Have you taken the Hippocratic Oath?
If you’re a physician, possibly. (Although it’s more likely you’ve taken one of the modern versions than Hippocrates’ original.)
If you have any other role in the healthcare industry – from nurse to administrator, from clinical researcher to pharmaceutical developer – the Hippocratic Oath is more of a curiosity than a commitment.
Which is a shame.
Because we live in a century when caring for the health of humanity has turned from “healthcare” into “the healthcare industry.” We have very impersonal data driving decisions of very personal impact.
Sometimes it takes some ancient wisdom coupled with modern intelligence – and modern data intelligence – to make our healthcare ideals a reality.
But we’re getting ahead of ourselves. Let’s dive into the Oath and see what we find.
Start at the Very Beginning
“I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses -”
Oops. No. I think we can leave that part in the past.
Private, Personal Particulars
Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.
2000 years ago, HIPAA could be summed up in four words: keep your mouth shut.
Alas, that time is long gone.
As healthcare information storage has moved from practitioners’ brains to written records, to electronic records, to the cloud, “keep your mouth shut” is no longer the gold standard of patient privacy standards.
Patient information can’t just be “kept secret.” It must be protected, encrypted and secured. It must be masked, depersonalized and anonymized. It must be made available to the patient and any authorized individual while simultaneously being made inaccessible to any unauthorized individuals.
Whew! How can you keep a handle on that?!
When you need to keep careful track of what’s happening to your data, data lineage for healthcare is your ally. Data lineage maps out the journey of any data asset or data point based on the metadata in healthcare systems. Pick any data point, and data lineage will show you its entire journey through your information landscape, from its entry to its final destination, including any transformations it underwent and all information that it informed.
So you don’t have to spend ridiculous amounts of time manually tracking down and securing (or masking, or deleting) personal patient information – and then live with the worry that you missed something. Point out just one piece of personal patient information and data lineage can trace its path through every single one of your systems, identifying every stop along its path as personal information, to be dealt with accordingly.
Complex Times Call for Complex Measures
I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan…
Medicine used to be relatively straightforward.
Giving a patient legumes to eat is (usually) good.
Giving a patient poison hemlock is bad.
Life – and medicine – have gotten a teeny, weeny bit more complicated.
There are over 24,000(!) kinds of prescription and over-the-counter drugs listed on Drugs.com alone. About 40 novel drugs are approved by the FDA per year. How do you know what drugs are lethal and what drugs are life-saving – and under what circumstances? And what about all the other, non-pharmaceutical treatments?
When it comes to clinical judgment calls, it’s critical to have a strong handle on all types of clinical data:
- Individual patient health records
- Aggregated patient health information
- Clinical and pharmaceutical trial data
- Medical research
If you get the right data and integrate it the right way into models and computerized decision support systems, it can directly power better healthcare decisions.
But all of this information is scattered throughout multiple layers of the healthcare data ecosystem. The data capture layer includes EHRs, mobile devices, wearables and data entry from clinical trials. Data is then stored in enterprise data warehouses, data aggregators, patient registries or portals and public records. Data is often analyzed or reported on in medical research papers, insurance claim reports or drug development updates.
How do you confirm that you’ve built your model or made your clinical decision using the right data?
And what happens if your decision doesn’t improve outcomes? Was it an error in the model or the judgment call – or was it an error in the data informing the model or judgment call?
Automated data lineage is the scalpel that enables you to see the anatomy of your clinical, data-based decisions with precision.
Data lineage for medical data grants you transparency into the information upon which you’re basing clinical decisions. Data lineage enables your organization to track where your clinical and operational data comes from, where it is stored and where it is used.
If you want to check the validity and authority of the data that serves as an important factor in a clinical decision – you have the ability at your fingertips. If you find out that some of your clinical data is invalid, data lineage gives you an easy, intuitive way to check where and how the error originated.
Whether it’s a dietary change, a pharmaceutical prescription or a therapy referral, data lineage’s contribution to data transparency and traceability makes your “greatest ability and judgment” to “benefit your patients” even greater.
Integrity, Corruption and the Chain of Custody
Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption…
In Hippocrates’ time, a healthcare professional was a one-person show. If you were careful to avoid any acts of impropriety or corruption, you were good.
Today, it’s not enough for you to exercise personal integrity. Whether your healthcare company staff numbers dozens, hundreds or thousands, even one person acting corruptly could impugn your entire organization.
This is why “chain of custody” has become such a big deal when it comes to healthcare data. It’s not atypical for information on a given patient to appear in twenty different systems and be accessible for editing in ten of them. If your organization is accused of improper treatment, negligence, corruption or any of those other bad things that you really don’t want on your record, you need a way to figure out what happened and who was responsible.
Who last accessed the patient record? Where? When?
Who last changed the data? In which system? What other systems did that affect?
Instituting a strong healthcare metadata management solution that is designed to keep track of all these details, with integrated data lineage to deliver a clear, visual representation of what happened to the data and in what system, can be your saving grace. Active metadata management can even alert you in advance to anomalies and potential issues so you can investigate before they turn into real problems.
Truth or Consequences
So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time.
However, should I transgress this Oath and violate it, may the opposite be my fate.
Interestingly enough, modern versions of the Hippocratic Oath retain the mention of positive consequences for keeping the Oath – but by and large omit mention of negative consequences for transgressing it.
That’s okay, though, because regulatory standards have stepped in where politically incorrect oath phraseology has stepped out.
Should you as a healthcare company transgress your regulatory requirements, may professional sanctions, hefty fines and even prison terms be your fate.
Of course, it’s not enough to just meet healthcare data compliance requirements. You have to prove you met them – sometimes through monthly or yearly reporting, sometimes in (eek!) audits.
Reporting an audit preparation can be a tremendous drain on your organization’s time, money and overall resources. Heightened stress, working overtime and downing shots of espresso are par for the course as your data team tries to figure out “just where did that number come from?!” as the deadline approaches.
It’s here that automated data lineage can be a lifesaver.
Need to know where that number came from? Just look at the visual map tracing the data point in question back through your systems to its source, along with all the transformations it underwent along the way.
Need to prove the integrity of your data to auditors? Automated data lineage quickly and clearly shows your information’s pedigree.
Empowering you to get more accurate answers in a fraction of the time, automated data lineage is an indispensable tool in your data governance for healthcare arsenal.
Physician with a Mission
Healthcare has been about helping the individual and society since long, long before being socially conscious and socially responsible was a thing companies boasted about.
But while healthcare’s ultimate goal hasn’t changed, the complexity of the modern world requires new means of reaching that goal.
Using automated data lineage, your healthcare organization can streamline its ability to guard patient privacy, create the best medical intervention plans, prevent corruption, prove compliance and stay true to its mission of caring for humanity’s health.
Hippocrates would be proud.