Why data interoperability is critical in delivering consumer-centric care

To improve the effectiveness of focused care, the full continuum of patient data needs to be collected from a variety of sources and shared among all entities in the continuum.

There is growing momentum to share patient data across systems to improve the quality of care they receive.

The healthcare industry has long lagged other sectors in sharing data among different stakeholders to optimize value from that data, even though the healthcare industry has the greatest need for broad data interoperability to deliver effective patient-centric care.

Delivering the best care requires making data fluid within and among healthcare entities. Sharing data across systems gives healthcare professionals a comprehensive understanding of their patients, which can lead to improved outcomes and lower costs.

Interoperability is having its moment

The challenge of how to share patient data securely and easily with the health professionals and entities that need to provide quality care is not new. Yet, the solutions to address this challenge are only recently gaining momentum for three key reasons.

Industry trends toward value-based care. As the industry transitions from fee-for-service care models to those focused on value-based care, healthcare providers will be dealing with capped budgets. That forces them to plan effective care delivery for patients across the full continuum to achieve positive clinical outcomes and cost efficiency. Data sharing is critical to success in a value-based healthcare construct. Intermountain Healthcare is one example of an organization that leveraged data sharing to improve patient outcomes through patient-centric care and lower operating costs. One of Intermountain’s programs used interoperability to select the most cost-effective antibiotic for a patient based on an analysis of that patient’s demographic and clinical data in the context of historical data of people with similar data profiles. Stan Huff, MD, the system’s former chief medical informatics officer, credited their achievements in data interoperability to the use of the HL7 Fast Healthcare Interoperability Resource (FHIR) standard to establish data sharing between the healthcare system and state health departments, among other entities.

Favorable regulatory environment. New rules under the ONC Cures Act require healthcare entities to share data in a standardized format. In 2021, the final rules were adopted, including requiring health IT developers to provide FHIR-based application programming interfaces (APIs) to enable seamless data sharing. As of February 2023, 95 percent of certified health IT developers met the compliance deadline.

Increasing adoption of cloud computing. The amount of data captured in electronic health records (EHRs) is growing exponentially, and cloud storage is the most economical way to store that data. This enables several downstream analytics applications that are critical to deliver effective care. It is imperative for the data stored in the cloud be standardized, which is another key factor in advancing data interoperability.

Data empowers patient-centric care

To deliver effective patient-centric care, it is crucial that the full continuum of patient data is collected and shared. There are multiple types of essential data.

Patient histories from EHRs. Sharing precise, concise and complete summaries of the patient’s history give every healthcare professional a quick yet thorough understanding of that patient’s background.

Social determinants of health. Knowing these factors help healthcare professionals understand the full context of the patient’s challenges. For example, if the patient requires regular follow-ups or a 10-day course of outpatient clinic infusions, does the patient have transportation, or do social services need to get involved to arrange it?

Pharmacy data. This information is critical to provide a complete picture of all medications and their dosages. Pharmacological history will also note allergies.

Claims data. Claims data provide a holistic view of the patient’s interactions with the healthcare system. It’s critical to identify patients at risk for developing chronic conditions, analyze medication adherence and assess adherence to care plans.

Genomic data. A watershed moment for personalized healthcare is the advancement of genomic data. Previously, genomic data were expensive to obtain. Next-generation sequencing technologies broke that barrier. Much of a patient’s genomic sequencing data is now available and can provide valuable information about the medications that may be optimal for that patient and can help determine more precise risk assessments for developing future diseases.

Patient-reported outcomes. Patients using sensors and mobile applications generate lots of data. This type of data is extremely critical in managing chronic conditions.

Key pieces of data architecture

To take advantage of data sharing and promote patient-centric care, a healthcare organization needs two major components of technology to ingest, store, analyze and retrieve the data.

First, an organization needs a cloud provider that delivers the system infrastructure, such as storage space, computing power and security. Many cloud providers also offer applications and analytics tools that mine data for insights. They typically also provide ready-to-use application development tool kits so that users can develop customized solutions.

The other critical piece of technology is a care operating system, also called an interoperability platform. This layer unifies a healthcare organization’s complete data infrastructure. It breaks down the internal data silos and normalizes and harmonizes the data in different standards into FHIR standards. This standardized data can be ingested into the cloud and made available to other applications. It has the capability to return insights generated by different applications into clinical and non-clinical workflows at the point of care for improved patient outcomes and operating efficiencies.

While many cloud providers also offer interoperability functionality, they typically lack the healthcare domain expertise to make the data flow effectively. This is why healthcare organizations may benefit by adopting best-in-class solutions based on core competencies, including cloud providers for storage and the necessary analytics infrastructure and a robust interoperability platform as the care operating system to bring data to life.

Fulfilling the mandate

People have always wanted patient-centric care. It enhances the patient experience and paves the way for them to seek early intervention rather than avoid visiting a provider at an early stage. As consumers, patients are increasingly used to a more personalized experience and now expect the same in their healthcare journey.

Wide data interoperability among and within systems ensures an improved and individualized experience. This reduces the cognitive burden on patients and clinicians and eliminates waste, including duplication of tests, prescribing ineffective medications and avoiding procedures that do not work for specific genetic profiles.

To deliver value-based care, positive patient experiences and precision medicine that improves patient outcomes, healthcare entities must implement a robust data architecture. Practices and hospital systems that want to keep and attract patients to their networks will need to provide the personalized care that next-generation data infrastructure makes possible.

Harish Battu drives healthcare partnerships at General Catalyst, a global venture capital firm, where he advises the firm’s portfolio of innovative digital health start-ups. He also serves on the digital health steering committees of several healthcare organizations.

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