Analysis Paralysis

37,000 of my closest friends and I attended the HIMSS Conference last week in Las Vegas.  For those of you who don’t have a propeller permanently implanted in your head, HIMSS stands for the Health Industry Management Systems Society.  It is an industry association self-proclaimed to be focused on “transforming healthcare through information technology.”

Despite the fact that I have worked in and around healthcare information technology (“HIT”) for nearly 25 years (since I was 7), I had never been to HIMSS before.  This year, when HIT has become the new, new thing once again, I decided I should check it out.

Have you ever gone to the park where there are a hundred kids attempting to co-exist in the sandbox with one shovel?  As you would expect, there would be a lot of screaming, pushing, shoving, cajoling, cringing and toddler-on-toddler contact as everyone jockeyed for control of the shovel.  That’s what HIMSS felt like to me.  There was such a cacophony of noise, information and activity that I went into sensory overload the minute I stepped into the conference area.  In Las Vegas, that’s saying something.  I have become somewhat accustomed to the lights, noise and human insanity that is Las Vegas, as I do go there relatively frequently for fun; but stepping from the Venetian Casino into the Venetian Expo Center (where HIMSS was housed) was like transforming from an observer outside the sandbox to becoming the shovel itself.  It was bedlam.  Think about the mind-numbing noise of a Nirvana concert combined with the technology-adoring throngs who would show up at a free giveaway at the Apple Store.  I have dubbed officially dubbed HIMSS “Nerdvana.”

Yes, it was great to see old friends and acquaintances at HIMSS and to meet with longstanding partners and new colleagues.  But I went in part to see what was hot and worth watching in the space and, as it turned out, this was not the place to do it.  The signal to noise ratio was far too low.

What you couldn’t help but notice by walking the exhibit floor, which was 3 stories tall, each larger than an airplane hangar, was the sameness of it all.  It was almost impossible to see the meaningful differences between the thousands of exhibitors showing their HIT wares.   Through the incredible din what you could pick out from the chatter were a few choice buzzwords used more frequently than the word “the”:  cloud, SAAS (software as a service pronounced by the twitterati as “sass”), big data, analytics, coffee and blister were the big standouts.   Actually, I think it was me saying “coffee” and “blister” over and over again.  Everyone else was screaming the other words at the top of their lungs as if saying them louder would give them real meaning.  I found it to be somewhat the opposite.  The more times someone would say “big data” and “analytics” and that they were delivering “SAAS in the cloud” the less meaning the terms started to have, and here’s why:  there is an avalanche of talk about how technology can transform healthcare by harnessing all of the data and using it for good not evil, but almost no talk about how organizations are going to change their cultures to make it actually happen.

During the course of the show, my attention was drawn to this schematic, created by Nuance Communications:

What I noticed from this picture was the section between the two green boxes on the top right:  “understand everything” and “use data for good”.  And what particularly stood out, aside from the cute little heart beside “use data for good,” was that there was nothing in between point A and point B saying how to do that.  It reminded me so much of a the underwear gnomes in South Park who say that their business is this:  steal all the underwear, reap profits; unfortunately there is no step in between that says how they are going to do this.

httpv://www.youtube.com/watch?v=TBiSI6OdqvA

The McKinsey Global Institute (“MGI”) recently wrote this in a May 2011 report:

“The amount of data in our world has been exploding, and analyzing large data sets—so-called big data—will become a key basis of competition, underpinning new waves of productivity growth, innovation, and consumer surplus, according to research by MGI and McKinsey’s Business Technology Office. Leaders in every sector will have to grapple with the implications of big data, not just a few data-oriented managers. The increasing volume and detail of information captured by enterprises, the rise of multimedia, social media, and the Internet of Things will fuel exponential growth in data for the foreseeable future.”

MGI goes on to say that if US healthcare were to use big data creatively and effectively to drive efficiency and quality, the sector could create more than $300 billion in value every year. Two-thirds of that would be in the form of reducing US healthcare expenditure by about 8 percent.

Well, that is obviously a good thing.  In a sector where costs are rising at 2-3 times the rate of inflation, technology that reduces healthcare costs is a great thing.  I am just worried that there is a huge amount of talk accompanied by a huge amount of technology spending and little attention being paid to how enterprises must psychologically, culturally and organizationally transform themselves to meaningfully take advantage of this opportunity.

Here’s what I mean.  I attended a breakfast put on by McKesson, a leading HIT company, which featured talks from three of their hospital customers, each clearly very smart people committed to using data to improve hospital system operations.  They each spoke about the products they were buying and the money they were spending and the objectives they were after (mainly improved efficiency, lower cost).  However, none of them spoke about how they were re-orienting their organizations around a concept of continuous quality improvement, in the true sense of the words, to ensure that the data received could actually be applied to create change.  I asked a specific question of the panel:  “what are you doing from a human resources and corporate culture change standpoint to make best use of this big data?”  What I got back was not much.

One of the hospital CEOs said that his senior management team was spending a lot of time learning and talking about how big data could help the organization.  But to me that’s only one part of a correct answer.  It’s the rank and file, the hundreds or thousands of middle managers and line employees of healthcare organizations that have to be retrained to use data to root out the cause of errors and inefficiencies and then take action to achieve real change.   If you take an organization of people who have worked in a particular way for a long time and suddenly give them a lot of new information, particularly information that points out where they have created systems that produce inefficiency, mistakes and poor outcomes, what happens if you don’t train them that it’s ok to find your mistakes, publicize them and invest in correcting them for the greater good?  Here’s what happens:  they take the data, rationalize why it’s not correct, put it in the bottom desk drawer and move on with their normal way of doing things.  I fear that this lack of cultural change is going to be the virtual missing link between the promise and the reality of big data and its friend, data analytics.  Yes, analytics turn data into information, but people turn information into action.

So what does this mean for entrepreneurs trying to tackle the big data opportunity? To me it means you need to provide more than just the information, and there are probably two ways of doing this.  1) You can augment your analytics technology with a companion service offering that specifically makes use of the data to solve a problem; or 2) you can provide a consulting service that helps your data analytics client transform their organization into one that understands exactly how to take the stream of information you are providing them, integrate it into their workflow and use it for good.

At the conference I met with several entrepreneurs who are building analytics businesses, each of which promised to “turn data into information” (another overused phrase) for their clients.  The question so few of them could answer was “so what?”   The corollary questions are: How do you turn information into action?  Now that there is all this information, who actually needs it for what specific purpose and to what specific end?  Who at the client organization will be responsible for taking this information and acting upon it to achieve cost-savings and what is the expected savings to be thus produced?  How will all this information, once delivered, be applied inside the operation to produce exactly what change in behavior?  Unfortunately, if you are an entrepreneur and you cannot answer these questions, you risk ending up hanging with the Underwear Gnomes–waiting for profits without a clear view of what makes them show up.