that volume is growing more and more each day. 

By Ed Deming

Originally published at VMware Blogs

Healthcare runs on data. Some say it’s the oil that keeps the engine running.  Healthcare Payer organizations are the stewards of an abundance of this data and that volume is growing more and more each day. 

Where is all this data coming from? What is all this data? Where will it go? How will it be used? Who will use it? Is it secure? Great questions.

Processing and paying claims is the obvious source of most healthcare data being accumulated. Adding to the volume and complexity are new applications and modern technologies solving for evolving healthcare consumer needs with new services and lines of business.  Merger & acquisition deals behind Payer consolidation and healthcare market verticalization are an additional source that have a rapid impact on the volume of data they have the responsibility of securing and managing. 

Payers and Providers are partnering on funding and care models improving the quality of care received and equally whether members are satisfied or not. Trusted access and timely exchange of meaningful data is imperative to ask and answer the more complex questions needed to correctly assess these objectives. Focusing on healthcare outcomes and member experience require new digital tools, technologies, and workflows that drive engagement and allow healthcare services to be delivered where the members want to be.

The digital transformation acceleration triggered by the pandemic has brought about a rapid adoption of virtual care and an equally rapid exodus out of the office, by health plan employees, to work at home arrangements.  Today telehealth and other digital solutions are commonplace. Payers across the industry are leveraging their newly distributed hybrid workforces to meet the needs of their members across their organizations.  

Challenges that put data at risk

Healthcare IT executives face many challenges as stewards of this abundance of healthcare data that’s growing along with the transformation of their industry. 

Visibility, volume, and management of data; whether it’s “build or buy”, new applications and functionality are being added at a higher rate of speed.  These new assets and the associated data may live in traditional data centers or are sprawled across multiple cloud vendors.  Healthcare IT executives are challenged with the visibility, management, and security of these new assets and the pace they appear.

Privacy & Security amplified; this by no means is a new challenge, it’s now only magnified by the transformation of digital assets across the enterprise.  As the walls of the traditional datacenter evaporate and blur across multiple cloud and SaaS solutions, the risk of data loss increases.   Healthcare IT executives are challenged with ensuring their applications and data are protected ensuring only the right users have access to the right systems – regardless of where they’re being used.

Accessible and available; new data sources from modern solutions need to connect and relate to traditional systems that may or may not be under transformation.  Assets brought in by M&A activity now need to be physically accessible and connected to new parts of the enterprise. Healthcare IT executives are challenged with how they connect the new with the old and vice versa and how they ensure this growing abundance of data is available, accessible to the right people with the correct access when and where it’s needed.

Usable and meaningful impact; Data’s value comes from being usable and meaningful. How do you know if it’s the right data? Is it in a usable format? Is the format readable and can it be used and connected with other sources?  Can you combine or relate disparate data sets about a member, and can a connection really be made? Healthcare IT executives are challenged with integrating and sharing the varied sources of data to enable improved decision making and meaningful impact.

So, how can Payers protect their data? They need modern and flexible IT architecture. And VMware can help. Read about the solutions in part 2 of this series!