The Interoperability Tipping Point?

Achieving interoperability in healthcare is not an easy task.  Lately, there has been a series of publications debating who is to blame for challenges of data exchange.  Is it Vendors? Hospitals?  Providers? Policy?  In our view of the world,  interoperability is a shared responsibility and, importantly, healthcare communities are finally coming around to that understanding.  The evidence we see daily is that significant progress is being made.  Are we approaching a tipping point?

As you lead interoperability initiatives at your Health Information Exchange (HIE), your hospital, or your own healthcare tech company, know that progress is being made.  In fact, here are four areas where we have seen the most progress.

Four Areas of Interoperability Progress

#1 – Sustainability

While it is true that the total number of Health Information Exchanges has dropped since 2012, those surviving HIE’s across the country have worked with their provider communities to form more sustainable business models.  Cities and States are seeing the public health and emergency preparedness value in exchanging data. Providers, payers and patients are deriving more value from the technology infrastructures and the community data sharing partnerships.  So we are moving from discussions of “should I connect to my local, regional or state HIE” to “when and how”.  A great example is the Arizona Health-e Connection HIE.  Within the last two years, they’ve completely reinvented themselves and are growing significantly. They are getting healthcare data moving in Arizona and even incorporating Behavioral Health use cases.  

#2 – Use of Standards

Real patient care use cases are driving use of existing healthcare messaging standards in the provider and the vendor communities, with a richer source of clinical data being exchanged.  The exchange of clinical summary documents such as CCD/CCDA occurs far more today than we saw even 12 months ago. Cross community exchange (HIE to HIE) is expanding.   And Direct secure messaging adoption is starting to move into the mainstream for provider to provider communication, slowly replacing fax machines and moving beyond merely MU2 “check a box”.  Emerging standards like FHIR (a standardized healthcare API) are starting to be experimented with, even though FHIR hasn’t been finalized yet by the HL7 standards group.  

#3 – Lower Costs

The combination of subject matter expert availability, technology advancements, and market demand is finally starting to drive interface and integration costs down. This trend helps overcome the financial hurdle many faced in the past, making data exchange more feasible today. Consulting companies (like Zen) are working to create tools that more efficiently solve common problems such as malformed CCD’s.   Facing some serious market pressure, some EHR systems have taken steps to try to address cost concerns.  The new eCW hub model is a good example as it can make it easier for HIE’s to connect with many different eCW sites with just one connection.  And NextGen has lowered costs for on-boarding to it’s own HIE solution.  (Small steps, but steps none the less.)  Of course the key is having access to that expertise and the right tools, but the point is, they are available to those who look.

#4 – Risk drives Data Sharing

As provider communities realize there is a shared “risk – reward” environment that comes with ACO participation, they are coming together to address the care for defined patient populations.  As a result of this new shared interest, data is being unlocked and shared more frequently, at least in places with at least some ACO penetration.  At the end of the day, shared risk will overcome the fear, uncertainty, and doubt that have historically compelled providers or health systems to block data access.

These four areas are testaments to the progress being made in healthcare interoperability. Data is flowing at a higher rate and we are now seeing practical evidence that it is improving patient care in several tangible ways.  Here are three emerging interoperability use cases.

Three Emerging Interoperability Use Cases

#1 – Prescription Medication Abuse Prevention

With the recent focus on addressing the growing Opioid addiction issue, the value of the exchange of prescription information and connectivity to state Prescription Drug Monitoring Program (PDMP) databases has emerged as a hot HIE / interoperability use case.   In some cases, new laws are mandating PDMP database queries.  Whether driven by regulatory action or simply communities coming together to find solutions to Opioid addiction, HIE’s can assist providers identify potential prescription abuse situations and seek the appropriate interventions.  Check out Maryland’s new PDMP requirements as described by CRISP, the State of Maryland HIE.

#2 – Elder Care / EMS

With the aging of the population, Emergency Medical Staff frequently find themselves facing difficult problems.  Time is of the essence. A patient’s history is extremely valuable.  How to ensure the care they are providing is consistent with patient wishes.  Does the patient have Advanced Directives? A DNR?  By connecting the EMS services to the local or state HIE,  the patient clinical and visit history, plus any directives on file can be made available in real time.  San Diego Health Connect offers an EMS hub.  CA EMS agencies are driving this and other HIE-EMS focused initiatives in CA.

#3 – Care Event Alerting

With the wider availability of aggregated clinical data from multiple sources and notification/alert systems, more Providers now have greater awareness of their patients’ care events that happen outside of their own facilities – a visit to ER, urgent care, hospital admission or transfer to long term care.  In turn, providers can provide more informed, collaborative patient care across care events and as their patients transition between events.  Virtually all of Zen’s HIE clients are rolling out significant care event alerting programs for their communities including HEALTHeLINK in Buffalo, NY.  

We hope you and your organizations are experiencing some of these interoperability successes.  Interoperability is still not perfect and the projects are often complex, but the end goals are being realized.  We all are benefiting from the progress.

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What interoperability success are you providing to your community?  We’d like to hear your stories.

Having difficulty finding the value or navigating the complexity of interoperability projects within your organization?  We welcome the chance to hear your story and see how we can lend a hand.  

Reply to this post, send us a note to info@consultzen.com or call us at 949.396.1295 to discuss your interoperability experiences.