Canadian Government Executive - Volume 22

November 2016 //

Canadian Government Executive /

Data Management

For this to work, all parties in the health-

care system need to begin taking a data-

based approach to care. From physicians

and provider institutions, to licensing

boards, these groups must begin to make

decisions based on data. Physicians and

provider institutions across the health

care system require better, ongoing edu-

cation about opioid abuse. A data-driven

approach to education will help physi-

cians understand what to look for. Where

physicians and providers fall short, licens-

ing boards will need to revise policies and

standards of care to fill in the gaps. Again,

data will provide the big picture view that

is necessary to make informed policy deci-

sions. Finally, data analysis can help pub-

lic health groups, community coalitions,

and substance abuse treatment improve

their operations, measure their results,

and contribute valuable data of their own

to the larger cause of saving lives.

Through data sharing, physicians and

their patients, medical policy makers and

licensing boards, pharmaceutical com-

panies and pharmacies that all work to-

gether can stem the opioid epidemic and

achieve the fundamental objectives of re-

ducing addiction and deaths.

Results and Benefits

Better treatment protocols can be devel-

oped through partnerships and relation-

ships based on information sharing, and

data management analytics. These moves

will affect pain in the first place and re-

mediation when patients become drug

dependent. Physicians should know how

their treatments and results compare with

those of their peers, as well as what spe-

cific patterns give early warning of addic-

tion or overdose.

Large hospital systems, licensing boards,

and public health agencies need the abil-

ity to benchmark providers in order to

get a better picture of where and how to

educate them. Pharmacies need to know

how they compare by geography, payment

source, provider and patient mix. Data

and analytics are fundamental to identi-

fying anomalies of distance and dispens-

ing behaviours. These organizations are

in the best position to aggregate and give

providers a peer-to-peer comparison. Ana-

lytics can inform treatment guidelines,

educational initiatives, and resource allo-

cations, including treatment centres and

community prescription drug take-back

programs.

Access to this data can help government

agencies distribute funding for treatment

facilities based on the combination of lo-

cal need and which facilities have the best

outcomes. Analyzing the populations in

treatment for opioid dependence can in-

form medical decisions (such as when to

prescribe Naloxone to counteract respi-

ratory depression), suggest how to keep

patients in the health care system (rather

than risk them transitioning to another

substance), and indicate which facility is

likely to best fit the patient’s needs.

A Success Story In The

Making

Despite the clear benefits of data shar-

ing among stakeholders, Canada has yet

to implement such a system. The prac-

tice is more common in the U.S. and one

success story is the Commonwealth of

Massachusetts, which saw opioid-related

deaths increase 350% since 2000. It recent-

ly released a report entitled

Chapter 55

, in

which it outlined how it took a data-first

approach at tackling this public-health cri-

sis. The Massachusetts case demonstrates

how government, academia, and the pri-

vate industry can all collaborate to answer

a complex health question.

From working through complex legal is-

sues around data privacy, to implementing

multiple agency MOUs (memorandum of

understanding) for data sharing, and ad-

dressing complexities with data integration

and entity resolution/identity resolution,

Massachusetts has shown that with the po-

litical will a data-based approach can pay

off. With the help of SAS, the state set up a

“privacy shield,” which is a mechanism that

anonymizes or sanitizes personally identi-

fiable information within the data, so that

the information was safeguarded from the

analysts conducting the work, yet still al-

lowed the analytics to occur.

While data collection and analysis is on-

going, insights gleaned so far have been

significant, and

Chapter 55’s

model of co-

operative data analysis has the potential

to become the new standard. For this type

of initiative to be effective in Canada, pro-

vincial health ministries would have to

drive the charge in establishing a similar

type of collaboration and fortified data ag-

gregation.

Conclusion

Bringing together data from all of these

sources will help constituencies work

more effectively together. It can provide

a more comprehensive overview of the is-

sue and identify areas for improvement in

order to put actions in place that will make

a real impact in the fight against opioid

abuse. This can only begin once we have

an in-depth understanding of the issue.

Much like a GPS navigation system can

tell you how to get somewhere, you still

need to input a destination. Forming part-

nerships among these stakeholders will

set the stage for a collaborative approach

to analytics which can provide a dynamic

view of how individuals are abusing the

system, identify high risk individuals, and

inform the best strategies for addressing

the problem.

reg

orne

is the National

Healthcare Lead at SAS Canada

Databases of written and filled prescriptions,

electronic health records, and emergency

room records are all key pieces of the data

puzzle the come directly from the

healthcare system’s frontlines.