Are you drowning in data, but no one is quite sure what to do with it? Do you find you’re spending more and more on technology systems, yet still don’t have the information you need? CCI's newest online course, Building a Data Driven Culture, is here to help. In this episode, our expert faculty discuss the fundamental concepts, techniques, and tools that will support your work to make the most of your organization’s data.
Are you drowning in data, but no one is quite sure what to do with it? Do you find you’re spending more and more on technology systems, yet still don’t have the information you need? CCI's newest online course, Building a Data Driven Culture, is here to help. In this episode, our expert faculty discuss the fundamental concepts, techniques, and tools that will support your work to make the most of your organization’s data.
Here’s where you can learn more about the people, places, and ideas in this episode:
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LAURA BLUMENTHAL:
Is your organization drowning in data and no one is quite sure what to do with it, and even less sure about its quality? Do you find you're spending more and more on tech systems, yet still don't have the information you need? Help is on the way. I'm Laura Blumenthal from CCI. Today, we're celebrating the launch of CCI's newest online class, Building a Data-Driven Culture.
LAURA BLUMENTHAL:
I'm here with SA Kushinka and Jerry Lassa, who have worked with CCI for many years and encapsulated their best content from years teaching data governance in CCI programs into a short course. We'll spend time getting to know SA and Jerry, understanding what data governance is and share some concepts from the course to get folks' feet wet. Without further ado
LAURA BLUMENTHAL:
SA and Jerry, thank you for joining us todayWe'd love to hear a little bit about yourselves and your background and when you became a data-driven culture evangelist.
SA KUSHINKA:
Thanks, Laura. Well, I'm SA Kushinka and I have a 35-year career in health information technology implementation. I've worked for EHR developers, national consulting groups. I started my own consulting group, so I was a principal and co-founder of Full Circle Projects. I've been a program director with CCI. I've spent probably the last 20 plus years of those 35 years working with the amazing providers and staff that make up our community health centers and public hospital systems.
SA KUSHINKA:
When did I become a data-driven culture evangelist? I think I'd have to say it was about eight years ago when I was working on a project for some funders in Southern California, and also a funder in Colorado. We were evaluating the effectiveness of their technology investments. They had been helping community health centers invest in disease registries and population health management systems, and of course, electronic health records.
SA KUSHINKA:
I remember specifically interviewing a pediatric nurse in Colorado who literally broke down in tears in the interview and said, "We used to be number two in the state in up-to-date pediatric immunizations. Now, I can't get my outreach reports. I don't think these statistics are reliable. Since we implemented our EHR, we seem to have less data than ever." Similarly, I heard from a QI director in LA ... or actually an IT director, I think he was.
SA KUSHINKA:
He told me that he stopped distributing QI metric reports because they were just a mess. He didn't know if the system was calculating things wrong, whether the data entry was flawed, or both. More importantly, he didn't know where to turn to find out how to diagnose that problem. Both of these organizations took what they called a QI hiatus. To me, it was heartbreaking and I realized something was terribly wrong.
SA KUSHINKA:
I think that was the first time I realized that there was a very distinct difference between the roles and responsibilities and methods for managing technology systems, and the roles and responsibilities and techniques of managing data, and so I wanted to take a deeper dive.
LAURA BLUMENTHAL:
I know somewhere in your journey, you got to meet Jerry. Jerry, tell us a little bit about yourself
JERRY LASSA:
All right. Well, great to be here as well. I'm Jerry Lassa and I'm a quality improvement professional of over 30 years. I started my career in healthcare in quality improvement. I'm also an adjunct statistics instructor. I've been doing that for over 20 years. I've worked at a variety of healthcare organizations, a academic medical center, then two community health centers, then a network of community health centers.
JERRY LASSA:
It was during the past 10 years where I came across CCI and SA and we began working on our data governance work. Yeah. When did I become a data-driven evangelist? Many people think that us QI and data types are born that way and always trying to get people to use the data that we're sharing with them. I'd say for me, there was a turning point about 10 years into my time working with data and creating dashboards and doing lots of analysis.
