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Perspectives on Innovative Interoperability

Posted by Matt Breese on Apr 19, 2016

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Not that long ago patients arrived at their doctor appointments with a bag of medicine bottles and a printed copy of their medical records, or had to wait for an appointment while their primary care provider’s office staff found time to fax a copy of their records. While those days are not completely history, advancements in information technology and the advent of the electronic health record (EHR) have gone a long way toward making those cumbersome practices obsolete.

Electronic health records prompt data integration

Integrated data access most notably benefits clinical practices and hospitals; but health plans and pharma also realize benefits. The EHR is arguably the greatest advancement in data integration. Although the learning curve was steep for many practices, EHRs are now a staple in the vast majority of medical practices. Unfortunately, the cost of launching an EHR, the required technical support or an organization’s basic culture, translates to small or solo medical practices, and even some health systems, falling behind with EHR developments.

The EHR makes it possible to share patient data about medical treatments, drug therapies, best practices and outcomes across care settings. Access to this information is at the core of informed decision-making. Interoperability that limits information gaps helps providers avoid:

  • Redundant testing
  • Treatments that did not provide ideal outcomes
  • Therapeutic errors
  • Readmissions

Developers of EHRs are working in partnership with their customers to further integrate medical device readings and patient-generated data, such as steps walked, daily blood sugar testing and dietary logs. Comprehensive integration provides connected providers with the broadest picture of a patient’s health and medical care.

Provider perception versus reality

KLAS Research recently measured providers’ perceptions of EHRs and how successful they were in promoting interoperability. They found that perception did not necessary match reality. While the general perception among providers suggests Epic has the most difficult time supporting interoperability, providers who have experience with Epic and other vendors ranked it best in five of eight interoperability measurements, including:

  • Proactivity
  • Commitment to industry standards
  • Working with other vendors and standards
  • Minimizing costs
  • Maintaining interoperability during upgrades

Epic also tied athenahealth® for ease of connection.

Many early-adopter medical practices and health systems found it challenging to implement an EHR. Often they failed to generate buy-in from their medical staffs, and initially providers viewed training and data entry as unwelcome, time-consuming burdens to the delivery of health care.

Today, it is widely accepted that medical staffs must be engaged as primary stakeholders in any interoperability project to:

  • Refine the project’s goals
  • Identify required interfaces
  • Protect nurses and physicians from burdensome data entry
  • Champion the system as an efficient addition to care delivery

Interoperability from a pharma perspective

Pharma also benefits from data interoperability. Emerging, secure cloud technologies deliver rich, real-life behavior information that pharma can leverage to customize messaging through all marketing channels, and improve responsiveness when it comes to the needs of health plans, health systems and individual medical practices.

A content management system (CMS) is vital to improve pharma workflow and performance, reduce the complexities and costs of doing business, and deliver on the promise of a strong, supportive partnership with clients. To make this work, however, requires C-Suite leadership that identifies information technology as a priority and supplies the resources need to build an infrastructure that includes the platform, secure data storage, application, analytics, and broad internal and external interoperability.

Focusing on nationwide interoperability

In December 2015, Carequality Interoperability Framework, an initiative of the Sequoia Project, took a giant step toward nationwide health-care data sharing. The five initial implementers (athenahealth, eClinicalWorks, Epic, NextGen Healthcare and Surescripts) agreed to provide health information exchange services for their customers under the comprehensive Framework.

"The Carequality Framework is a testament to health-care vendors' commitment toward making seamless interoperability a reality for patients and providers," says Dave Fuhrmann, vice president of Interoperability for Epic.

In real-life terms, the interoperability that Framework produces could make a significant difference in a medical emergency by providing emergency department personnel easy access to life-saving information about an unresponsive patient who is traveling outside his or her medical community.

“Through the Carequality Framework, Surescripts is breaking down legacy barriers and collaborating with other industry leaders to make nationwide health-care interoperability a reality,” said Tom Skelton, CEO of Surescripts.

Portability was one driver of the Affordable Care Act. Portability, however, is much more than ensuring individuals can keep their health insurance when they leave their jobs or move. True portability also ensures health-care information is readily available wherever a patient happens to need care — whether it’s from the patient’s primary-care provider, a specialist in the same health system or an emergency department on the other side of the country. Access to healthcare data aids providers in making informed decisions and delivering quality care, facilitates appropriate and timely claims processing by health plans, and helps pharma support its clients. It is also provides patients a sense of security and confidence that their care providers know the details of their medical history — whether they are able to share them or not.

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Topics: Industry Trends, Market Access, Provider