Or­ga­niz­ing sys­tems to de­mand IT in­ter­op­er­abil­ity

Modern Healthcare - - INNOVATIONS - By Beth Kutscher

Med­i­cal de­vices now mea­sure and track many types of clin­i­cal in­for­ma­tion about pa­tients. But few of these de­vices can com­mu­ni­cate with oth­ers. In­stead, healthcare work­ers must man­u­ally trans­fer data from the de­vices to pa­tients’ elec­tronic health records.

“If you’re ill, you’ll be sur­rounded by as many as a dozen de­vices,” said Dr. Joseph Smith, chief med­i­cal and science of­fi­cer at the West Health In­sti­tute. “Each of them fo­cuses as if it’s alone.”

For ex­am­ple, the med­i­cal de­vice that de­liv­ers a hy­per­ten­sion drug also should be able to ac­cess a pa­tient’s blood-pres­sure read­ing and ad­just the drug ac­cord­ingly, Smith said. “This is some­thing that tech­nol­ogy does ex­tremely well, if you let it,” he said.

EHR sys­tems of­fered by dif­fer­ent ven­dors of­ten don’t share in­for­ma­tion ei­ther. This lack of in­ter­op­er­abil­ity re­sults in a greater risk of er­ror, lack of co­or­di­na­tion among care set­tings, and wasted time and money.

“The big­gest cost is, we’re wear­ing out our healthcare work­ers,” said Ed Cantwell, ex­ec­u­tive di­rec­tor of the Cen­ter for Med­i­cal In­ter­op­er­abil­ity. His group hopes to lever­age the clout of healthcare providers to force tech­nol­ogy ven­dors to build low-cost, twoway “plug and play” in­ter­op­er­abil­ity for seam­less data ex­change into all health in­for­ma­tion tech­nol­ogy sys­tems.

The West Health In­sti­tute es­ti­mates that med­i­cal in­ter­op­er­abil­ity could save the U.S. healthcare sys­tem as much as $30 bil­lion a year by re­duc­ing re­dun­dant test­ing, ad­verse events, man­ual data en­try and in­for­ma­tion de­lays that cause longer lengths of stay. One study found that 16.5% of missed emer­gency depart­ment di­ag­noses that harmed pa­tients were linked to prob­lems trans­mit­ting test re­sults to the provider.

Un­til now, de­vice and EHR ven­dors haven’t had in­cen­tives to de­velop soft­ware and other tech­nolo­gies that com­mu­ni­cate with com­peti­tors’ prod­ucts, Cantwell said. In the U.S., no sin­gle health sys­tem makes up enough of any ven­dor’s busi­ness to force change. Healthcare tech­nol­ogy pur­chasers have to change that dy­namic, he ar­gued.

“If you be­lieve in the free mar­ket, the buyer has some clout over the ven­dor,” said Smith, who serves on CMI’s board.

Cantwell, a for­mer Air Force fighter pi­lot, en­vi­sions a healthcare in­ter­op­er­abil­ity plat­form that func­tions like an air traf­fic con­trol sys­tem. His group’s first task was to re­cruit health sys­tem CEOs who share this vi­sion. The 14-mem­ber board in­cludes 11 CEOs from ma­jor sys­tems in­clud­ing HCA, Com­mu­nity Health Sys­tems, Scripps Health and Cedars-Si­nai Health Sys­tem.

Smith said he was in­vited to speak at the next meet­ing of the Ad­vanced Med­i­cal Tech­nol­ogy As­so­ci­a­tion, the trade group for de­vice­mak­ers. “They have their own con­cerns, but they ap­pre­ci­ate that there is a cer­tain com­mon­al­ity on how data are or­ga­nized,” he said.

CMI also en­gages in ad­vo­cacy with pol­i­cy­mak­ers. Its board mem­bers have met with the fed­eral health IT co­or­di­na­tor’s of­fice and the Food and Drug Ad­min­is­tra­tion. They have sent a let­ter to Dr. Karen DeSalvo, the na­tional co­or­di­na­tor for health in­for­ma­tion tech­nol­ogy, ask­ing her agency to de­fine a na­tional in­ter­op­er­abil­ity roadmap, and to en­sure that fed­eral health IT con­tracts push to­ward de­vice in­ter­op­er­abil­ity.

The not-for-profit cen­ter was spun off two years ago by the West Health In­sti­tute, an or­ga­ni­za­tion that fo­cuses on pi­o­neer­ing tech­nolo­gies to ex­pand healthcare ac­cess and re­duce costs. CMI’s fund­ing comes from the Gary and Mary West Foun­da­tion as well as dues-pay­ing mem­bers.

Cantwell, who spent much of his ear­lier ca­reer in the telecom­mu­ni­ca­tions in­dus­try, noted that the ca­ble TV in­dus­try es­tab­lished a stan­dard for trans­fer­ring elec­tronic data. He would like to see sim­i­lar stan­dards for healthcare tech­nol­ogy. “Our the­sis is that healthcare is the most im­por­tant util­ity,” he said.

Be­sides hav­ing de­vices that can feed data di­rectly into a pa­tient’s elec­tronic record, a more im­me­di­ate CMI goal is to have dif­fer­ent ven­dors’ EHR sys­tems com­mu­ni­cate with each other, said CMI board mem­ber Dr. Jon Pryor, CEO of Hen­nepin Healthcare Sys­tem. “Peo­ple bounce around be­tween sys­tems,” Pryor said. “There’s a greater po­ten­tial of los­ing in­for­ma­tion if it’s not all in one spot.”

By the end of the year, CMI plans to open a lab­o­ra­tory at a yet-to-be de­ter­mined lo­ca­tion to de­vise, test and cer­tify in­ter­op­er­abil­ity so­lu­tions. The lab will recre­ate the space, equip­ment and IT sys­tems found in healthcare set­tings. CMI al­ready has more than 20 engi­neers work­ing in an in­terim lab, and Cantwell thinks it needs about 150.

“This is per­haps one of the big­gest un­der­tak­ings in healthcare,” Cantwell said. “It’s go­ing to come down to a group of re­ally strong lead­ers.”

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