Redefining interoperability in the digital age

From Amazon pharmacy to Apple Health to Epic and Cerner battles to digital drug companions, the state of healthcare interoperability has come alive with digital power. And the COVID-19 pandemic accelerated this ability making telehealth mainstream for most medical specialties. These shifts and advancements have also stretched the concept of interoperability, with connection to patients, payers, providers, and pharma all taking place via high-speed internet.

But as digital connectivity enables users to be more connected to their health and healthcare providers, does the old definition of interoperability still apply to today’s digital world?

Recent Achievements in Interoperability

In 2016, Congress passed the 21st Century Cures Act, which makes patient information more accessible, and emphasizes the importance of making patients aware of their rights to access that information. Nationally, 95% of hospitals and 86%  of providers now use EHRs. Patients who were offered access to their online medical record by a health care provider or insurer was 42% in 2014 and had risen to 51% in 2018, and 63% by 2020.

Payer portals also make things easier for the patient. For instance, providers log in digitally to get information about prior authorization requirements and upload medical records. While barriers still remain in sharing information between hospitals or providers due to an individuals’ health care use, internet access and socioeconomic factors and solution development are helping to reduce those challenges and make connectivity more feasible.

As data gathering and information sharing has improved due to digital innovation, patients are reaping the benefits with less time spent at the doctor’s office.  For patients in diabetes management programs, reports are now generated electronically and can identify missing information or unusual patterns via remote monitoring devices. This means clinical staff can spend time reviewing information with the patients, rather than collecting it.  And it means that routine medical visits can now take place in a patient’s home instead of the physician’s office.

New rules of Interoperability

Initially, interoperability focused on what technology could do. Now, the focus is shifting to deliver the most value from data and standardize it across platforms and parties. To do so, data must be useful to clinicians and accessible to patients. In the digital age, it means redefining data standards, and ensure sensitive patient information is transmitted and organized consistently and meaningfully to support a cohesive and skillful patient experience.

Moving beyond standardization also means looking at where automation, machine learning, artificial intelligence and natural language processing can add value. As the volume of health information grows, systems must ensure that the most relevant data is shared so that clinicians can focus on insights that are relevant to a patient’s overall health. Machine learning allows for enhanced filtering through vast amounts of unstructured data and the ability to highlight the most relevant elements so that users can make more effective clinical decisions. With more users, more data, and more integration, technology can capture more insights and gain a more complete picture of patients’ health and advance how to address issues toward improved outcomes.

Health Interoperability Gets Personal

From the beginning, the exchange of health information was placed at the center while patients were viewed as more peripheral partners in the interaction. But with the advent of digital connection, that perspective has shifted to place the patient at the center with electronic health records and information exchanges as its supporting spokes. Patients are empowered to take control and use their healthcare data toward more healthy choices and engage in health-focused actions.

The result of digitally engaged patients have led to the advancement of greater interoperability achievements, including:

• Through mobile health records and digital initiatives like Apple Health Records, patients can control their health data and share it with providers. These tools promote rapidly growing partnerships that allow payers and providers to understand health behaviors outside of a clinical setting.
• Through the 21^st Center Cures Act and the Trusted Exchange Framework and Common Agreement, ONC is advancing the framework for HIEs to communicate with each other. This requires data sharing agreements, a trusted exchange framework and a common set of standards and guidelines. Implementing and adhering to this framework can create a comprehensive view of the patient record, while empowering the patient, who can be notified of requests for information and authorize them.
• Health-focused apps and digital drug companions put health insights directly into the hands of patients. Platforms such as Medisafe give patients access to their medications in complete view, track dosing, receive timely updates on titration scheduling, contraindications, and connect with providers to support adherence.

Patients now hold the greatest power in the interoperability debate, demanding increased access to their own information, support to manage their own health, and the ability to share information with their providers. Interoperability is no longer relegated to providers and payers, but now includes the person most impacted by the decisions – the patient.

The future of interoperability

Most would agree that the goal for healthcare is an open and secure ecosystem where individual patients can access their data effortlessly through smart apps, and clinicians can access additional information from external systems efficiently and seamlessly. Health systems, payers, providers, and hospitals are all striving toward innovative and yet manageable approaches to interoperability. In the very near future, expect to see more advanced organization of claims, accurate diagnosis, computer assisted coding and other patient insights using the latest artificial intelligence in healthcare.

Real-time data exchange of relevant healthcare information between payers and providers improves not only the quality of care, but the efficiency in which it is delivered

in the evolution to value-based healthcare. Simplifying the previous pains of a manual process relieves the stress of managing a chronic condition, for both the provider and patient, can contribute to an improved patient experience for a wide range of healthcare needs.

Consumerization of healthcare is also a major force that is propelling health innovation all over the world. Health systems have responded with new digital initiatives and departments specifically focused on the digital health. Expect to see more connectivity between provider and patient as security channels improve.

Interoperability in healthcare will create a more productive, coordinated, safe and accurate patient experience that enables providers to access data from disparate sources to more holistically understand the patient’s medical history and inform treatment decisions. The result of enhanced connectivity is fewer hospital losses, reduced clinical errors and costs, and increased margins for the industry with greater likelihood of retaining patients.