Health Data Interoperability: Online Shopping Provides Model

According to most surveys, at least half of medical practices have still not adopted EHR systems. And for many sites who have adopted EHRs, they are primarily still in "data-entry" mode, merely replicating their manual paper-based processes. Those processes usually don’t translate very well into the electronic world; indeed, many facilities keep much of their pre-EHR process flows in place, even after EHR adoption, thus duplicating effort and increasing cost. Then those sites become part of the chorus of naysayers who loudly proclaim that EHRs "don’t work."

One complaint that is often heard about EHR systems is that they don’t "talk to each other." However, an announcement last month at the annual convention of HIMSS - the Health Information Management Systems Society - shows great promise in removing some of these critical barriers. This is a pivotal step in creating a truly advanced digital healthcare ecosystem.

The announced collaboration, named CommonWell Health Alliance is a not-for-profit alliance of six major healthcare software vendors. It is designed to provide for unprecedented standardization and interoperability. The six companies are Greenway, Athenahealth, Allscripts, RelayHealth, Cerner, and McKesson. They represent the entire spectrum of providers and care settings, from ambulatory to acute. 

This is a critical step for many reasons, not the least is the obvious one …every patient who goes to a physician’s office, a hospital, or a clinic is growing increasingly frustrated with the ubiquitous front-desk clipboard, the excessive amount of duplicate paperwork, and the overall inefficiencies that are obvious in healthcare. They wonder why they have to manually fill out their medical history for the umpteenth time, but yet they can use their smartphone to find an open table at a nearby restaurant or scan a UPC sticker and find the best price on a big screen TV. Even for those who are fortunate to go to a provider or clinic that has implemented and optimized an EHR system, they are frustrated that those systems don’t communicate well with each other.

The CommonWell alliance recognizes an important fact - patients don’t care about your EHR, they just want you to have healthcare data automation that works, and one that gives them the freedom and flexibility in healthcare that they are used to seeing in their other personal/consumer arenas.

Healthcare can take a lesson from online pioneers like Amazon. When Amazon first launched, the value proposition was that you could browse from a large catalog of items (primarily books), and any time of the day or night, you could easily buy pretty much anything in their massive catalog without getting dressed up and driving to the bookstore. In other words, it was about convenience. The experience was efficient, but singular. It is unlikely that Amazon’s early software developers thought about anything other than supplying a massive product database catalog to an even more massive customer audience, and automating the buying process. However, once Amazon gained traction and a huge customer following, they realized not only that they could expand into other things beside books, but more importantly they realized they had an incredible amount of valuable data. Even people who merely browsed their site and ended up purchasing nothing added to Amazon’s growing trove of user data.

Today’s Amazon is much less about buying books while in your PJs, and much more about data liquidity, interoperability, and predictive analytics. Today’s Amazon users find the experience seamless, transparent, and intuitive, and it supports the way people think and act, not the way Amazon’s software developers expect or want them to act. Amazon doesn’t merely serve up what you are looking for, but makes suggestions – based on your prior behavior – of other things that might be of interest.  These latter attributes and feature are a form of optimization - the continuous improvement of the way Amazon designs their user interfaces and delivers their services to their customer base.

For healthcare, the CommonWell alliance is an important first step in developing and delivering an optimized digital healthcare experience to patients. Until now, software vendors have been developing and selling their software to and for providers, with each system being created largely in isolation. In spite of industry standards like HL7, subtle differences in database and program design has still created a hodgepodge of unique systems. Software interfaces, which are the technical (and expensive) analog of a Rosetta Stone, have provided for some interoperability. And the focus has been primarily on convenience.

Now with the CommonWell Alliance, we can get the major systems talking to each other, and eventually we can develop and deliver the kind of optimized data analytics that are commonplace at Amazon and other data-centric organizations.

For healthcare, one can only think of the tremendous benefit that could be gained when we have amassed the tremendous amount of data, along with the tools to analyze and make use of it. That will truly allow for the achievement of the Institute for Healthcare Improvement (IHI) Triple Aim - improved care, reduced cost, and better patient experience. I for one can’t wait to see it.