Government Reimagined: From Small Sets of Data – To Giant Leaps of Insight

As far back as I can remember, I’ve always been fascinated with what came before the “final result”. For instance, I was much more interested in HOW and WHY my toys worked than the fact that they did work. Over the years, my curious nature led to many a toy, including sophisticated toys, real automobiles, musical instruments and computers which I at least partly disassembled to satisfy my curiosity and my need to understand more.

More recently, I’ve been focused on breaking down data-driven projects in government to learn how they come about and how they mature. The type projects that fascinate me most are the ones that have delivered insights far greater than ever intended, especially those resulting in some form of “social good”. What some government organizations are beginning to realize is, the wealth of data they have previously collected to support a particular mission or goal can often serve as a starting point to support additional initiatives.

Here’s an example. Consider the type and nature of data collected to support a government agency’s efforts to combat fraud. To have any hope of discovering fraud, data regarding all transactions, including enrollments, claims, payments, etc. must be made available to a data analytics platform. The data set will include information regarding patients, time, date, location, costs, prescriptions, providers, diagnoses, treatments, outcomes, all of which is needed to discover patterns of unlawful behavior.

So, now that all this data has been collected, what more can be done with it? Rather than speculate, we can look to CMS, the Centers for Medicare and Medicaid Services to see what they are doing with their Integrated Data Repository. Beyond using data to uncover fraud, waste and abuse in the system, the agency is leveraging the past seven years of data to further support better data-driven decisions for these activities:

- Medical trend and utilization analysis – past and future
- Healthcare costs and assessment – past and future
- Policy analysis and development
- Provider profiling and management
- Quality and effectiveness - pay for performance
- Program integrity – past and future
- Rapid response to legislative inquiries
- Supporting data requirements for external analysts and researchers

Talk about hitting multiple birds with one stone! Beyond addressing efficiencies, CMS is now leveraging the same data to make programs more effective, to drive compliance and to become more transparent. Further, beyond using the same data to support multiple goals is the nature of the questions being asked. Similar to how many projects start, the original intent was to look back over time and ask “What happened”, providing users some form of report or analysis. However, more recently, advanced predictive analytics are being leveraged to answer questions such as “What may happen?” For decision makers, this is a huge leap forward. Of course, business experience and expertise will always be important, however, forward-looking decisions can now be made with the benefit of supporting data.

CMS is but one government agency that is being successful leveraging already existing data to solve additional business challenges. How do they typically go about it? There are many factors that have helped contribute to their success. So, there are a few commonalities to consider:

- Don’t Assume - Data that may have no value today may be the critical link to answering a question in the future
- Technology Matters – beware of single purpose applications and platforms, there’s no “silver bullet” – the technologies you opt to use should be agile and scalable for performance, capacity, workload, complexity, user type, etc. – a platform that can perform one type query blazing fast becomes worthless if you need a different type query – it should be capable of supporting users of different skill levels
- Curiosity and Creativity – a great way to innovate is to allow people to discover hidden insights by asking new questions – encourage and reward your innovators – the more questions you can answer, the better you can serve your citizens and constituents

I am always on the lookout for new examples of government using data for social good or some other innovative project. If you are aware of or affiliated with a such a project and you’d like me to write about it, please contact me directly at any of the following places.

Email: [email protected]
LinkedIn: http://www.linkedin.com/in/bobbycaudill/
Twitter: @BobbyCaudill

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