Guest Column | February 3, 2017

Is Your Health Data Appetite Bigger Than Your Mouth?

HITO Buff Colchagoff, RosettaHealth

By Buff Colchagoff, CEO, RosettaHealth

As with any industry sector, there has been a tremendous rise in the volume of data in the healthcare arena with many drivers responsible for this increasing tidal wave of health information. These include incentives put in place by Meaningful Use and the Affordable Care Act (ACA) to capture and use electronic records, innovations such as telemedicine and wireless medical devices, and other technical advances which have made it easier to collect and analyze information from multiple sources.

As such, written scripts and paper charts are nearly obsolete. In fact, the incentives from the HITECH Act’s Meaningful Use has skyrocketed the use of EHRs. Currently, more than 90 percent of all U.S. hospitals have achieved meaningful use of EHRs. In addition, the percentage of office-based physicians adopting EHRs went from less than 20 percent in 2004 to over 75 percent by 2014. We have also seen over a five-fold increase in health records moved across our infrastructure in 2016 alone.

Add in the rising trends of telemedicine, wireless monitoring devices, and newly affordable digital imaging technologies, as well as fitness tracking devices, and we have a vast amount of data sources offering different windows into a patient’s health. The end result is an explosion of computable health data.

Rise Of Data Opportunities/Challenges
This epic rise in data presents great opportunities such as improving patient care, reducing hospital readmissions, managing costs, and helping to develop new treatments. Though, it also comes with some epic challenges.

One of the most significant hurdles is moving sensitive data safely and securely between systems and communities to where clinical decisions are being made. In essence, the appetite for patient data is much larger than the ability to effectively transport this information.

Establishing connections to move data between health systems or health communities has usually required significant time and effort. This ultimately limits the flow of data between vendor systems, as well as between points of care where this information is most needed.

Part of the issue is many health IT vendors want to maintain leverage by limiting access to select partners, thereby creating their own data ecosystem. Many healthcare organizations also rely on diverse systems to help deliver care, further complicating exchange architectures.

In addition to leveraging all of the new sources and volume of data, these vendors need substantial expertise in HIT interoperability standards and interfaces to effectively manage the large amounts clinical information. The challenge is most organizations try to use existing resources to scale the interoperability infrastructure. But the problem requires more resources and time needed to support these efforts.

Before the trending surge in data took hold, health data transport and interoperability was a cottage industry that required modest resources. With the coming ubiquity of health data exchange, new, cost-effective solutions are needed.

The Age Of Standards-Based Exchange
Often with health IT interoperability, there’s either a question of which standard to use, or will the new shiny standard fix our problems? Truth is: we are in the age of standards-based exchange which includes Direct Secure Messaging, the eHealth Exchange, Commonwell, HL7 V2, FHIR, and more. For most exchange scenarios there’s already a workable standard to use, but not all systems support each standard. So how do we tackle this issue dealing with many systems using many different standards?

The most effective solution would completely remove the barrier of negotiating different standards and interfaces for moving medical records between healthcare organizations — a mixed-use solution that will conform to the easiest standard for each sharing scenario and each system involved. For example, Health Level-7 or HL7 Version 2 is commonly used for sharing information about patient events in specific care setting, while document-based exchange standards focus on exchanging the information for an episode of care, or a whole longitudinal record across organizations. In addition, from a telemedicine perspective, there are different needs, and therefore different standards.

With differing standards coming about from different health information exchange scenarios, a simplifying solution is needed.

New Cloud-Based Approach
Fortunately, the exchange of electronic records can be affordable and ubiquitous for hospitals, health systems, ACOs, mobile health apps, and Big Data needs like public and population health.

New cloud-based health buses can send and receive medical information, and maintain connections with other health providers no matter what systems they are using. These SaaS solutions aim to mitigate some of the biggest challenges of electronic health record sharing — data access and interoperability.

For example, the solutions offer a single interface to send, receive, and automatically update medical information while also maintaining connections with the entire healthcare ecosystem. The cloud-based bus can use any standard to connect to other organizations and systems, but provides a single interface for the bus client.

Furthermore, these solutions achieve this without expensive custom interfaces, but by utilizing the entire suite of standards-based protocols, including HL7 V2, REST, FHIR, XDR, XDS, XCA, NwHIN, and Direct Secure Messaging. They are also highly resilient and scalable, handling round-the-clock exchange of records with redundant systems and monitoring.

Overall Benefit
Ultimately, the entire healthcare IT ecosystem can benefit from the ubiquity of health data — from EHRs, hospitals, health information exchanges, mobile health apps to analytics vendors — allowing every provider to make better clinical decisions by having relevant health data available always.

As every health organization’s data appetite continues to grow, and more sources of information increase, the barriers that make information exchange difficult compound to limit an organization. Fortunately, emerging SaaS solutions are precipitating a major change where health data transfer will be seamless for everyone allowing everyone’s information appetite to be met at any time.

About The Author
Buff Colchagoff has over 16 years of health IT experience with large projects, including building the VA’s PHR MyHealtheVet, as operations manager for the Nationwide Health Information Exchange (NwHIN) which grew into the Sequoia Project, the Direct Project, and now as CEO of cloud-based health messaging and exchange platform RosettaHealth. To learn more about RosettaHealth, please click here.