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Welcome to APCD Journal!

President, Freedman HealthCare, LLC

John, principal of Freedman HealthCare LLC, has 25 years of experience in performance measurement & improvement, health IT, care delivery, and health care reform. At FHC he has helped many states create all-payer claims databases, implement health insurance exchanges, and support health care transformation.

We aim to be your source for news and insights in the APCD world, as well as other relevant topics, such as health data, health policy, healthcare financing, and delivery system reform.

We’ve organized around six themes. These may evolve over time as we hear from readers and keep pace with trends.

The first theme is Data Quality. Anyone who has worked in data and analytics will tell you that 90% of the work is getting the data in order.  The analytics and reporting follow much more easily after. Data Quality is making sure that your data actually are what you think they are, that they are timely, accurate, reliable. In a word, are your data CREDIBLE? Without credible data, you can’t do credible analysis or report credible results. That said, data quality is relative. Just because the old White Pages always had some number of errors – disconnected lines, changed addresses –printed phone directories were still hugely valuable time savers. Think of it this way, your data WILL ALWAYS HAVE ERRORS. Your job is to know your data well enough that you understand where errors might occur. You’ll never eliminate all of them. You can stomp out enough of them to prevent a material impact on your work.

The second theme is Analytics. Our world is awash in analytics engines, statistical and query software, and ever-more-powerful computer processing and storage – at lower prices than ever. So why do we still fight to pull out accurate, actionable information? I argue there are two big problems. One, most of the amazing new analytics engines – think of them as business intelligence tools applied to health data – have great front ends but inadequate back ends. The user interfaces are slick. There’s lots of drag-and-drop, click through, slice and dice, colorful graphics. But, they lack the ability probe deeply into the data in a way that excellent analytics requires. And number two, often there is a lack of analytical thinking in project conception and/or follow-through. We end up asking the wrong questions. We curtail analyses (or attempt elaborate workarounds) to adapt to the limitations of our installed analytic tool or serious quality issues in our datasets.

Third is Reporting. The first step of reporting is deciding WHAT to report. Many people find this hard. What’s fascinating to one audience is ho-hum or worse to others. We will explore how to apply a principled approach to your selection process. Consistently implementing a few best practices can help ensure your best and most important evidence gets seen and has an impact. We will also discuss the WHERE and HOW, in other words, effective communication and data dissemination. This brings me to data visualization. Those who know me know that I am a fanatic about proper data visualization. It’s part science and part art.

Our fourth theme is Technology. In addition to greater power, broader choice and (often) reduced costs of available technology, we have whole new options now open to us. Cloud computing is rapidly growing as the platform of choice for security and scalability. Optimized tools for dealing with big data (e.g., artificial intelligence or environments such as Hadoop) can further leverage the more powerful infrastructure. How these technologies evolve will determine the best approaches to Data Quality, Analytics and Reporting.

Fifth is Regulation. Hard to believe that HIPAA is now old enough to buy itself a drink. HIPAA set standards for health transactions (such as claims and eligibility checks), common language (what we call code sets), and most famously, the HIPAA privacy rule. Of course, many other state and federal regulations are also relevant (HITECH, 42 CFR, OMB Circular No. A-130, Federal Information Processing Standard 200, Special Publication 800-53, etc.). If you work with HIPAA’s privacy rule now, you know that it does not tell you quite what to do. Instead, most consider HIPAA as a guide to always assessing, monitoring, improving, and definitely worrying.

Regulation is nothing more than a governmental directive on how to take care of something. That’s why our sixth theme is Security. In addition to whatever the regs say, none of the above is possible without a holistic application of Security throughout the process.

In future posts we will elaborate on each of these issues with discussion, insights and hopefully, even a few solutions. This is what we aspire to be for you – your guide to the wonderful opportunities in health data analytics, especially for APCDs.

John Freedman, President and CEO of Freedman HealthCare

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