Patient-centered care in an interoperable environment

The final rule on interoperability from the Office of National Coordinator of Health Information and Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) were issued early in March of 2020 and were nothing less than a landmark; however, just weeks later, the interoperability rules were pushed back as US healthcare streamlined all of its resources to battle the COVID-19 pandemic.

The interoperability mandates that would have nudged healthcare into a truly digital era became an afterthought as the country dealt with a crippling pandemic. The paradox is that COVID-19 has highlighted the critical need for exactly what the rule would have encouraged: the advancement of interoperability for care coordination and greater data sharing across healthcare organizations.

Interoperability is critical to the fight against COVID-19

Although CMS has only announced a delay in enforcing the rule, the need for making healthcare data interoperability has only become more obvious. Had interoperability gone into effect earlier this year as planned, many healthcare organizations would have been able to securely share the data they have around their patients for seamless care coordination. Data flowing across geographical borders would have been extremely useful in detecting risk factors, identifying resource shortages, and pharmaceutical development.

So far, the current healthcare system is only slightly better than a patchwork of different data systems, and COVID-19 has exposed these gaps. While we have pivoted our efforts to combat the pandemic, the success of these containment measures will heavily depend on the timely exchange of critical information. Healthcare’s response to the pandemic will rely on the effective collaboration of healthcare providers, community health organizations, labs, and insurance companies to test patients, identify patterns of infection, and design ways to improve these activities over time.

Creating a foundation for impactful health innovation

Technology in healthcare has continued to evolve, but the siloed nature of data systems and archaic practices of sharing data thwarts much of the potential positive impact. However, with the COVID-19 outbreak, the stress on frontline healthcare workers to assess a patient’s healthcare history and prioritize them based on their risk has increased dramatically. A patchwork of systems or makeshift data exchange infrastructure will not suffice.

Although electronic health records (EHRs) have been around for a long time now, data from other systems often doesn’t flow into the EHR. As a patient moves from facility to facility in the continuum, the information rarely moves with them, except for physical notes. Implementing interoperability among systems would allow real-time, patient-centered care.

Critical patient information can be delivered to providers to understand more about their patients, their risk profiles, their travel history, previous episodes and more. The quick access to data would be useful in reducing redundancy in tests and procedures and helping the patient receive more rapid care. Additionally, interoperability among providers can ensure that all physicians are accessing information that reflects real-time changes and can better coordinate care among themselves for the patient.

Interoperability can be significantly helpful in reducing patient-facing tasks such as filling out forms repeatedly or explaining their medical history to every new provider. Access to updated and real-time information can result in faster and more efficient treatment and better patient experience of care. In addition to that, the new ONC interoperability rule encourages healthcare organizations to let patients have ownership of their own health data. The patient is the common entity in all healthcare encounters, and it’s important that they have access to their information and that their providers have access as well, because they are ultimately the ones coordinating all of their care.

The road ahead: advancing interoperability for the future

The Coronavirus outbreak demonstrated the importance of the ONC rule. While it’s only an idea of what critical data capabilities we need for future crises, we know that a strong data infrastructure could help in being more precise in our response. Interoperability will ignite significant and sustainable change in healthcare quality, delivery and payment and we need to make sure that individual health systems are connecting in an interoperable as well as an effective way, with a strong, scalable infrastructure backing it up.

_{About the Author}

_{Abhinav Shashank is the CEO and co-founder of Innovaccer, a leading San Francisco based healthcare technology company.}