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Exchanging data, improving care: Interoperability gains momentum


Health Gorilla’s Steven Lane talks about the growing support for sharing information, the obstacles ahead, and why interoperability can lead to greater health equity.

As a primary care doctor for more than 35 years, Steven Lane says he has long been enamored with the idea of using data to offer better healthcare.

And he viewed interoperability, the sharing of health information, as “the next frontier.”

Now, as the chief medical officer of Health Gorilla, a health data sharing platform, Lane plays a role in moving toward that next frontier. This week, the federal government named Health Gorilla as one of the first companies to have an approved application to become a Qualified Health Information Network to expand the sharing of health data.

The networks are key components in implementing the Trusted Exchange Framework and Common Agreement (TEFCA), which establishes a set of governing principles for the exchange of health information. With these newly designated health information networks, healthcare organizations will eventually be able to more easily share information with each other. Eventually, when a traveler on vacation goes to a hospital, the doctor should be able to see the patient’s history, including chronic conditions or allergies.

Federal officials and healthcare leaders have hailed the Trusted Exchange Framework as a key in making interoperability a reality. And Lane sees great promise with Health Gorilla helping to expand interoperability, and its much-hyped promise, to transform healthcare.

“The goals of bringing together, accessing and leveraging as much clinical data as possible to support care at the individual and population level, it makes perfect sense to me,” Lane says.

In an interview with Chief Healthcare Executive, Lane talked about the importance of interoperability, its role in health equity, and how healthcare leaders should be embracing these possibilities.

(See portions of our conversation with Steven Lane in this video. The story continues below.)

More interest in interoperability

Many healthcare leaders are supporting TEFCA. In a recent Health Gorilla survey on the state of interoperability, most chief information officers said they support the idea of setting nationwide interoperability standards. And the majority (55%) of C-level executives at health systems said they plan to spend 5% to 20% more on interoperability products and services in 2023.

Lane says it’s encouraging to see “how much the respondents to the survey are thinking about interoperability, how much they're anticipating increasing their investment.”

“I think we're sort of coming to a new place, where people really appreciate the value of interoperability, certainly in value-based care for public health purposes, you know, and so many other use cases, and they're really seeing this as critical to how they move forward,” he adds.

At the same time, health leaders gave mixed reviews on the quality of data getting shared. Only 40% of health system executives believe the data retrieved through health information exchanges is of "good or great" quality.

Data quality has emerged as “a new rallying cry in our industry,” Lane says.

“It's something that really only a few of us have been talking about for the past five or 10 years,” he says. “But we're clearly evolving to the point where people are thinking about not just the volume of data, but really, what are you getting?”

In the near future, the healthcare industry needs to determine what is needed in terms of data quality, since it has several dimensions, he says.

“I think it's important that we, as an industry, start to think about what those are … the completeness of the data, the timeliness of the data, the accuracy of the data,” he says. “I mean, there's a whole host of things that fall under that rubric of data quality.”

The workflow challenge

Even with growing momentum for interoperability, a host of obstacles remain, and Lane chuckles a bit when asked to identify the top challenge. “There's so many I mean, it's hard to say the biggest,” he says.

But he continues, “I think getting data into workflow is always a critical issue for providers. So that that data, no matter where it was sourced, no matter how it came to you, is right in front of your eyes, and in your mind, when you're making a clinical decision.”

Clinicians, care managers and others in the health system need to have easy access to that information. While other challenges remain, including data quality and sharing information in a timely manner, the goal is to enable providers to use the data to make better decisions on patient care.

“You want the right data in front of the right user at the right time in the right format, with the right supporting workflows, so they can make the right decision,” Lane says.

Health equity

The greater exchange of health information is an important step in closing disparities in healthcare among disadvantaged groups, Lane says.

“If you believe that health data can help improve care, you want to leverage that improvement, where it's going to make the largest difference,” Lane says.

“If we can access exchange and use health data for individuals and populations that today do not have equitable access to data and care and health outcomes, we can build that from the bottom up,” he says.

Lane says he appreciated the call to add health equity as a pillar to the “quintuple aim” for healthcare, which was proposed in a viewpoint article on JAMA Network.

“Health data, and data exchange, and access is really the only intervention that I can think of in healthcare, that stands to improve all five pillars of the quintuple aim,” he says.

“I mean, if we can effectively access, exchange and use health data, we can address the health of the population, the per capita cost, the experience of patients, the experience of caregivers, and equity, which are the five pillars of that quintuple aim. I can't think of any surgery or medicine or healthcare delivery arrangement that can touch on all five of those pillars.”

Advice for healthcare leaders

Even with the other challenges they are facing, including staffing shortages and a difficult financial environment, healthcare leaders should continue to move toward improving the exchange of data with providers and patients, Lane says. And he’s encouraged that more leaders share that perspective.

“I think most health care leaders are well aware of the central role that information, data and technology can play, and contribute to their success,” he says.

“The truth is that having access to the data, being able to utilize data meaningfully … it's going to serve all of the other pillars of your mission, from equity to health outcomes.

“So I think my recommendation is to keep that focus, double down, stay aware of, and a part of, the nationwide movement towards greater interoperability,” Lane says. “I really see the TEFCA framework as a train that we should all be getting on to, and moving forward together.”

While interoperability has been talked about for years, Lane says the better exchange of health information will eventually lead to better health outcomes.

“I really do believe that what we're working on, as a country, as a company, is a part of the solution that will help us to do better,” he says.

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