JERRY LASSA:
It was coming across a framework called the Baldrige Performance Excellence Framework, when I started training for it and began serving as an examiner for high-performing organizations. It was there where I began separating out the data activities I was doing from the culture that surrounded the use of that data. That's when I made a very deliberate attempt in my quality improvement practice to spend just as much time working on data culture, meaning working with leaders, managers, frontline staff, on how they were using data.
JERRY LASSA:
Spent just as much time on that as I spent analyzing data. The very first health center that I worked at is on the west side of Chicago. It was the first health center I worked at after working at a hospital and so I was just getting oriented to community health. We were initially serving 20,000 patients and I was very, very deliberate about incorporating in the notion of using data or having a data-driven culture, and also providing good reports as well.
JERRY LASSA:
Found that a lot of the techniques and tools for aligning your data focus to strategic initiatives and specific measures of performance and spending time on those areas of strategic importance were really, really important. In my five years there, we ended up doubling the number of patients that were serving. I attribute it a lot to the data-driven culture that we practiced. I won't say I did it. It's not something any one person does.
JERRY LASSA:
It's something you build and grow over time, but that's where I saw it was just really, really important to just balance the amount of time between data tools and data culture.
LAURA BLUMENTHAL:
You both shared some stories about the kinds of problems that being data-driven can help an organization solve for. I'm curious whether it's in growing a clinic patient population, or some of the things that you mentioned, SA, with the immunization rates. I'm curious how you've seen organizations use data and build a culture to advance equity.
SA KUSHINKA:
Well, let me take a stab at that. I think one of my favorite quotes is attributed to W. Edwards Deming who's I think often called the godfather of improvement science. The quote is, "Without data, you're just another person with an opinion." I think we think that we're doing the right things. We feel that our actions are having the desired result, but that may not be the truth.
SA KUSHINKA:
Very often when we use data, we only use the data that would seem to support our beliefs and our desires. Therefore, it only reinforces our biases if we're being selective in the data that we use. So we might be missing the mark and putting our efforts into things that turn out to be suboptimal solutions. It's not intentional, but we really need to think about the questions we want to ask and make sure, I think that we're collecting the data to answer those questions.
SA KUSHINKA:
With CHCs and their focus on ensuring equity, if we really do want to ensure equity in our work, we'll need to be able to collect the right kinds of data and stratify all our clinical ... Well, not just clinical data, but operational data. We need to be able to slice and dice it by race and ethnicity, sexual orientation, gender identity, so that we can really get a detailed picture of how our care delivery processes and outcomes vary by these characteristics. Then it's there in black and white.
SA KUSHINKA:
It's not just how we feel or what our intentions are. We see what's actually happening. While I don't have a specific example that comes to mind at the moment, I do see how centers are much more attuned to this now and realizing that in some of their important metrics, they need to really get more detailed and stratify that information and be more mindful in planning their data collection efforts, so that they'll be able to get the information that they need and take action that's effective.
JERRY LASSA:
Yeah. I would, SA, add a term I've heard recently among a health self-management education group. A nurse educator was referring to microtargeting, which is something a lot of marketing professionals are familiar with, where you aim a product at a very particular audience. She was sharing how important it was now more than ever to microtarget with her diabetic patients and hypertension patients.
JERRY LASSA:
That it wasn't enough anymore to just look at the usual demographics of age and gender and race, and that you had to dig even deeper and look at, in addition to the ones you mentioned, SA, social determinants, food insecurity, housing insecurity, transportation, and in particular, given the past year with the shift to virtual care, looking at the digital divide.
JERRY LASSA:
Because you need to understand all those variables in order to help your patients and get them to improve their A1C or their blood pressure management.
