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Who's Itching to Increase Interoperability?


Healthcare is far from achieving a universal approach to connecting its disparate systems, but many bright minds are making strides.

Ask health information technology experts which buzzword they most dislike, and they might respond with a surprising answer: interoperability. Earlier this year, Healthcare Analytics News™ (HCA) heard that gripe firsthand, backed by complaints that the seamless exchange of medical data had gone from an accessible goal to an unattainable dream. Hailing industrywide interoperability as something viable, they reasoned, was akin to hoping blockchain will solve all of healthcare’s problems.

In 2015, less than 30% of hospitals had found, sent, received, and integrated information in electronic medical records (EMRs) from outside providers, an increase of 5 percentage points from the previous year, according to a report in the policy journal Health Affairs. Still, only 18.7% of hospitals had claimed to use such data “often” in patient care, and other results further suggested that “progress toward interoperability is slow” and not rooted in clinical decision making, the report said.

But it might be too soon to write off interoperability. The brainpower and resources allocated to cracking the data-sharing code offer some reason to silence the cynics, and no place has more innovative projects on display than the Interoperability Proving Ground, a digital platform designed to connect researchers.

The Office of the National Health Information Technology Coordinator launched the hub roughly 2 years ago, and the group began spotlighting featured interoperability projects in late 2017. To be featured, a project must be new or have just published its findings. A computer then selects a new interoperability endeavor to highlight each week. HCA analyzed the efforts that have left their mark on the IPG and selected some of the most interesting for the list that follows. And although their success is not guaranteed, these projects provide hope that healthcare might achieve some level of interoperability.

Making the Most of Meds

IPG’s first featured undertaking, Pharm2Pharm aims to strengthen care transition and coordination using a model centered on hospital and community pharmacists and managing medication in high-risk patients. To get the project off the ground, the Hawaii Health Information Exchange and the software solutions firm HCS built medication reconciliation and drug therapy problem assessment modules. And their work seems to have paid off. Researchers recently found a “significant decrease” in the drug-associated hospitalization rate of senior citizens and a better return on investment for pharmacists—all through the improved flow of information.

Leveraging EMR Data at Scale

Can EMR-based data-collection forms undergo an upgrade to make information useful beyond direct patient care? This collaboration between Cincinnati Children’s Hospital Medical Center and ImproveCareNow attempts to scale improved data-collection methods to connect dozens or hundreds of providers. Researchers launched digital case-report forms from EMR systems, prepopulated certain fields, completed the remainder manually, and then sent the forms to an outside data bank. Ideally, the project will improve data infrastructure and standards beyond the clinic and into claims and pharmacy benefits. A manuscript is expected soon.

Connecting Ambulances and the Emergency Department

For the 30 million patients transported to health systems by emergency medical services (EMS) each year, few things are more critical than time—in terms of the ride itself and the trip their data must take to reach the emergency department (ED). EMS workers often deliver acute care information in person, and faxes containing data for nonacute cases typically take 24 hours to reach clinicians. For this project, the interoperability company Kno2 has developed a platform that enables EMS crew to ask providers medical questions about patients, more efficiently transition care to the ED, complete prehospital reports, obtain outcomes data, and access payer information. Research findings have not come in.

Incorporating Outside Analytics in the EMR

When clinicians want to access actionable insights in their EMR systems, they often find themselves out of luck. Instead, they must jump to an outside portal to get the patient-care knowledge they need. Moxe’s Convergence platform, on the other hand, weaves outside analytics into existing EMR platforms, through a “streamlined, integrated user-interface embedded,” the company said. Still awaiting project results, this tool helps physicians identify gaps regarding risk adjustment, Health Effectiveness Data and Information Set scores, and more. Convergence checks a key box for many interoperability leaders: making data not only available but useful.

The Data Show Interoperability Has a Way to GoBillions of dollars in government incentives have gone a long way toward the near-universal adoption of electronic medical records. But the technology alone is incapable of helping health systems improve interoperability levels. If healthcare aims to unlock patient data and improve care, it must expand its abilities to connect with outside institutions and leverage patient information in a clinical setting. Here, health systems are upping their game in some ways, but they fall short in others. These visuals, built on statistics provided by the Office of the National Health Information Technology Coordinator, illustrate the disconnect between EMR adoption and data optimization.

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