Interoperability Promises a Superhighway of Data, but Some Hospitals are Stuck in the Parking Lot | Deloitte US has been saved
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By Steve Burrill, vice chairman, US Health Care Leader, Deloitte LLP
Regardless of where I am, interoperable banking systems give me the ability to access accounts, deposit checks, transfer money, and pay bills—all with a few taps on my smartphone. Unlike my financial transactions, which are online and accessible, bits and pieces of my health history are scattered throughout the country. A lifetime of medical test results, drug prescriptions, specialist visits, and diagnoses are sitting in paper files and computer systems owned by physician offices, hospitals, and vendors in more than a dozen cities in which I’ve lived and worked. Similarly, my claims history is owned by a handful of health plans that have covered me during my career. None of these stakeholders can share any of this information with each other or with me.
Interoperability in health care appears to be several clicks behind financial services, and hospital executives regularly tell me they are worried about the impact this could have on quality and outcomes. Imagine if our complete health history existed in one place and could be accessed as easily as we pull up a checking-account balance on a computer or phone. Radically interoperable data promises to let consumers own their personal health information and share it with stakeholders (in real time) through a secure multi-lane superhighway of data.
Data belongs to patients, says CMS chief
At last month’s HIMSS conference in Orlando, US Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma outlined interoperability rules that were recently proposed by the US Department of Health and Human Services (HHS). If finalized as proposed, provisions of these rules would take effect as soon as January 1, 2020, leaving limited time for health care stakeholders to prepare.
Historically, when we have talked about interoperability, it has been among health systems and physicians. Patients, their families, and care teams have generally not been part of the discussion. Verma emphasized that patient data belongs to patients, and health plans, health systems, physicians, and government entities need to make it possible for patients to access and share this information. The idea that patient data belongs to providers or vendors, she told attendees, is “an epic misunderstanding.”
Taking baby steps toward interoperability is no longer an option
Many hospitals are unable to share information across their own software platforms, let alone with other patients, health systems, health plans, or physicians outside their network. Some hospitals and health systems are investing in software add-ons and patches to integrate their various software systems. Others have figured out how to share data with physicians who aren’t on the same software platform, but who are part of their Medicare Shared Savings Program (MSSP). However, there is typically a lag when sharing this information and developing dashboards—rather than the near-real-time data sharing that interoperability could deliver.
While hospital leaders have been taking baby steps to improve interoperability, they should pick up the pace to get to the future of health that CMS envisions. As health systems and physicians enter into more risk-based contracts, they need to be able to seamlessly share data to reduce costs and improve outcomes. All stakeholders—the patient, the clinician, the hospital, the drug and device manufacturer, and the health plan—should be committed to interoperability. Hospital and health system leaders should consider these strategies to improve interoperability:
While banking is far ahead of health care in terms of interoperability, medical information is far more complex than financial information. It comes in a variety of formats and typically includes highly nuanced and personal data. However, once interoperability issues are resolved between departments within a hospital and among hospitals in a health system, radical interoperability should be an easier transition. This is becoming increasingly important given the amount of health data being generated through wearable devices, apps, and connected at-home medical devices. As more care is delivered at home—rather than at a doctor’s office or hospital—interoperability will likely become indispensable.
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