By Alexander G. Izaguirre, Chief Data Officer & VP, NYC Health + Hospitals
On May of 2019, I was appointed New York City Health and Hospitals’ (NYC H+H) chief data officer. My first order of business was to lead the system to develop an enterprise data and analytics strategy. Our intent ultimately included driving behaviors that would lead to improvements in health care, quality and safety, care experience, equity, and better financial outcomes; merging our digital strategy with our data strategy seemed natural. Consequently, the enterprise application development team was placed under the data and analytics (DnA) department. While the link between data and digital has already proved to be a strong approach for connecting data insights to better engagement opportunities, it would take the pandemic to truly uncover the power afforded by having an application development team report to the data and analytics department.
During the first and second COVID-19 surges, the DnA team at NYC H+H were repeatedly asked to develop dashboards and reports with data that our source systems are not configured, or in some cases designed, to capture. Under typical circumstances, our DnA team would have informed our health care system leaders that our line of business systems lacked the data necessary to create the required dashboards and reports. To better understand this, it is useful to recognize that most enterprise data and analytics organizations follow a similar data life cycle. Typically, source data from line of business systems are ingested into data lakes or an enterprise data warehouse where the data is reorganized into facts and dimensions necessary to present reusable data constructs. The data constructs are then leveraged by analytics cores, reporting developers, data scientists, power users, and others via a centralized or self-service model. The timely orchestration of processes and procedures to get even one dashboard to achieve the desired business goal can at times prove challenging. Often, inconsistent business glossary and data definitions, decentralized and asynchronous data repositories, and poorly entered data will be cited as reasons for poor data quality and dashboard publication delays. However, it is generally understood that the data and analytics team can only report on the data they have available to them. But during a pandemic, simply stating that the data is not currently being captured is unacceptable.
Our enterprise app dev team, led by Andrew Vegoda, deployed a number of rapid application solutions to address key data capture limitations in our line of business systems.
Health care institutions have overcome the data capture limitation by introducing ad hoc data capture tools such as excel, share point sites, surveys that function outside of typical workflows to collect the missing data. While these solutions help fill the data capture gaps, they introduce unintended consequences. Firstly, data generated from ad hoc capture solutions is often decentralized and difficult to aggregate for use with robust dashboard and reporting solutions. Secondly, ad hoc capture solutions typically introduce new processes that require training to assure compliance as well as uniform and timely data input. Finally, as more ad hoc capture solutions are introduced, staff report that inputting data becomes overburdening and begins to negatively impact their ability to keep up with normal operations.
This is where having an app dev team reporting to data and analytics is magic. Our enterprise app dev team, led by Andrew Vegoda, deployed a number of rapid application solutions to address key data capture limitations in our line of business systems. For example, early in the pandemic, we needed to maintain an inventory of personal protective equipment (PPE). Due to shortages, PPE distribution would need to be throttled to a level that could ensure our health care works and staff would remain safe for the duration of surge 1. Our app dev team designed and built an application tracking the PPE allocations and number of requests made by each health care worker at each of our 11 acute care facilities. Consequently, in less than three weeks, we captured the necessary data and created robust reports to keep our workforce providing care while keeping them safe.
Our team also developed an application, point of entry (POE), to facilitate the registration of family members seeking to visit loved ones hospitalized due to COVID-19. This was especially important for multiple reasons. We wanted to support our community in staying connected with loved ones. We needed to make sure anyone entering the facility would not get infected or possibly infect others; all during a pandemic and within visiting hours that vary by the facility to accommodate each community. Again, there existed no cost-effective and quick solution in the market to address this need. In less than a week, our team developed a solution that supported the operational needs and offered reports to various agencies interested in our progress in effectively supporting our patients, their families in a safe manner for them and our health care heroes.
Ultimately, our app dev team developed nearly 40 application solutions varying in size and complexity. These applications helped address operational needs for our health care system. Moreover, they generated missing data necessary to offer critical situational awareness necessary to run the nation’s largest public health care system during the worst pandemic of our lifetime.