Providers have made strides on in­ter­op­er­abil­ity; let’s add ur­gency to fi­nally cross the fin­ish line

Modern Healthcare - - Comment - By Rick Pol­lack and Chip Kahn

Imag­ine if your iPhone could only ring other iPhones, but not con­nect calls or send text mes­sages to An­droid-based mo­bile de­vices. That wouldn’t ren­der your phone use­less, but its value as a com­mu­ni­ca­tions tool would be greatly di­min­ished. The telecom­mu­ni­ca­tions sec­tor has wisely avoided this sit­u­a­tion, de­sign­ing con­nec­tiv­ity sys­tems that bridge tech­ni­cal vari­a­tions be­tween man­u­fac­tur­ers, mod­els and op­er­at­ing sys­tems.

We must do the same for pa­tients. Our re­cently re­leased re­port, “Shar­ing Data, Sav­ing Lives” (AHA.org/in­ter­op­er­abil­ity) is a col­lab­o­ra­tive wake-up call from seven of the na­tion’s lead­ing hospi­tal as­so­ci­a­tions about the crit­i­cal im­por­tance of cross­ing the fin­ish line to full in­ter­op­er­abil­ity of pa­tient health data.

What does this mean? It means an upto-date, com­pre­hen­sive elec­tronic health record gen­er­ated from all sources—from doc­tors’ notes to test results to Fit­bit feed­back—that are ac­cu­rately and eas­ily shared be­tween providers. These records equip the care provider, pa­tients and fam­i­lies with the in­for­ma­tion nec­es­sary to make de­ci­sions that lead to suc­cess­ful out­comes. The se­cure ex­change of these records is vi­tal to the fu­ture of care.

As a na­tion, we are only par­tially there. Hos­pi­tals and health sys­tems have in­vested hun­dreds of bil­lions of dol­lars and made much progress in re­cent years to­ward achiev­ing full in­ter­op­er­abil­ity of health in­for­ma­tion. For ex­am­ple, 93% of hos­pi­tals na­tion­ally give pa­tients the abil­ity to view their health records on­line, up from 27% in 2012. And 88% of hos­pi­tals now send records to am­bu­la­tory-care providers out­side their sys­tem, up from 37% in 2012. This val­i­dates the sig­nif­i­cant ex­pan­sion of pa­tient-friendly por­tals cre­ated and sup­ported by care providers.

De­spite this com­mend­able progress, our sys­tem of shar­ing, se­cur­ing and trans­fer­ring com­plete pa­tient health data is still lim­ited in many cases by dif­fer­ing ven­dor plat­forms, ge­o­graphic re­gion, in­con­sis­tent use of stan­dards and other fac­tors. As a re­sult, health records and data that would pro­vide a more com­plete pic­ture of an in­di­vid­ual pa­tient’s health can be gar­bled in trans­mis­sion or re­main bot­tled up at the source.

In our call to ac­tion, we urge all pub­lic and pri­vate stake­hold­ers to re­dou­ble our ef­forts to com­plete a na­tional sys­tem of in­ter­op­er­a­ble health data.

What will it take? We of­fer six path­ways to ad­vance a sys­tem that works for all:

■ Se­cu­rity and pri­vacy.

Stake­hold­ers must be able to trust that shared data is ac­cu­rate, se­cure and used in ac­cor­dance with best prac­tices and pa­tient ex­pec­ta­tions.

■ Ef­fi­cient, us­able so­lu­tions.

Data must be avail­able where and when it is needed and in a use­ful for­mat.

■ En­hanced in­fra­struc­ture.

The in­fra­struc­ture to con­nect in­for­ma­tion-shar­ing net­works will re­quire con­sis­tent use of stan­dards, se­man­tics and a com­mon set of “rules of the road” for ex­change.

■ Stan­dards that work.

Con­nected sys­tems re­quire stan­dards im­ple­mented to min­i­mize pro­pri­etary so­lu­tions and gate­keep­ing.

■ Be­yond EHRs.

In­ter­op­er­a­ble sys­tems must ex­pand to in­clude pop­u­la­tion health, the so­cial de­ter­mi­nants of health and pa­tient-gen­er­ated data.

■ Best prac­tices.

All stake­hold­ers should ex­change best prac­tices so we can con­tinue to build on what works.

These ap­proaches will help to over­come the re­main­ing hur­dles block­ing in­ter­op­er­abil­ity ef­forts un­der­way across the na­tion. One ex­am­ple high­lighted in our re­port: HCA Health­care has au­to­mated a process for clos­ing the sur­gi­cal re­fer­ral loop. A sur­geon re­fer­ring a pa­tient to an HCA hospi­tal sends the rel­e­vant pa­tient records in ad­vance of ad­mis­sion. Upon pa­tient dis­charge, HCA au­to­mat­i­cally sends up­dated in­for­ma­tion back to the re­fer­ring sur­geon, who can pro­vide in­formed fol­low-up care.

There are many sim­i­lar ex­am­ples of in­no­va­tive think­ing and prob­lem-solv­ing in ac­tion. Hos­pi­tals and health sys­tems have done the best they can us­ing the tools avail­able to them, but we need more.

Achiev­ing full in­ter­op­er­abil­ity will ben­e­fit the en­tire health­care sys­tem. It will lead to strength­ened care co­or­di­na­tion; im­proved safety and qual­ity; em­pow­ered pa­tients and fam­i­lies; and in­creased ef­fi­ciency and re­duced costs. We’ve come far and the fin­ish line is in sight. Let’s cross over. ●

Rick Pol­lack, left, is pres­i­dent and CEO of the Amer­i­can Hospi­tal As­so­ci­a­tion. Chip Kahn is pres­i­dent and CEO of the Fed­er­a­tion of Amer­i­can Hos­pi­tals.

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