How a New Age of Interoperability Unlocks Massive Benefits for Health IT Organizations, Patients, and Providers
By Jonathan Shannon, Senior Director of Healthcare Strategy, LexisNexis Risk Solutions
The concept of interoperability in healthcare IT has had its fair share of challenges over the years. Compounding challenges around security, organizing the vast amount of data, and making such data available in a timely fashion has hampered the ability to meaningfully exchange such information in healthcare. However, thanks to recent regulations and increasing consumerism in healthcare, we are beginning to usher in a new age of interoperability.
As consumers, we are all becoming savvier when it comes to usage of our data, including our health data. More and more patients, just like you and me, are looking to have better control and understanding of their data as they try to navigate a very complex healthcare ecosystem. Federal regulators, Centers for Medicare & Medicaid Services (CMS), and Office of the National Coordinator for Health Information Technology (ONC) are using mandates to create industry standards to streamline the process. As a result, 2022 could be the year that interoperability becomes operable in a meaningful and actionable way.
It’s been about two years since the Interoperability and Patient Access Final rule was released; the key catalyst to accelerating this change. Now, we are starting to see interoperability move beyond its fits and starts towards a fast, secure, and meaningful approach to data exchange empowering us to build the path to create a more comprehensive view of a patient’s health journey at the point of care.
APIs to Better Healthcare
Part of the rule making included the creation of application programming interfaces (APIs), which are providing opportunities for forward-thinking healthcare companies. Healthcare technology professionals who know how to optimize this data transfer based on Fast Healthcare Interoperability Resources (FHIR) standards and have the knowledge to write to an API can help patients access and understand their healthcare data. Companies that can facilitate efficient digital translation between different healthcare applications, and do it well, have the potential to establish a strong foothold in this burgeoning area.
APIs have proven their worth in other industries like finance, technology, and travel – and now it is healthcare technology’s turn to maximize their potential.
Some statements from the ONC and CMS can be interpreted that the goal is to have individuals open a laptop and connect to the “Patient Access” APIs themselves. However, that is highly unlikely and certainly not scalable nor efficient. This creates a huge opportunity for health IT organizations to work directly with individuals to pull down and interpret their data.
Such organizations that successfully embrace interoperability standards and processes now will be positioning themselves for years to come. This is important, as the number of APIs are expected to grow significantly, especially in 2023 when regulations requiring thousands of providers/electronic medical records (EMRs) to publish similar APIs come into effect.
Going Beyond Data Control for Patients
Data access goes beyond patients simply seeing their medical records. Patients gaining control over their own data – dictating who can access it, for what reasons, and for how long – is the main goal driving the ONC and CMS interoperability initiatives.
The patient, for example, can request their information be shared among a network of their preferred primary care doctors and specialists digitally, which could improve their care coordination. It could also spare them from inappropriate medicines or lifestyle interventions prescribed empirically rather than tailored to their specific needs. By sharing data with appropriate partners, patients can develop a more tailored and useful picture of their health and well-being.
When done right, interoperability can make it easier for patients to access their own data and control who they share their data with. This is a pivotal step in reducing the frustration caused by the lack of transparency and expediency in the whole data management process.
Even More Opportunities for Healthcare Organizations
Companies who offer middleware solutions, and are data facilitators, or insight curators can add substantial value by enhancing the ability to access or interpret this data and even link it to additional information. Combining a patient’s demographic data, emergency department utilization and active prescriptions, for example, can yield a meaningful picture of his/her status and an ability to intervene in their care.
App developers who have a direct relationship with the consumer have a very important role to play in this new world of data exchange. It is important to note that all of this data exchange hinges on patient consent. To obtain consumer buy-in and consent to this data sharing, the companies asking for permission/access will need to educate individuals that the potential benefits that they can provide with this data will outweigh any risk to their privacy. Building trust and demonstrating that their technology ensures security and transparency of data transfer can go a long way to reassure consumers to leverage these health IT platforms.
