Data Changemakers: Lorraine Fernandes, Principal, Fernandes Healthcare Insights

by Steve Parry on 20th February 2018

Lorraine FernandesLorraine Fernandes has 30+ years health information management (HIM) experience as a director and consultant in both sales and marketing. She is a prolific writer and an accomplished public speaker. Recently she has had a global focus on healthcare transformation and relevant technology, including analytics and big data.

She specializes in information governance, health information management, privacy, data sharing/exchange, person and provider identification, analytics, big data, sales and customer relationships>

Please describe a little about your own background and you ended up working with data?

I began my career as a Medical Records Health Information Professional. In those days documentation was almost all paper-based but some data was captured electronically, diagnosis and procedure codes, for example ICD-8 or ICD-9. I also managed staff that handled specialized clinical registry data, for example on cancer or trauma. I loved the combination of people, process and outcomes and that has continued throughout my career.

Today I run my own health information consultancy but I am also the President-Elect of the International Federation of Health Information Management Associations (IFHIMA). This is an umbrella organisation and an NGO affiliated with WHO – we support policy, particularly for accurate coded data, now ICD 10, and advocacy for health information professionals globally. So you could say that I still love the same combinations of things!

What is so fascinating is to be involved with collecting and analysing accurate coded data for morbidity and mortality which is so vital around the world. Accurate ICD 10 data is vital to WHO programs in countries around the world.  We have twenty-four member-organisations from Botswana and Barbados to the USA and we promote health data; privacy; information governance and related topics. We have recently created a white paper talking about the importance of governance in healthcare around the world as well.

Would you say that you are a business person or a technical person or something else?

I am a business focused person – I trained in the business of healthcare and then started to embrace data and technology as my career advanced.

I have learned that decisions have to be rooted in the business need but that the ability to increase the quality and reduce the cost of healthcare, and wellness initiatives,  should rely on the data and its availability around the world.

What is your current role and its main responsibilities for or connection to data?

Two years ago I left IBM to form my own healthcare consultancy to focus on data and its governance. I bring a range of different skills and experience to my clients based on working in small to large health systems, governments, and doing consulting for software firms in corporate USA.

Now during the last leg of my career journey, I want to continue to work with great people and organisations to move strategy forward. I will be less hands-on with data than in previous roles but with the knowledge that strategy must be executable in the real world.

I am passionate about data governance and specialise in person, provider, citizen identity challenges – the foundational elements of this type of data are always the same: Who are they? Where is their data? How do I connect it? How do we build trust?

What has been the most challenging data-related project you have worked on and why?

There was a time when I was involved in interim management for healthcare organisations – California particularly. I had a defining moment during a project which was very compliance orientated where we were accountable to State and Federal Regulations.

A situation arose where we had to prove that we were in compliance with these regulations by exploring and validating our data and substantiating compliance beyond doubt. This took weeks and I learned a lot about trust.

You have to be able to trust your data but also your relationships -internal and external – and at all levels. Having trust is so essential to moving strategy and vision forward.

Fortunately, the project was a success both internally and externally because we were able to prove that we were in compliance. We also had enough confidence in our data that we were able to stand our ground and push back against some of the unreasonable regulatory requests where they were not in our stakeholders’ interests.

What do you think are the key trends in data management for Healthcare today and how do you think it will change the way individuals and departments are able to do their jobs?

Data has left the siloes that historically existed and is being used to inform care and wellness – it is front and centre in everything in healthcare today.

For example, there is huge emphasis on data in precision medicine where we have the opportunity to use genomic data to design treatments for individuals.

The reverse side of this huge opportunity is that we have an obligation to ensure that data is accurate, consistent, complete and secure. Security is a particularly vexing issue in healthcare as evidenced by the many data breaches and ransomware attacks we read about in the US, and around the world.

While hackers and careless behaviour will likely always exist, we must do more in practice and funding to reflect the importance of secure healthcare data. 

Cloud usage in healthcare is really picking up speed. There are several ways to see this and they are moving fast now. Cloud is automatically a part of new, disruptive initiatives – collaboration can really be enabled by it.

The Amazon, Berkshire, JP Morgan consortium announcement is about to disrupt healthcare – whatever they do, common sense says it is going to be cloud-based. They will be disruptive either around quality or cost and I’m excited to see where that’s going to go.

Another example is a consortium of around 300 healthcare professionals who are about to get together and make generic drugs. They are fed up of being at the mercy of the big corporations. Their whole data process will undoubtedly be cloud-based because it needs to be agile.

Disruptors will use Cloud.

What advice would you give to people embarking on a large data-related project – public or private sector – today?

I always say that the fundamentals are more important today than ever before. These are the basics of People, Process and Technology.

People – you’ve got to train, educate and certify them and encourage them to collaborate

Process – this must be consistent and well-articulated to create trustworthy, uniform data for operations, analytics, research and so many other uses.

Technology – this is always the third step. If you have the others then when you use the technology it is built on the right foundation. If it is not, then the outcomes won’t be what you want.

With so much technology available to assist with data and analytics today how should they go about making choices on which tools and applications to use for best results?

The main thing is to really think about how you want to use it. You need to go into any evaluation with an open mind:

You also need to be willing to innovate when you are considering technology.

It’s not good enough just to automate an existing process. Think of a way to do it differently. Can there be five steps instead of ten? Can we improve the quality of the data by using this tool?

Are there any particular skills or qualifications you consider to be vital to your success?

Transparency is the one that is most important – I guess that ties to the trust I mentioned earlier. Be transparent in actions and words so you build teams that can execute on a vision – they will do this if they understand fully what is expected.

What are you best known for or what do you like doing outside of your working life?

I love to travel the world. This shows in my career especially in the many trips I’ve made to Canada, Asia and Australia.

I love to experience new cultures and all the diversity you can embrace through global learning. It is mind-opening.

I also love the outdoors. I grew up in rural America and I love gardening, hiking and other activities that can be done outside – it is uplifting and mind-clearing. One of my favourite things to do is to sit on the deck of our home in Montana enjoying the beautiful scenery – mountains, trees and wildlife.

What three words would you use to describe yourself?

Honest, Diverse and Fun!

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