What Will It Take To Achieve True Interoperability?
Four steps to hasten the efforts to improve health data exchange.
By Paul Black, CEO and President, Allscripts
There are two common reactions when the topic of interoperability is raised in conversation. The first is recognition of how important it is for providers, patients, and other appropriate stakeholders to be able to reliably and consistently exchange health data. The second is frustration we haven’t yet made enough progress with interoperability to achieve the full promise of health IT.
The healthcare industry has made some progress, but many of us wonder: What will it take to achieve true interoperability? Following are a few suggested means of hastening efforts to improve health data exchange.
- Optimize Use Of EHRS
Only a holistic approach to EHRs will enable the healthcare industry to reach its goal to consistently exchange accurate, meaningful data. For example, there currently is a noteworthy lack of true electronic clinical quality measures, as well as incomplete and inaccurate code sets. The optimal process is not a matter of simply converting pre-existing measures into an electronic format, but would include clinical technologists to help evaluate how ideas will affect workflows in the real world.
To move into a quality-driven healthcare world, we will need agreement from clinical experts on what quality means. Evidence-based guidelines can be useful in determining which outcomes are, in fact, good outcomes. Clinical quality measures should also have structures that are flexible enough to change with clinical and technological advances.
- Ensure Data Liquidity “Above The EHR”
Clinicians need patient information to move securely and easily beyond the organization’s own EHR system, otherwise known as data liquidity. Technology solutions that sit “above the EHR” should enable intra-organization data exchange, regardless of EHR system.
An important consideration in evaluating data liquidity is the physician practices and independent hospitals that have been pressured to move off of their current EHR system to one used by the large enterprise health system in their area. It’s called “data bullying,” because one party isn’t committed to establishing connectivity between current systems and, in some instances, will even put up indirect roadblocks associated with their own business goals. For example, sometimes larger health systems compel change through conversations about referrals and threats not to include people in data or payer networks.
No information technology certified by the ONC should be allowed to facilitate information blocking — period. The government should work with the ONC to establish the rules and governance for electronic health information exchange that would curtail blocking, with demonstration of intent being a critical component of this effort.
Variation in state laws is also an obstacle, both laws about security and those about opt-in vs. opt-out approaches. It creates confusion for providers and patients crossing state lines, as well as challenges for software developers. Stronger rules and definitions in this area would help alleviate the difficulties in this area.
- Connect The Consumer
Public and private payers have designed many programs to encourage stronger “patient engagement” with providers. But rather than patient engagement, we need to encourage activation — inciting patients to take accountability for their health and apply the powers of technology toward that goal.
It’s important that providers offer tools through which patients can learn what is in their medical record, gain access to test results and facilitate information sharing with other relevant caregivers. But we must also be able to incorporate health data that patients generate outside the physician office, capturing those behaviors that have a significant impact on outcomes.
New technologies, such as remote monitoring and wearables, are driving patient demand and engagement, but we should address how to present this flow of information to caregivers in a useful way within their workflow. For patients and caregivers to be truly engaged as partners, we must develop new strategies on how to use this data to provide better guidance.
- Deliver Precision Medicine
Healthcare has always looked for ways to deliver better, more precise treatment. A recent and renewed focus on precision medicine — matching treatment based on genomic, environmental and personal health factor — will require interoperability at its foundation to be successful.
Why is interoperability important? Because, to be effective, precision medicine requires a holistic picture of the patient. For example, care teams treating cancerous brain tumors include primary care providers, neurologists, oncologists, surgeons – and they could all be using different systems. Integrating their information with genomic maps becomes impossible without interoperable systems.
Allscripts recently partnered with NantHealth to incorporate genomic information into care plans. Just as mission control meticulously tracks an astronaut’s health in real time, someday our physicians will be able to track our health the same way. Precision medicine will make it possible for caregivers to help patients prevent illness and even understand potential outcomes and costs in real time.
Interoperability makes it possible to move from reactive treatments to precision medicine’s predictive approaches. As caregivers and consumers recognize the value and potential of precision medicine, it will hasten interoperability, which is the backbone of these endeavors.
The software development industry will continue to collaborate with all stakeholders to make further strides toward true interoperability. Taking some of the steps above will hasten our progress, and we will achieve the promise of health IT.
About The Author
Paul Black serves as Allscripts Chief Executive Officer, President, and Director. Paul was appointed CEO in December 2012 after having served on Allscripts Board of Directors for eight months. As Chief Executive Officer, Paul leads the direction of the comp any and its global commitment to delivering an Open, Connected Community of Health.
Prior to joining Allscripts, Paul spent more than 13 years with Cerner Corporation in various executive positions, retiring as Cerner’s Chief Operating Officer in 2007. During his tenure with Cerner, he helped build the company into a market leader in healthcare information technology with more than $1.5 billion in annual revenue. Prior to Cerner, Paul spent 12 years with IBM Corporation in a variety of leadership position s in sales, product marketing and professional services.
Paul has held positions on multiple private company and non-profit boards of directors. The businesses ranged from healthcare information technology and healthcare services to software and SaaS-based consumer Internet marketing. Paul’s leadership experience on those boards includes serving as director, chairman and executive Chairman. Paul has also provided investment advice to several private equity firms on both coasts.
He is currently Immediate Pas t Chairman of Truman Medical Centers, as well as an Officer of the Corporation. Truman Medical Centers is a 400 — bed safety net academic hospital in Kansas City. Paul earned a Bachelor of Science degree from Iowa State University and a Master of Business Ad ministration from the University of Iowa. He is married with two children and enjoys running, travel and coaching youth sports.
About Allscripts
Allscripts (NASDAQ: MDRX) is a leader in healthcare information technology solutions that advance clinical, financial, and operational results. Our innovative solutions connect people, places, and data across an Open, Connected Community of Health™. Connectivity empowers caregivers to make better decisions and deliver better care for healthier populations. To learn more, visit www.allscripts.com, Twitter, YouTube and It Takes A Community: The Allscripts Blog.