LAURA BLUMENTHAL:
I know you're both experts in the field and I couldn't think of anyone better to create a course for CCI on building data-driven culture. Can you share a little bit about what the course is, what it's based on and who should take it?
SA KUSHINKA:
The course is based on a program that was developed in 2014 at CCI, the Safety Net Analytics Program. The program had evolved and iterated and changed over time. It was originally a year-long intensive program. It was also delivered as a six-month program, a day-long workshop, and now certainly a series of short videos.
SA KUSHINKA:
We've really tried to distill the fundamentals of what's needed from an organizational development perspective for building a data-driven culture, yet also, I would say provide a springboard for more advanced analytics and increasing data literacy within a healthcare organization, and specifically a community clinic I would say. We were really fortunate in the early development of the Safety Net Analytics program to have had input from national experts and superstar community health centers from around the country.
SA KUSHINKA:
So we've been able to leverage that into this course and really tailor the curriculum specifically for community health centers.
LAURA BLUMENTHAL:
Who are the kinds of folks that would be a good candidate for this? Because I know I was going through it and I was like, "Oh, these things even apply to my work at CCI."
SA KUSHINKA:
I think there's really something for everyone to learn in this. I do want to emphasize that this is not an online analytics course where you learn a programming language or something. It's not that at all. It's really geared towards those processes and tools and methods and ways of interacting with your peers that can help you to harness the power of data.
SA KUSHINKA:
I would say most times in our work, and Jerry I'd love your thoughts on this too, I tend to see middle managers in an organization, regardless of what functional domain they come from, but it's usually these managers that are trying to either manage up and get the attention or resources of senior leaders for more attention and resources around collecting and sharing of data. At the same time, these managers are also trying to push the data down to line staff to show them how data and analytics can empower them in their work.
SA KUSHINKA:
It's my sense that these middle folk, the glue of an organization, that they are the ones that will most likely be taking the course, but we very mindfully put in some things for senior leaders and for data analysts as well.
JERRY LASSA:
Absolutely. I would add, or just emphasize there's something for everyone. Senior leaders, directors, managers, medical providers, behavioral health providers, QI people, data people, IT people, finance people. We've paid a lot of attention to incorporating value-based care principles and the need to focus on the value equation with your data strategy. Yeah. There's something for everyone.
JERRY LASSA:
I think as with a bottle of wine or your favorite beverage, it's best consumed in a group and with representatives from different areas because really the content is aimed at a lot of different audiences so that they can all work together better to make better use of data. Though certainly, we hope and welcome individuals to seek it out for single use.
JERRY LASSA:
Just to add in a few by the numbers, it is four modules broken out into 14 lessons, and each of those lessons are somewhere in the neighborhood of three to five minutes. Laura, you mentioned earlier that we crammed everything that we learned over the past five years into the session. We've talked about how we've taken close to 50 hours of content and condensed it into roughly an hour, no more than an hour and a half.
JERRY LASSA:
You also mentioned that we were experts in this area. I think we both consider ourselves students of data governance and building a data-driven culture, because really we've learned a lot from some of the leaders out in the field who really are doing great things with their data-driven culture, and have been very deliberate about including some of the best organizations, health centers that have been doing great things with data and including their stories.
LAURA BLUMENTHAL:
You've described it over the course of this conversation, but could you both try to, in one sentence, say ... or fill in the blank. You'll know that your organization has a data-driven culture when dot, dot, dot.
SA KUSHINKA:
When staff feel that they have high quality data when they need it to make good decisions.
LAURA BLUMENTHAL:
A decision-making tool. Like easy-to-access decision-making tools. What about you, Jerry?
JERRY LASSA:
I'd say that it's when your work feels easier because data is there at multiple levels to help you in your work. That means you've got leaders in the organization using data to prioritize things so that they're not overworking people, they're aiming efforts in the right way. You've got managers using data effectively on a day-to-day basis to manage a clinic and volume and clinical quality outcomes. You've got frontline staff who have good guidance from their managers and leaders.
