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    December 15, 2020

    Fluid Metaphors

    As regular readers know, my education and early career work was in organizational psychology with a focus at the intersection of change, culture, leadership and strategy.  That was a nice amorphous glob of fuzzy stuff that allowed me to get away with tossing out metaphors, stories and analogies as a way to sound smart without having to do real work.   Actually, that is a pretty good description of what I still do every day.

    One of my best such efforts, if I do say so myself, was in a presentation that I did back in 2013.  We were on the front end of the HITECH frenzy and were implementing EMRs and EHRs at the speed of heat.  Everyone was all twitterpated with software demos and deciding if we were going to put laptops on carts or in the exam room.

    My presentation at that conference actually included a picture of Bachmann-Turner Overdrive’s 1983 ‘You Ain’t Seen Nothing Yet’ album cover.  That was a perfect fuzzy story-teller thing to do.

    I laid out a three-phase journey that healthcare was starting.  It was nothing original on my part, just an observation from what happened in every other industry that has gone before us…which is almost everyone.  An advantage of being the laggard is having the breadcrumbs.

    First, everyone must digitize their data.  We need bits and bytes, not paper and file folders.

    Then we start to exchange and share the data across organizations.

    Finally, the industry starts to change.  Disrupters can disrupt; progress comes.

    For that middle stage, I coined (OK, I stole it from someone, but since I can’t remember who we will pretend it was my idea) the phase ‘data liquidity.’  The data would flow.  It made me sound like such a visionary, which is like a rock star without the money, drugs, groupies, or cool hair.

    Well, that was a long time ago and it is time to update the metaphor, though fortunately, we get to stay in the realm of water.

    Your new metaphor is the ‘data lake’ and clearly, it is not my idea.   Credit any number of tech wizards, or specifically Amazon, who recently announced their HealthLake offering, a part of their AWS business.

    What is a ‘data lake’ you ask?

    Here’s the not quite technical definition: a big ‘ol pile of raw data gathered together in the cloud, just waiting for someone to do something with it.

    Amazon’s clients (Cerner was one of the first to sign on) dump all sorts of data into their lake and AWS does its aggregation/standardization magic in minutes instead of weeks, getting it cleaned up and into the Fast Healthcare Interoperability Resource (FHIR) format so people can begin to use it and make sense of it.  Analysts fish in the lake, I guess.

    So, impress your friends and start throwing ‘data lake’ around in your conversations.  And know that this is how giants like Amazon and Google are going to march into our industry.

    We ain’t seen nothing yet.

    Tim Coan
    Tim Coan

    CEO and founder

    Tim Coan, ALN’s CEO, writes an insightful and witty blog weekly about a variety of topics relevant to independent physician practices.