June 3, 2019
By Sophie Griggs, Eon Application SpecialistIn healthcare, we as a society expect the people in charge to make the right decisions and to fix the broken pieces of the system. As a 22-year-old with no background in this industry, of course, I assumed that the healthcare system worked and that the stakeholders make all of the right choices with patients’ best interests in mind. When I joined the Eon team last September and became more exposed to this industry, I quickly realized that this most definitely is not the case. The stakeholders that are responsible for mending the broken parts of this system are failing to do so, and without anyone holding them accountable for their actions, this industry continues to flood with misaligned incentives. As contributors to this industry- no matter the capacity of your role within healthcare- it is our responsibility to challenge these questionable motives, encourage accountability to those in charge, and realign these insufficiencies. As a consequence of becoming comfortable in the inferior position we are placed in by these decision makers, we often lose sight of who genuinely holds the position of power to implement change within healthcare. This power does not solely lie in the hands of the stakeholders, but instead change can be made by those who are passionate enough about mending this fragmented system and have the persistence to hold arbiters accountable to correct these tainted incentives. One Friday last month, I sat at my desk littered with dozens of data registry documents, sticky notes, and an embarrassing amount of empty coffee cups- exceedingly frustrated. As an Application Specialist at Eon, I am in charge of ensuring that our application stays 100% compliant with the data requirements established by the American College of Radiology (ACR) for the Lung Cancer Screening Registry (LCSR). I had spent that entire week digging into their guidelines for LCSR submission and Centers for Medicare and Medicaid Services (CMS) compliance, using both their data dictionary and electronic submission mapping documents to make sure that our application is in perfect alignment with these guidelines for our clients. As I became an expert on these supposedly uniform documents and their submission requirements, the inaccuracies and mistakes within these resources became increasingly evident. I had written pages on pages of inconsistencies I found between their data requirement documents, where fields labeled as optional in the data dictionary were marked as required on the electronic submission mapping document and vice versa. Knowing the repercussions that this was causing downstream, the lack of ground truth left me incredibly frustrated. Being the only data registry in the nation that is approved by CMS for lung cancer screening, I expected that the stakeholders at the ACR wouldn’t let these obvious mistakes happen. Nearly 2,000 hospitals and thousands of physicians participate in lung cancer screening – I was baffled that there were so many apparent flaws in such an essential process of lung cancer screening and that no one in charge cared to fix them. That Friday, I became determined that I was the person to right this wrong. Instead of patiently waiting for all of the physicians, academics, or committee members who should be more qualified to fix these significant errors, I decided to hold the people in charge accountable for correcting their mistakes. I am 22 years old, fresh out of college with a degree in communications- probably not the most presumable heroine in this narrative. However, during my last eight months at Eon, Aki and Christine have taught me one of the most valuable lessons of my life: Success and opportunity are not dependent on your credentials, it’s dictated by your will to learn and dedication to implement change. I took that advice and ran with it. I created a 10-page document that mapped out all of the inconsistencies and mistakes within the LCSR’s documentation and sent it over to them. I prepared myself for immediate rejection or a drawn-out, daunting process to get these changes implemented. To my surprise, albeit with a couple dozen emails, a few phone calls to the right people, and an unrelenting approach, they fixed their mistakes. The LCSR released new versions of the data dictionary and electronic mapping document that corrected the errors I had pointed out. It wasn’t the thousands of doctors, nurses, academics, or researchers involved with the LCSR that implemented this change. These mistakes were corrected by a 22-year-old with a relentless passion to fix the flaws embedded in a broken system and who’s unwilling to succumb to inadequacies created by the stakeholders in charge. My time at Eon has made me realize that it doesn’t take a medical degree or years of healthcare experience to hold the decision makers in this industry accountable to their responsibility of mending this broken system- all it takes is the persistence and dedication of making your desired change happen. In the grand scheme of things, a new version of the LCSR data dictionary is a small feat- but every step in the right direction of fixing healthcare matters- no matter how big or small.