At Hospital IQ, we start projects with strong data management. We maintain a data specification that we share with customers so they can understand and scope out the amount of work necessary to set up our software platform. A detailed review of this specification usually happens at the main kickoff meeting after the contract has been signed, but it can also happen pre-sales to ensure the client’s IT department is on board and can perform the necessary work.

Read the first blog in Ben Resner’s series on how to best manage IT projects, The Best Way to Engage a New Client’s IT Team

Data Management in Hospital IQ’s Platform

Most people are surprised to learn the data specification is not actually the format of how we want data from the client.  Rather, the spec is the format of how Hospital IQ stores data in our internal cloud databases. Each client configures and stores data differently, even if two clients are using the same EHR product and vendor. We find we get the best results when clients deliver data in their native data format as opposed to them fitting it to our format. 

A seemingly simple example that can quickly become complex — we ask for wheels in time for when surgeries are considered to begin. The client may store this as one or more values such as “surgery start time,” “OR start time,” “room in time,” etc. In instances where there is more than one value being stored, we need to establish a prioritization if values disagree or are missing. Even more complex examples are where the value that we require (e.g. boarding start time) is an aggregation of multiple client data points like inpatient attending admission order, ED attending admission order, or bed clean time. In these situations, we ask the client to provide us with the raw data and we do the compilation, rather than have the client do it on their end.

Even though we don’t actually expect or receive data in the format of the data spec, the spec still performs a vital function, and it’s essential to review it in detail with the client so they understand what we are asking for. The data spec is a contract between Hospital IQ and the client that establishes when the data integration will be considered done. It is a promise we make to the client that declares, “When you get us the ingredients to fulfill this request, the project is over.” The spec lets us track progress with the client to completion and avoid surprise data requests that can delay an implementation.

Flexible Data Specs Keep Projects on Track

Starting an IT integration project by establishing where the finish line is essential to prevent what we call forever-itis. A clear finish line not only lets client IT teams know when they can disengage, it allows us to pace effort towards that goal.  

A common mistake vendors can make with their data spec is being overly strict about enforcing compliance with the details of the data format. This can leads to malicious compliance on the part of the client IT. The data is made to fit the specification and delivered on time, but the quality is low and is often backed by extremely complex extraction scripts that are nearly impossible to maintain over time. In the boarding start time example above, the heuristic used to compute this value would be opaque to us if it was computed by the client before sending the data to us, and would likely break on a system upgrade, IT staffing changes, or other configuration change. It also means we need to pull in hospital IT resources when answering clinician questions about the details of a given metric. Flexibility to accept data in the native client format allows us a deeper understanding of the data, which translates into being able to better support the client after go-live. It also allows us to tweak heuristics on our end without submitting time-consuming IT change requests.

I often think IT departments sort projects into two broad buckets — projects that will never go away no matter how much effort is poured into them, and projects that will end once defined goals have been met. The specification is our plea to be placed unequivocally in that second category — projects with clear requirements and deliverables. Give us this well-defined set of data, and the project is over. We’ll praise you to your boss, and you’ll hear praise from the clinicians who rely on our products to manage critical hospital operations.

 

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