Data sharing for light, not heat

During the pandemic, all organisations have had to find ways to work together. Having spoken for many years about data sharing, integration, and population health as an approach, the most successful organisations were already digitally mature, while others have found ways to push past the barriers in time of emergency.

Where to start?

Data sharing can seem daunting, with perceived barriers including information governance, data quality, and anxiety about how the data might be used (performance monitoring etc). If your perception of data is limited to that stored in computer systems, you may be right. But data, information and knowledge are also held by people and organisations – systems that do not talk to each other.

Dr Sakthi Karunanithi, Director of Public Health & Wellbeing, Lancashire County Council, coined a phrase that struck a chord: “Data for showing light rather than providing heat”. Promoting openness and sharing to enable learning and better service delivery without fear is critical for understanding things that went well and, equally importantly, those that did not.

In a recent Health+Care webinar covering population health management (PHM), the key message was that, while access to data is important, PHM is 10% data and 90% culture change. Even without data, PHM approaches can be employed.

Common understanding

Joined-up data and information enables us to use our knowledge and cognition to make PHM more targeted, allowing timely delivery of the right services to those in most need. We can think of the above terms as follows:

• Data = 50, it could mean anything.
• Information = data in context, 50 is a heart rate.
• Knowledge = information in context. A heart rate of 50 could be a super-fit person or someone with heart issues.
• Cognition = the process of using data, information, and knowledge, to make sense of the environment around us and acting accordingly[1].

Ade McCormack expresses the view that one of the most wasted assets is human cognition, and that harnessing it results in greater innovation and deeper customer experiences. Success occurs where people talk meaningfully and with equality, and then act on the art of the possible.

Call to action

We need to understand our local populations far more effectively. Until agencies and organisations share information (police, fire, ambulance, local council, NHS organisations, third sector etc.), those ‘art of the possible’ solutions are not visible.

The real challenge is: how can you use disparate data/information sources to provide a single truth? At a superficial level, the answer is surprisingly simple: do not let perfection become the enemy of progress; plan to do something rather than nothing.

The 90% culture change referred to above is about people and relationships, the ability to act for the common good. And, as GGI said in its 2018 report on population health management, it’s about leaders embracing a culture that favours collaboration over competition. Flat structures (across and within organisations) bring together clinicians, prescribers, executives, data analysts, information governance experts, etc. Empowering all to speak freely unencumbered by rank, leads to beneficial outcomes, where the art of the possible outweighs the need for perfection. Importantly, it also promotes action at the speed required rather than the speed of technical solution deployment.

As discussed in previous bulletins, this approach enables organisations/systems to challenge their stance to volatility versus stability, risk versus reward and doing something now versus just too late.

Leadership, commitment, and investment are required. Given the layers of accountability and measurement, there is no single agency that has the funding to do this. It requires a system-wide approach that recognises the value – as well as leaders who value the wider benefit.

Planning for the future

COVID-19 has demonstrated that a more flexible approach is needed when responding to emergencies, in the ability to act now but also in the underlying architectural approach to systems, procurement, and deployment.

For many years there has been an alternative way of working possible – a different architectural approach to systems design and deployment. Service-oriented architecture (SOA) and its modern variants allow designers to take advantage of the latest developments – for example, the ever-expanding number of data sources. Some of the most important frames of reference include user-centricity (consumer access and potentially improved business, clinical and operational data relevance), interoperability (common rule set that allows vendor and technology neutral decision making), and decentralisation (underlying data held where it is captured, but connected with local, regional and national health information systems) [2]. SOA approaches properly implemented mean that users are less worried about and impacted by individual systems and logins.

Gartner noted in its Trend Insight Report[3] the opportunities for taking greater risks by turning to smaller vendors to ‘change the game’.

These resources show that real action can be taken now – but medium-term architectural effort is also required to allow flexibility to be built in to ‘the system’ for a better future.

This raises the issue of governance, risk tolerance and approach to benefit reassessment.

Questions for boards

• Should your risk appetite be reviewed given the change witnessed in response to COVID-19?
• Are you working with other organisations as part of a population health drive?
• Does your organisation learn lessons from others, or do local procurement rules drive your organisation to redo work carried out elsewhere?
• How does your organisation balance risk versus reward; certainty versus uncertainty; stability versus volatility; and do something now versus just too late?
• Is your organisation really data/information rich and able to act based on it?
• Can your business plan that acknowledge the value of cognition as an effective tool?

If this briefing prompts any questions or comments, please call us on 07732 681120 or email advice@good-governance.org.uk

[1] Ade McCormack – Digital Readiness Blog - An Executive’s Guide to Cognition
[2] EY – How will you design information architecture to unlock the power of data? Creating the right data environment for a connected health ecosystem.
[3] Gartner – Cool Vendors Enable Radical Rethinking After the Reset: A Gartner Trend Insight Report

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