Q&A: Scott Harrison of Parkland Hospital Discusses Leveraging Data, Interoperability

Scott Harrison, vice president and chief data officer, Parkland Hospital

Scott Harrison is the vice president and chief data officer at Parkland Hospital in Dallas County, Texas. Parkland is a safety net hospital that provides care to the needy and indigent patients that don’t often have other forms of receiving medical attention.

Harrison spoke with Chief Healthcare Executive™ about how Parkland is benefiting from real-world data, interoperability, and how the hospital maintains privacy.

CHE: How is Parkland leveraging data and technology, especially now during COVID-19?

Scott Harrison: Data have always played a very critical role at Parkland more so in the most recent years. I've been there for about two years and since my arrival, they've really put a lot of effort and a lot of investment in improving our abilities to manage data and to curate data in a very efficient manner. And so those investments just aren't immediately plugged in and able to realize the value. So, you have to grow those over time. Over the last couple of years, those investments, from capital investments that were made in the mid 2000s-2015 timeframe, have really started to mature and now we're starting to see an evolution of being able to take data from just about any type of system and blend those data with what we're capturing in our medical records that are electronic, and really pushing that data out to our clinicians and business operations folks that can take that information and make very sound decisions.

What we saw with the pandemic when it hit is that data were at the center point of everything that we needed, we had a command center that was stood up, really to help converge all of the business, clinical, and financial operation teams in one place to focus on what we needed to do to keep our hospital operations going, because there was so much unknown early on in the pandemic. And of course, they came to our teams really asking for help to say, “Hey, we need a dashboard,” or “We need some way of really managing what we're telling these folks to do. What do you know, how can you guys help us?” That was really our moment to start giving some free promotion and marketing material to the products that my team produces, which are, the dashboards.

So, we built a dashboard that is put up in a lot of big screens throughout the command center and that really drives a lot of our executive huddle in the mornings. We don't have that anymore, but early on in the pandemic, the executive huddle really was kind of the focal point that all of our teams would rally around and look through the metrics, look through the numbers on the dashboard, we would make decisions from that, like, “Hey, we need to staff up here,” “We need to talk to our supply chain to get more supplies in.” It really became, a very big tool that was leveraged across the organization and not just in certain pockets, which was kind of a shifting paradigm for Parkland.

I would say within the last year, year and a half, they've always felt data were important, but never did data have the full enterprise visibility that they did, when we had our big dashboard up in the command center with everybody sitting around it. That thing's getting hit more than 2,000 times a month being accessed and the next closest ones about 40 times a month. So that gives you some perspective as to how important data have played at an enterprise level and more specifically with the COVID-19 response.

CHE: When you think about data, you often think about interoperability or a lack thereof. How has that affected your operation at Parkland, especially during the pandemic when you have people presenting that you might have never seen before?

Harrison: The interoperability piece, I think is challenging, because the patients don't often hold the information on their person that's contained about their medical history. I mean it's housed in these various healthcare organizations data centers. And for the patient getting access to that, and being able to transport that, to give insights to other care providers who may be providing care, where they are, logistically, it's just been challenging.

When the pandemic hit, we were a mobile society, so being able to seamlessly exchange those records, we could in some instances. Our EHR vendors are stepping up their capabilities. But a lot of times, the devil’s in the details. Somebody maybe has transcribed some information incorrectly, and so that data item doesn't transition over as part of that interoperability piece. And so those are the challenges that we're faced with is how do we get out of the areas that don't exchange easily? Or if there's mistakes, how do we correct those? And so that always becomes an exercise in how well we are actually governing the information that's being housed and stored as part of our legal medical record.

We're fortunate, we've got a very mature team that handles a lot of those exchanges. My role from a data side of things is to make sure that what we're curating and putting available for those teams has high quality. So, we try to get the data on the front end and really make sure they’re scrubbed, indexed, catalogued, and defined. Then also, now the teams know where they can go to retrieve that information. I think that's key in showing how my role can play a facilitating role in interoperability. I'm not really the guy that's going to produce that for the exchanges, but I can make sure that the data are high quality and able to be exchanged and once the recipient gets the data, they know where the data go.

CHE: Increasingly, the need for real-world data is becoming more and more important. Patients are using Apple Watches and other wearable devices and smartphones to leverage data. How have you been using real-world data at Parkland?

Harrison: We are just beginning our journey into real-world data and it's something that I've been talking about over the past couple of months with my teams to really up their literacy. We're really shifting the paradigm right now in healthcare, not just a Parkland, moving from a system of record, which is largely EHR systems, over into a system of reference where we're

taking data from multiple systems, we're referencing that and we're blending it together in a comprehensive universe, like our warehouse.

Then I think the area that we're moving towards is more of that system of engagement where patients are in charge of a wearable or a smartwatch or heart rate monitor. We've got our CMO and some of our physician leaders pushing virtual care where patients are actually taking devices home and we're connecting them in their home so that they can manage their disease conditions or their illness at home and not have to come into the hospital. All of those are really cool capabilities. But from a data guy like myself, it creates quite the conundrum of what do we do with all of those various entities? And how do we reference those in a single catalog so that people know what they're using? Those attributes are collected in multiple different systems, once again, we have to blend those in like that system of reference. And so, think it becomes super critical that you focus on data quality and entity resolution and making sure that we know what that attribute is, and it's defined, and if it's referenced in another system, we can then blend it together to enhance that attribute.

So, it's used across multiple systems, and not just one. And I think that's where we really see the future of healthcare going is to be more in the patient's hand where these wearables, these at-home medical devices are telling a story. That’s where we're really focusing our efforts at Parkland to become a little more agile. How can we integrate and persistently integrate those data points into our warehouse so that it tells the story and it's once again providing that information to our clinicians, business, and clinical operations so that they can drive decision making?

CHE: What about privacy concerns when it comes to all these data sets?

Harrison: I’m not just the data guy, we're also a government entity. So, we're highly scrutinized at how we're protecting not just the data, but the rights and any of that sensitive information from getting out. So, the good thing is that I'm not in charge of applying or creating a lot of those rules. We have a very robust team and comprehensive group that really sets the tone that I follow.