Data Integration Challenges Stymie Health IT

It takes 16 days for an agency to confirm health care benefit eligibility for a new recipient, according to a survey from MeriTalk.

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Data integration challenges are wreaking havoc within IT systems, costing health and human services agencies billions and their customers a reduction in quality care, according to a survey of 155 IT executives and program managers working with health care and other social service benefits.

The MeriTalk survey found 63 percent of caseworkers say enrollment rates for health care assistance and/or benefits have increased at their agency in the last two years, but 85 percent of managers say their agency faces challenges when it comes to the eligibility and verification of health care beneficiaries.

"I think the most surprising finding would be if anyone was surprised by the findings. Those of us that have worked for or in the government, or like me, both, have seen these data-oriented issues building for years and watched them slowly reach a tipping point, Bill Fox, vice president of health care and life sciences for MarkLogic, told eWEEK. "It seems that as awareness of new-gen technologies that can solve data integration and other challenges begins to reach a wider audience, the people tasked with managing these processes and assuring that people that need these programs benefit from them, and those that don't, don't. They are starting to speak up and ask why this can't be fixed—now."

On average, it takes 16 days for an agency to confirm health care benefit eligibility for a new recipient, and two weeks to verify the status of a current recipient if it comes into question.

"Technologies that allow an agency to integrate data quickly and securely—regardless of where it comes from or the form it's in—and eliminate massive ETL processes, can speed integration and solution development exponentially," Fox said. "This means less cost, fewer man-hours and faster time to value. Older relational databases have a tremendous footprint inside the government, and are still fine for certain types of tasks: That investment isn't just going away. But as the study demonstrates, the current technology infrastructure isn't up to the volume, velocity and complexity of the data it's being asked to deal with, and this is costing taxpayers dollars and leaving people without benefits."

Caseworkers estimate 89 percent of their agency's current beneficiaries list is accurate, which means approximately 11 percent of the people who receive government health care benefits are not actually eligible.

"There are people inside these programs and agencies that are itching to move to new-gen technologies that solve issues like data integration and pushing hard, but making that happen is also very hard. There are many established interests at work who might benefit from no change at all. The challenge is to continuously bring these issues to the fore so the public demands that things change," Fox said.

"Also, companies with these capabilities must work together with their government partners to develop specific solutions that clearly demonstrate the value of incorporating these technologies in more and more programs and solutions," he continued.