Recently, Jay Desai, our Senior Vice President of Strategy & Partnerships, was a guest on a HealthLeaders webinar, where he presented: “Harnessing the Power of Interoperability to Cultivate Whole-Person Care Collaboration across Providers, Patients, and Payers.” Jay discussed the past, present, and future of interoperability and explained the importance of it from various perspectives. The following is a summary of Jay’s presentation. You can watch the full webinar recording here.
Today in America’s healthcare landscape, there is an ongoing shift from fee-for-service to value-based care, where providers are financially rewarded for positive health outcomes rather than paid based on volume. Although part of the impetus for this shift started with the federal government’s Medicare program, many private payers now participate, and tens of millions of Americans are enrolled in different types of value-based care programs.
While this evolution has led to better care, it has also fueled the fire for a greater level of interoperability for payers and providers. In short, interoperability is the ability of different technology platforms to consolidate and share patient information between them. With greater interoperability, payers and providers—including primary care physicians, specialists, and other care team members—have more complete views of their patients. They can even receive real-time alerts when their patients are admitted, discharged, or transferred to and from other facilities.
While that sounds simple enough, there are many players involved and a bright, yet complex future.
The Many Players Involved
Interoperability efforts span far and wide, starting with our federal government. The Centers for Medicare & Medicaid Services, better known as CMS, leads the charge with their Interoperability and Patient Access final rule, which “establishes policies that break down barriers in the nation’s health system to enable better patient access to their health information, improve interoperability and unleash innovation, while reducing burden on payers and providers.” In Washington D.C., there is also The Office of the National Coordinator for Health IT, known as ONC, which “is responsible for advancing connectivity and interoperability of health information technology (health IT).” Finally, there are a number of regional- or state-led health information exchanges, or HIEs, along with a mix of private and public companies working to collect and share patient data around behavioral and physical health and social determinants of health.
The Recent Progress
Over the past decade, much of the progress has been foundational. More and more patient data is being collected and stored across myriad technology platforms. Many healthcare information technology companies are responsible for this. CommonWell Health Alliance, for example, has seen two billion queries for 159 million patients. Here at Bamboo Health, we have seen seven billion queries around prescription drug monitoring for tens of millions of patients. And this is just the tip of the iceberg. There are billions of patient data points, albeit somewhat disconnected and difficult to share. The only logical question is, how do we share them? And how do we make them actionable?
The Transition from Foundational to Actionable
Fortunately, there has been a strong tailwind to push interoperability to this point. Now, we sit at the precipice, where we cross over from foundational to actionable. By actionable, we mean not only sharing data in real-time, but also being able to analyze and effectively use the data to create more detailed care plans and make more informed clinical decisions. This is the future of interoperability for payers and providers alike. It is a future where they will have more complete pictures of patients, which grants them the opportunity to offer better care. And it is a future where the patients themselves will live healthier, more fulfilling lives.
Will your organization be a part of the future of interoperability? Are you taking the right steps? Working with the right vendors? Pushing your state’s health department to innovate? Listen to the full webinar recording to learn more about interoperability and how your organization can be a part of its future.