The new world could see fitness trackers expanding their capabilities to include evidence-based holistic treatments to diabetes and connecting members to community-based health resources based on their current care team and treatments.
Improving the patient user interface and creating a user-friendly experience pose additional opportunities. Remember, these are real people giving real consent for their data to be shared, just like you and me, and software needs to be accessible and foster a positive user experience. The goal should not be to overwhelm users of a specific platform with pages and pages of consent documents or the endless scroll of small font legalese but demonstrate the benefits to their health and transparency into how the data will be used.
Instead of people crossing their fingers when they check the ‘I agree’ box they often are required or feel obligated to check, explaining in clear terms precisely how their data will be shared and for what purpose can help reassure them.
It is all about using data for good and in this case, enabling a way to gain a more holistic picture of a patient’s health at the point of care for better treatment and better outcomes.
Healthcare Providers Stand to Benefit Too
Enhanced insights delivered in near-real-time will also help doctors, nurses and other healthcare providers make more informed decisions with patients at the point of care.
Historically, information was siloed, difficult and slow to access from other sources, and only updated during an annual checkup. APIs and a standard format allow for a much faster and comprehensive ability to exchange data between settings of care and ensure that nothing falls between the cracks.
The data can also be larger in scope. For example, interpreting lab results in the context of patient demographics and health utilization pulled from multiple sources (e.g., the individual’s health plan and provider office) will provide a more comprehensive view of an individual and the factors contributing to his/her healthcare needs.
As the data is curated and analyzed, healthcare recommendations can get more sophisticated and precise.
A doctor might adjust his/her recommendation for a rigorous exercise regime, for example, if they find out a specialist just diagnosed the same patient with a respiratory limitation like chronic obstructive pulmonary disorder (COPD).
Similarly, a wellness app might change its recommendations for subscribers with asthma or diabetes.
Furthermore, if a physician learns from pharmacy records that the patient just started a drug that can cause dizziness, they can hold off on recommending physical activity right away. Data creates knowledge, and the knowledge creates smarter and improved health decisions for the patient.
What’s Needed in an Interoperability Solution?
Those companies, may it be health IT organizations, payer, or provider groups, who are early adopters and on the cutting-edge will see both short- and long-term benefits of investing in the right interoperability solution. Of course, tech companies and technology departments can write their own APIs, but writing hundreds if not thousands, building all those connections, and maintaining them is no easy feat and eats up a lot of resources. Why do that when you can have one connection point with a middleware solution offering a single API that is pulling in all the data you need from all the sources you need it from?
Leveraging a dedicated vendor who builds out connectivity provides the immediate benefit of scalability and allows companies to focus their attention on analyzing the data and providing insights for their members.
Plus, there is the security part of the conversation. Managing access to a single API creates far less risk for the company leveraging the interoperability solution having to monitor thousands of connections.
Lastly, depending on the interoperability solution provider, if they too are an aggregator of proprietary data, you can go beyond what is accessible via a Patient Access API at a health plan and connect more patient data. Think about the possibilities if you could layer social determinants of health (SDoH), updated patient demographics, a universal patient identifier, for example.
Propelling Future Connections
Although it has been said for years that interoperability will help connect all the healthcare IT industry players “in the near future,” 2022 really could be the year to watch these aspirations turn into a reality. Even as you are reading this, interoperability is evolving.
Yes, there is still a lot of work to be done – there always will be. But interoperability is taking shape in a way that makes clear that the potential benefits could be shared among health IT companies, providers, payers, and patients.
By minimizing hurdles and closing gaps in data transmission, the quantity and quality of data generated through interoperability will only improve as we progress further into 2022 and beyond. With better and more comprehensive data on patients like you and me, this in turn could promote greater overall efficiency and cost savings for the U.S. healthcare system, not to mention better quality of care and continuity.
The time to embrace the new age of interoperability is now. Is your organization ready?