As organizations implement EHRs and participate in health data exchange, healthcare interoperability is an area that will only continue to grow in importance.
Technology is ever-evolving, and with that evolution comes an increasing amount of data. Healthcare interoperability is a way for organizations to utilize information and ensure that patients can receive proper care, even if they move from one provider to the next.
When healthcare organizations have different EHR platforms, it can be difficult to connect with one another and can even lead to difficulties with patient care. For example, Black Book found that 36 percent of medical record administrators reported that they have EHR interoperability issues when exchanging health records with other providers.
About 25 percent of surveyed physicians stated they still cannot utilize a lot of meaningful patient information received electronically from external sources as currently shared outside siloed EHRs.
Twenty-seven percent of medical record administrators added that transferred patient data was not presented in a useful format, an increase from the 22 percent that said the same in 2017.
There are certain tools or initiatives that can aid healthcare organizations as they work toward improved interoperability options.
Updated federal regulations, artificial intelligence (AI), growing interoperability networks, and increases in patient data access options are all top healthcare interoperability areas that will impact the industry in the coming months.
Changing federal regulations
In April 2018, CMS announced that it would be overhauling the EHR Incentives Programs. The meaningful use program was renamed to “Promoting Interoperability” and the Merit-Based Incentive Payment System (MIPS) Advancing Care Information performance category was also renamed to the “Promoting Interoperability” performance category.
CMS will also require providers to use 2015 edition certified EHR technology (CEHRT) in 2019 to demonstrate meaningful use and qualify for federal incentive payments.
“This updated technology includes the use of application programming interfaces (APIs), which have the potential to improve the flow of information between providers and patients,” CMS stated. “Patients could collect their health information from multiple providers and potentially incorporate all of their health information into a single portal, application, program, or other software.”
Changing the meaningful use program will increase flexibility and reduce burden, and will also “emphasize measures that require the exchange of health information between providers and patients,” CMS explained. Furthermore, providers will be incentivized to ensure that patients can easily obtain their own medical records electronically.
The proposed rule received early praise from industry stakeholders, with several noting the importance of focusing on healthcare interoperability.
CHIME Board of Trustees Chair Cletis Earle stated that his organization has long advocated for interoperability in our healthcare systems and commend CMS for making interoperability a focus.”
Healthcare organizations should keep themselves current on all federal requirements with regard to healthcare interoperability, ensuring that they remain compliant and are not penalized in their efforts to further health data exchange.
The Artificial Intelligence (AI) push
With the push for nationwide interoperability, there is an increasing amount of data as a whole. Healthcare organizations need to implement the right tools to handle that information, and advanced analytics capabilities like AI is quickly becoming a top option.
Researchers at Leavitt Partners published research in May 2018 that demonstrated how new data analytics options could improve patient outcomes. Specifically, the research team reviewed state health and human services (HHS) enterprises for how those organizations can improve population health, decrease costs, as well as reduce substance use disorders, unemployment, and homelessness.
“Data, and the ability to share data, sits at the center of these cross-governmental and health care collaborations,” researchers explained. “Data has the potential to connect distinct hospitals, clinics, government agencies, and community-based organizations and provide a more complete and accurate picture of an individual and their needs.”
Seamless connectivity is difficult because organizations often have to overcome the variety of IT systems, diverse levels of sophistication, and varied interoperable capabilities. Additionally, data governance, interagency relationships, and developing common data definitions can be challenging.
“Unlike traditional data analytic systems, cognitive computing can consume both structured and unstructured data and present it in ways that are actionable for decision-makers,” the research team wrote. “Moreover, similar to the human brain, cognitive computing systems possess the capacity to improve and develop over time with the input of additional information.”
AI can also aid EHR use as healthcare organizations could utilize and integrate quality EHR data and algorithms into clinical decision-making, Picnic Health CEO Noga Leviner said at the 2018 World Medical Innovation Forum hosted by Partners Healthcare. Leviner added that the possibilities for medical advancements are endless.
“We don’t have perfect data now, but if you look at just genomics in and of itself — genomics and EHR — you put them together and you’re already dealing with a data set that’s providing a perfect use case for AI,” Leviner said. “Doctors on their own [are] just not going to be as good at saving lives and providing care as those doctors combined with algorithms.”
AI advancements, machine learning, and improvements to EHR usability could all transform patient care through increased interoperability options.
Interoperability networks offer secure options
Healthcare organizations have different options for secure data exchange, which can expand provider access to patient records and aid the industry transformation to value-based care.
The Surescripts interoperability network had a 26 percent increase in its secure health data exchange transactions in 2017, and increased the number of healthcare professionals in its network by 13 percent. The total number of Surescripts in-network providers rose to 1.47 million in the last year.
The Surescripts Network Alliance continued to make remarkable progress in 2017, signaling that healthcare interoperability is indeed happening today,” Surescripts CEO Tom Skelton stated. “Over the last decade, E-Prescribing has matured and scaled. Now, newer functionality like Record Locator & Exchange and Real-Time Prescription Benefit are ramping up at an impressive rate.”
Healthcare alliance DirectTrust also reported increases in its health data exchange transactions for the first quarter of 2018. DirectTrust transactions increased by nearly 90 percent over the first quarter in 2017, while healthcare organizations served by DirectTrust health information service providers (HISPs) and engaging in Direct exchange rose 19 percent.
“Despite the tremendous amount of attention being given to FHIR and APIs, the growth here is solid and reflects the value of electronic ‘push’ technology to replace fax and paper,” DirectTrust President and CEO David C. Kibbe, MD, MBA said in a statement. “We are also noticing an uptick in patient/consumer involvement in Direct secure messaging, and improvements in EHR vendors’ software features and functions that make Direct more user-friendly for clinicians and their staffs.”
Patient data access further pushes interoperability
Ensuring that patient data access is a reliable and secure option is increasingly critical as healthcare works to adopt value-based care. Numerous stakeholders agree that a well-informed patient is a better patient, and improved communication options will help patients receive the best care possible.
Better patient-provider communication and higher patient satisfaction scores can reduce the likelihood of rehospitalization by 39 percent, according to a 2017 study published in BMJ Quality & Safety.
Patients who said their doctors always listened to them were 32 percent less likely to be readmitted to the hospital.
Patients want to have the ability to access their own data, and want that ability in numerous ways, Tufts Medical Center Chief Medical Information Officer Dr. William Harvey previously told EHRIntelligence.com.
“The healthcare system is starting to understand that they want that same kind of accessibility and ownership of the process,” he said. “That relates to accessing things like booking appointments or downloading copies of their medical records, without having to charge to the basement of the hospital.”
Patient data access is empowering and can speed up the patient care process, Harvey added.
“If the patients can access their portal and show me the data I need to see, then I’m less apt to repeat testing they’ve already had or do something that’s already been thought of or tried by their other doctors,” he said.
Along with Promoting Interoperability, CMS also stressed the importance of the MyHealthEData initiative and Patients Over Paperwork. Both are meant to encourage providers to share information with patients as a way to engage individuals in their care.
With MyHealthEData, patients will have access to their own EHRs through the device or application of their choice. Patients can also choose the provider that best meets their needs and grant that provider secure access to the patient’s EHRs.
“CMS serves more than 130 million beneficiaries through our programs, which means we are uniquely positioned to transform how important healthcare data is shared between patients and their doctors,” said CMS Administrator Seema Verma said in the March 6 announcement. “Today, we are calling on private health plans to join us in sharing their data with patients because enabling patients to control their Medicare data so that they can quickly obtain and share it is critical to creating more patient empowerment.”