A look at data interoperability and how the industry will move forward.
Somewhere amid the hot flashes and chills, Christine Bechtel’s golfing buddy, Becky, lost her longtime taste for whiskey. Symptoms small enough to ignore, until one day Becky passed out on the kitchen floor. Chalk it up to menopause, her primary care provider said. See an OB-GYN. Ask a neurologist. Consult an endocrinologist.
Lacking the full picture of her health, the deep bench of specialists — with no way to easily share data between each other — was no match for Becky’s undiagnosed stage 4 lymphoma. But if you search hot flashes, loss of taste and her other symptoms in Google, lymphoma pops up. Becky’s story hammers home the unavoidably human element in healthcare’s data sharing problem: tragic and costly health outcomes.
2019 marked a hallmark year for data exchange and interoperability, as the Office of the National Coordinator for Health Information Technology is set to lay additional foundational elements to create a better system, restructuring the flow of health data and drafting rules to bring health organizations, hospitals and doctors onto the same page.
To help consumers and healthcare stakeholders understand impending changes to the application of health data, Cambia Grove, a healthcare innovation center, hosted a two-day consumer-focused Interoperability Summit over the summer. The Seattle-based innovation hub featured keynotes from Susannah Fox, former Chief Technology Officer (CTO) of the U.S. Department of Health & Human Services (HHS); Christine Bechtel, national patient advocate and Co-founder of X4 Health; and Aneesh Chopra, former CTO of the United States and president of CareJourney.
Maura Little, executive director of Cambia Grove, encouraged stakeholders to step back and examine the practical application of healthcare dataflows before rushing to implement value-based care and other initiatives fueled by free data exchange. She asked healthcare stakeholders in attendance, how we can design thoughtfully to prevent resurrecting the silos hampering care delivery today?
Susannah Fox opened the conference by gauging the data literacy of the current health data system. She compared our knowledge of the health data landscape to 15th century world maps, asking, “What are we missing when we focus too closely on what is currently available? What treasures lie just beyond our view, in unexplored or restricted areas?”
Fox spoke of expanding our health data horizons and a new taxonomy of health data, one including grocery and gym habits. In Japan, for example, if a senior citizen hasn’t used electricity by the standard time their records routinely show usage in the morning, help is dispatched.
Perhaps the most well-known example of health data access is Blue Button 2.0 — a Centers for Medicare & Medicaid Services (CMS) initiative to boost consumer-directed health record sharing. Aneesh Chopra launched the original Blue Button initiative in the Veteran’s Administration in 2010 and shared how simplifying consumers’ access to their own data has evolved since. When he last visited Cambia Grove in 2017, he discussed that technology's role isn't to drive change, but to enable doctors, hospitals and even patients to create change. Chopra added that when technology isn’t enough of a carrot, the stick of data exchange regulation is a swift alternative. For example, government-sponsored plans, as of January 1, 2020, will be required to disclose claims and clinical data; by 2022, hospitals must share real-time discharge notes to physicians.
Interoperability has the power to integrate medical claims data from providers, provider network data, medication and prescription data, pricing information, and more. Organizations like The CARIN Alliance and the Da Vinci Project continue to standardize complete data exchange supported by HL7 FHIR®, positively impacting clinical quality, cost and care management outcomes.
Members of the Da Vinci Project are forging industry-first interoperability use cases such as Cambia Health Solution’s partnership with MultiCare Connected Care and OHSU, explained Kirk Anderson, Cambia Health Solutions CTO, during his presentation at the Summit. Although upending HIPAA-ruled processes may be intimidating, consumers have come to expect the convenience and mobility only FHIR-enabled records are able to provide. CARIN members have created similar guidelines to follow with an implementation playbook for payers and providers to support more efficient and coordinated care, which will ultimately empower millions of Medicare beneficiaries to more easily access their health information.
By combining disparate health data sources into one portable 360-degree view of health history, consumers can easily access records and are more likely to change their behavior based on having that access. Solutions offering a one-stop shop for health data improve not just health outcomes, but their business case as well. Drawing on her experience caregiving for her two elderly parents and aging sister, Bechtel encouraged entrepreneurs to “solve real problems for real people. Then you don't have to engage them, they'll come to you.”
There’s much work to be done as technology continues to transform healthcare. People now demand the same seamless, easy-to-understand, personalized consumer experience they have in other areas of their lives for making their healthcare decisions. We all deserve to be just as informed as our counterparts in the 5 Points of Health Care™. Little brought the discussion full circle from the human element in interoperability by underscoring the need for building trust with all parties — the first step – before creating thoughtful data flows.
“As we have heard time and time again, the technology is there,” Little said. “Partnerships are key in turning possibilities into practice. Cambia Grove will continue to bring together these essential connections to advance a more person focused and economically sustainable healthcare system for all.”
For these partnerships to take root entrepreneurs and organizations must reach common ground. Cambia Grove facilitated four interactive roundtables with summit attendees to name the barriers and unmet needs preventing interoperable innovations today. In order to design solutions that serve each sector of the health industry, we must consider each sector’s perspective before anticipating their needs.
*Strengthen the Business Case
*Governance and Leadership
*Policy and Regulatory
About the Author: Nick Jackal is the community engagement director at Cambia Grove.
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