Interoperability: Putting Patients at the Center of Care
Widening the Health Care ‘Circle of Trust’
We are in the midst of a technology revolution that stands to benefit the health care industry. “Interoperability” has thus been a buzzword in recent years — how to connect all of health care’s various, disparate data systems — with increasing frequency at the government policy level. The Office of the National Coordinator for Health Information Technology (ONC) says that its interoperability efforts “focus on improving individuals’ ability to control their health information so they can shop for and coordinate their own care.” Why? Because patients increasingly desire access to their own data across the various care settings and want more power over their personal health outcomes.
A study by Quest Diagnostics states that “nearly half (47 percent) of adults would like access to their health information online to make better decisions for themselves and their loved ones.” The rise of mobile health app economy is attempting to address some of this need, with over 500,000 medical technologies currently available. Ranging from wearables, monitoring devices, and imaging machines, to more simple technologies, there is a massive amount of health care data that results from these platforms.
This “appification” of health care has the potential to better engage patients and connect their team of family caregivers who often have difficulty accessing information that can make a big difference in patient outcomes. This appification works only if they further the goal of optimizing health by providing seamless access to the right information needed to more comprehensively understand and address the health of individuals and populations. After all, this is the very definition of “interoperability,” at its core.
There already have been many suggestions and speculations on how advancing technology might impact the industry. John Kelly, principal business advisor for software firm Edifecs, in a recent Modern Healthcare article, conceptualized the idea of a patient “smart card,” which patients would own and bring to providers, for them to update patient medical history information.
Alistair Erskine, chief informatics officer at Geisinger Health, further suggests in the same article: “You have this additional benefit that the patient is no longer a spectator of their record — they become the owner of that record,” Erskine said. And when the patient is the one who is pulling and managing their own data, many problems of patient-matching are noticeably simplified. This is an interesting perspective with which to flip these traditional, and oft-cited, blockers to interoperability on their head.
Maintaining Balance in EHR Design and Usage
One of the most essential places where patients can be at the forefront of their own care is when it comes to electronic health records (EHRs). In the actual development and advancements of EHRs, we can ask ourselves: does the EHR functionality cater to the provider–patient communication process, or hinder them? And is the EHR interoperable with other systems, preventing dual and manual entry for care providers and staff (a well-documented and pervasive cause of their (burnout)?
When used effectively, and when integrated with other systems, such as a customer relationship management (CRM) or other third-party platforms, the EHR can actually serve as a source to improve primary care provider and patient interactions. EHRs, in this context, could provide answers to some of the ongoing challenges in the health care industry today. In a national survey, doctors who are ready for meaningful use agreed: 75% of providers report that their EHR allows them to deliver better patient care.
Next Step: Giving Patients a Voice
Historically, patient data has always been at the forefront of the conversation when it comes to interoperability among health systems and medical professionals, but bringing patients’ personal access to that data into the fold is becoming increasingly important.
Patients are frustrated this isn’t happening — and with good reason. They are frustrated at siloed patient portals, which require separate logins and data-pulls for each network of care providers. And they are frustrated that, on one hand, their current-day experience as retail consumers could entail a drone delivering an online order on their doorstep within a matter of hours, while, as health care consumers, “they are left to lug paper” from one physician’s office to another, “even if both use electronic systems,” as Ira Nash, senior vice president of Northwell Health, put it.
One way to begin chipping away at this frustration is by giving patients a voice.
Nash further elaborates: “One of the important elements missing from current patient data is the narrative from the patient about their own health.”
As a cardiologist himself, Nash also implores EHR designers to better encompass what he considers the most important parts of a patient encounter — “the insights, background and backstory we used to be able to include in the narrative.” Now, clinicians “are so busy clicking and pointing, we can’t hear the patient story.” What can we do to change this?
All individuals, or family care givers, should be given the ability to exchange and easily access their, or their loved ones’, electronic health information in a manner that is appropriate, secure, timely, and reliable. Unlocked and more frequently communicated data then enables more informative, decision-making processes for these individuals at some of the most critical life-or-death junctures there are.
According to Bridge Connector’s Director of Solutions Engineering, John Milano, “The problem has evolved into a cultural situation. Most legacy EHR systems historically required some heavy lifting to get to a place where the EHR could interface with another system, never mind being able to do so in a patient-centric way. Government regulations provided a catalyst to greatly increase the adoption of electronic health record systems, but those regulations can inadvertently delay certain innovations for some EHRs as well. However, if we can create a more positive patient-centric culture that promotes native, open systems when EHRs and other third-party platforms are being developed, data can be more easily consumable by the end-user, requiring less repetitive data input as well,” said Milano. “Less time on data input stands to greatly bolster provider–patient communication, which is key to putting patients at the center of care, improving their customer service experience, and ultimately, their care outcomes as well.”
Patients are Entering the Catbird’s Seat
We’re already on the right track. Announced this year at HIMSS 2019, CMS broached the MyHealthData initiative, which works to increase patient access and better optimize interoperability practices. It aims to make the available data more useful and easier to propagate between safe and standardized formats, while mitigating the blockers, including increasing penalties for those who are participating in actual “information-blocking.”
Along with its blue health initiative, it’s clear that CMS, the ONC, other government entities, and even trade organizations are stepping up their game to encourage collaboration and improve health care system technology between patients and providers that will result in better health for all involved.
With this in mind, we now have viable solutions to the bevy of health care providers exchanging patient data on their own accord.
“By continuing to advocate for patients to have access to meaningful data from their providers, we will eventually strike the critical balance between the available tech capabilities, with all of these tools — patients apps, EHRs, CRMs, all of the fragmented areas that haven’t been thus far connected — being consolidated to achieve that elusive continuity of care,” said Milano.
With countless ideas being broached on how tech can impact the health industry, significant progress is being made due to the proper use of interoperability when it comes to putting patients at the center of care.