JERRY LASSA:
I think something we found a common thread among organizations that are really good at using data is that the staff are happy, the managers are happy, the leaders are happy. Everyone knows it is a very, very transparent organization. Transparency is considered one of the highest levels of achievement in a data-driven organization where you know what to expect. You're very tuned in.
JERRY LASSA:
Last comment on that. I think we have found that over the past year that those organizations who had a very data-driven culture, were able to respond very quickly and effectively to challenge us in the industry like COVID. That's something to look forward to as well, is that you find yourself just able to navigate the ship much easier.
LAURA BLUMENTHAL:
Can either of you name a favorite lesson from the course that you just feel like if folks were going to go watch one thing, it would be this?
SA KUSHINKA:
Oh, that's a tough one because I'm thinking of it so much in terms of the content deliverer. Yeah, I think that ... Well, my favorite lesson has changed over time I think. It used to be just the data governance lessons, the early modules, or what would be contained in the early modules, because I always felt that it was really grounding, foundational, and it helped to really demystify a lot of the jargon around data analytics or data governance in general, and just really providing a simple approach.
SA KUSHINKA:
Lately I've come to really the lesson where we introduce and show how to use the data strategy worksheet, because I think it really encompasses so many of the fundamental lessons and then helps the learner to develop a specific and very practical application for some of those principles by using the data strategy worksheet. That's my latest favorite module. I think that people would benefit from looking at those two.
SA KUSHINKA:
There's a module that introduces the data strategy worksheet and why it's important and how to use it. Then the second video supplements that one by actually going through a sample, a completed sample of the data strategy worksheet.
JERRY LASSA:
For me, I'm the data geek so I have to say the data literacy visual presentation module, where I have crammed into three to four minutes, the best data visual display techniques that I've learned over my entire career. You can go from zero to 90 with your dashboards in three or four minutes.
LAURA BLUMENTHAL:
Wow. Now I'm like, "I got to go to that video." Because I don't think I'm that far. I'm like halfway through. I wanted folks to hear a little bit about how you're currently using the course. How are you using it in your other work and how might other folks consider using it?
SA KUSHINKA:
Well, I think how we would like folks to use it is to really select a project that you're involved in. You can come to it and just go through the fundamentals and all the modules, but I think it's much more valuable if you come to it with a project or something that you're trying to achieve. Maybe it's a new grant that you've gotten, or you want to reduce disparities in hypertension control across your population. Come to it with a specific thing in mind, and then it'll help you to really, I think, absorb the lessons better.
SA KUSHINKA:
It also emphasizes a principle that we try to stress throughout the whole thing. That is just start small. Really don't try to boil the ocean all at once and change your entire organization overnight. This gives you a way to start small and then show value.
JERRY LASSA:
One more thing I'd add to SA's comments about making best use of the course and something that we have found with many of the health centers is the way that they've reconciled any differing opinions about where the state of data use or data culture is at. We have a number of tools that we have teams complete so that it can put everyone on the same page about where they need to focus.
JERRY LASSA:
Every time, we found on many occasions that staff from the same health center will have wildly diverging views on where they're at with use of their data. This is a great way to bring people together and have them share, in a very unbiased way, their perspectives on the state of data governance and data use and help them move forward into prioritizing areas that they can work on to come together.
LAURA BLUMENTHAL:
Those types of alignment conversations are so important. It's like everyone thinks they have the same understanding of where things are, and then you put pen to paper and it's like, "Oh, no, we all are interpreting this differently." I saw that and I was like, "Oh, I think it's really valuable that that's how you set the table for the course." I really want to thank SA and Jerry for joining us today in conversation. If you are interested in exploring the course more, you can go to academy.careinnovations.org.
LAURA BLUMENTHAL:
Again, it's full of videos, worksheets, tons of things that you can use just the same day to incorporate into your work