healthcare IT today covid-19 interoperability
April 29, 2020

Interoperability Driven by COVID-19

As part of our Healthcare IT 100 in 100, we asked a wide variety of healthcare interoperability experts to chime in on the impact of COVID-19 on healthcare interoperability.  Plus, then we asked them how it will impact health data sharing going forward.  Their responses were largely positive, but did highlight the challenges we still face with interoperability in healthcare.

One thing was abundantly clear from our panel of experts.  COVID-19 has exposed many of the flaws in healthcare.  Lucie Ide, Founder of Rimidi, shared that “The pandemic really highlights the need for data in a standardized format that’s connected to the patient record in the EMR across different health systems, different EMR vendors, different geographies, etc. How can we study trends when we don’t have a full clinical understanding of patients who test positive?”

Plus, Ide also added that “Only 5.8% of known COVID-19 cases had data available pertaining to patients’ underlying health conditions or potential risk factors. We need to connect data about pre-existing conditions and other patient characteristics to testing in order for public health officials to get a clear picture of risk.”  I’d add that it’s not just public health officials, but clinicians on the front lines need this data as well.

Marilee Benson, President of Zen Healthcare IT offered praise to existing health information exchanges and national trusted exchange networks like Commonwell, Carequality, eHealth Exchange, but also pointed out gaps like CMS asking hospitals to manually submit manual excel sheets daily.  Really?

On a positive note, Josh Douglas, Chief Technology Officer at Bridge Connector, said “The pandemic has forcefully exposed flaws and misalignment within the system, the fixes of which will hopefully be expedited as a result of the rapid response COVID-19 has required. Everyone has had to lend a hand for the greater good, and this has really been remarkable to witness.”

Benson from Zen Healthcare IT and Douglas from Bridge Connector both pointed to the way COVID-19 has helped overcome some of the previous political obstacles that existed prior to COVID-19.  However, Benson suggested that we better make sure that we address the technical issues as well when it comes to working across a wide range of new and old technologies that must coexist.

Chris Klomp, CEO of Collective Medical, described the new environment of collaboration this way, “Over the past few weeks it’s been incredible to see unique and free flowing collaboration between different stakeholders. For instance, some community resources and epidemiologists are now working in tandem with care teams on the front lines to ensure patients receive the proper follow-up care and continued instructions for their health. Equally important, these groups are also alerting emergency departments if a patient who is at high-risk, or has been exposed, enters their facility. This is great because EDs now have the knowledge to protect themselves, their staff, and other patients so they can continue to serve their communities.”

None of us would have chosen a pandemic as the solution to healthcare interoperability’s political problems, but it’s great to see healthcare organizations collaborating to ensure the right information is there to treat a patient and to understand the progression of the pandemic.

Looking at interoperability from a different angle, Matthew Michela, President and CEO of Life Image, highlighted how lack of interoperability poses other risks when health data sharing is done by what I call “sneaker” net.  Michela offered this example, “Approximately 80% of all medical images are still being exchanged using physical media such as CDs, a technology that is obsolete in the consumer world. The result is increased operational costs, unnecessary repeat exams, inconvenience, clinician frustration, poor patient satisfaction and outcomes. But, now more than ever, it is imperative that healthcare workers have as much relevant clinical data in advance as possible through digital connections before a patient arrives. Virtualizing and digitizing care not only helps with care coordination, it also supports social distancing and reduces infections. ”

It’s great that many of the previous challenges are starting to be set aside and we’re finally benefiting from healthcare interoperability.

What does all of this mean for the future of Healthcare Interoperability?

Overall, the experts we worked with seemed to agree that coming out of the pandemic we’re going to see increased interoperability across the spectrum.  Plus, we can expect care teams working together to come up with unique solutions that they wouldn’t have been discovered otherwise.  The value of interoperability has never been more apparent than it is right now.

Douglas from Bridge Connector predicted that, “Payers will want to better predict — and mitigate — risk for the next event of this kind. The required population health data and insight to deliver on this can only be gleaned from a more interoperable healthcare industry.  Plus, when the pandemic is over, it seems unlikely any one of these stakeholders will want to to “put the genie back in the bottle” and revert to data systems that are not integrated. I suspect legislators will also increase the incentives to improve interoperability as we try to prepare for the next global pandemic or national health emergency.”

In order to push this along, Ide from Rimidi looked at after the Ebola outbreak as a predictor for what we’ll see after COVID-19, “The case for connecting EHR data to public health research was made in a JAMA article following the Ebola outbreak, and I think similar pushes will be made post-COVID-19.”  I’d just suggest that won’t be one article like Ebola.  It will be hundreds of articles.

Eric Rosow, CEO of Diameter Health, offered a different take that focuses on the clinicians, “Provider abrasion” or the negative effects of manual processes and busy work on healthcare providers have been brought into focus by the pandemic. By contrast, data-based automated processes have the capability to save precious provider time and stress by providing accurate and actionable data.”  I hope that he’s right and we can do things to improve provider efficiency and remove those things that were making providers inefficient.  I’m looking at you operational minutea, reimbursement requirements, and regulations.

The good news is that the technology to make this a reality is here and available.  Michela from Life Image aptly pointed out, “The technology to digitally transfer medical images and information at scale, across all manufacturers and in a highly interoperable way that eliminates the need for CDs, has been widely available for more than a decade.”  This is true not only for images, but across the whole spectrum of healthcare data.

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Published by John Lynn, Healthcare IT Today, April 29, 2020.