The document discusses the need for a National Alliance of Regional Data Aggregators (NARDA) to overcome healthcare data fragmentation and improve interoperability. It proposes that NARDA would establish regional data aggregators to store, analyze, and share big healthcare data between organizations. This would benefit providers, health departments, insurers, and patients by improving quality of care, monitoring health trends, evaluating costs and quality, and enabling predictive analytics. However, significant challenges remain such as the lack of data standardization between existing electronic health record systems, the proprietary nature of health IT vendors, and the difficulty integrating different infrastructure and applications.

1. Overcoming Fragmentation to Health Informatics:
The Need for a National Alliance of Regional Data Aggregators (NARDA)
Kathlene
Fanshaw,
Eric
Hoffman,
Luke
Stolz,
J.
Spencer
Wilson,
David
Zandona
Health
Services
AdministraCon
Program,
James
Madison
University
• The
lack
of
interoperability
between
healthcare
organizaCons
with
the
current
electronic
health
records
(EHR)
has
become
a
costly
issue
for
every
stakeholder
in
the
healthcare
system.
• There
are
many
definiCons
of
big
data
and
this
project
has
interpreted
big
data
as
the
capture,
storage,
distribuCon,
management,
analysis
of
healthcare
informaCon
(Franks
2012).
• The
NaConal
Alliance
of
Regional
Data
Aggregators
(NARDA)
represents
our
conceptual
framework
for
overcoming
fragmentaCon
for
health
informaCcs
through
the
uClizaCon
of
big
data.
Implementation
1. Selec'ng
a
database
• A
relaConal
database
model
is
the
most
ideal
product
recommended
in
order
to
fit
the
analyCcal
needs.
• The
benefits
of
a
relaConal
database
ensures
successful
analyCc
strategies.
2.
Building
Rela'onships
• Insurance
companies
would
benefit
through
accurate
and
Cmely
uClizaCon
informaCon.
• State
and
local
health
departments
would
have
access
to
more
complete
informaCon
and
be
able
monitor
trends
and
exchange
informaCon
amongst
themselves.
• UClizing
NARDA
would
provide
accrediCng
bodies
the
ability
to
more
effecCvely
evaluate
their
accredited
HCOs.
• HCOs
would
benefit
through
the
incenCves
offered
by
MCOs,
more
Cmely
noCficaCon
of
populaCon
and
community
health
issues,
and
posiCve
publicity
through
the
accrediCng
bodies.
• HCOs
would
be
incenCvized
to
uClize
an
EHR
system
that
integrates
with
NARDA,
and
vendors
who
parCcipate
with
NARDA
would
have
a
compeCCve
advantage
when
HCOs
are
looking
for
new
or
improved
EHR
systems.
3.
Extrac'on
and
Normaliza'on
Methodology
• New
methodologies,
such
as
Apache
Hadoop,
must
be
implemented
for
efficient
extracCon
of
big
data.
• As
a
result,
more
successful
analyCcal
tacCcs
can
be
applied
to
the
database
(Hernandez
2013).
• These
new
methodologies
will
aid
in
the
normalizaCon
of
data
and
help
to
ensure
a
high
level
of
data
integrity.
For
subscribed
companies,
regional
data
aggregators
would
provide
a
number
of
services:
• Data
storage
and
duplicaCon
• Data
analyCcs
• PredicCve
analysis
and
noCficaCons
Function of the Regional Data AggregatorBenefits
HCOs
&
Providers:
• UClizaCon
trends
• Quality
improvement
Health
Departments:
• Health
trend
analysis
• PredicCve
analysis
MCOs
and
Insurance
Companies
• Data
regarding
quality
and
cost
PaCents:
• Higher
quality
care
Future Innovations
• Conversion
of
unstructured
data
to
structured
data
• RetrospecCve
extracCon
of
data
• Foster
external
partnerships
• AddiCon
of
paCent
generated
data
• Ability
for
paCents
to
view
their
enCre
EHR
Do
you
share
data
aggregately
already?
PracCce
Administrator,
Specialty
Care
Facility
“Yes
and
no,
we
use
a
system
called
Updox
which
allows
us
to
share
data
with
other
organizaCons,
however
our
system
is
not
compaCble
with
theirs”
CMIO,
Hospital
“No,
we
are
not
currently.”
Technical
Associate,
Health
Network
“It
took
three
years
to
integrate
New
Milford
Hospital
system
to
align
with
Danbury
Hospital
system”
What
are
the
most
relevant
issues
limi'ng
the
ability
to
implement
a
data
aggregator?
PracCce
Administrator,
Specialty
Care
Facility
“Challenges
involving
cost,
training,
loss
of
producCvity,
and
meeCng
quotes
when
implemenCng
a
new
system”
CMIO,
Hospital
“The
Health
InformaCon
Exchange,
the
holy
grail
of
healthcare
IT,
proprietary
programming,
cannot
agree
on
standardizaCon”
“Health
IT
vendors
are
naConal,
they
will
not
change
their
system
for
regional
purposes”
“Every
organizaCon
wants
to
innovate
but
no
one
communicates”
Technical
Associate,
Health
Network
“Because
all
systems
are
different,
it
takes
effort
to
bring
together
infrastructure.
The
integraCon
of
applicaCon
takes
a
long
Cme”
IntroductionFeedback from Healthcare Professionals