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Information Is The Connective TissueINTEGRATED CAREINFORMATION MANAGEMENT CHALLENGESIntegrated care is not an entirelynew business model. And soare the related informationtechnologies that support it, suchas telemedicine, electronic healthrecords and clinical decisionsupport systems. Pilot initiatives,particularly in Western Europe,North America and Australia havebeen running, for the past tenyears; and in emerging countries,for the past three or four years.However, full-blown transformationhas been hindered by a number ofbusiness and technical challenges.Governance modelsThe transformation from traditional service delivery, tointegrated care implies profound change in the governanceof national healthcare systems and in the organizationof individual providers. The fact that “organizationalrestructuring and consolidation” activities rank very low,among top business priorities, confirms the difficulty ofdriving change. (Link to Figure 2)Big dataIn many healthcare organizations, the BI/DW technologystack cannot leverage clinical documentation that is by natureunstructured. This has thwarted efforts by providers tocreate highly structured data warehouses common to otherindustries. Clinical data is also extensive, inconsistent andmultidimensional, creating issues for warehouse designers.These BI architectures, and the scalability of the underlyinginfrastructure, will be challenged further by the increase indata volume, velocity and variety. (See Figure 3)Regulatory complianceIn jurisdictions where cultural and religious considerationsare carefully considered, lack of data privacy legislation hasslowed down information integration. However, advancesin IT security tools and information assurance managementpolicies and practices permit further progress.Cultural changeWithin any given healthcare organization, the technicalrationality of IT professionals and suppliers often collides withmanagerial rationality of hospital managers and the medicalrationality that puts clinical care at its center. Effective changemanagement during an implementation project becomesessential to educate staff about the potential benefits andrisks to their daily routine, as well as their involvement inensuring patient safety.Figure 3EMEA HOSPITAL SECTORBIG DATA ADOPTION DRIVERS5--------------- IMPORTANCE ----------13.453.913.55Western Europe3.683.603.83Middle East & AfricaVolume Variety Velocity12