Interoperability: The Next Step in Successful Consumer-Driven Health?
While we’ve focused on interoperability on a small scale in previous blogs — EHR integration between a hospital and other local providers across the continuum of care — an even bigger challenge lies ahead. After all, we live in a mobile society. Shouldn’t patient data management happen at a national — and ultimately global — level in order to support consumer-driven health care?
That’s precisely what the Senate Finance Committee set out to discover when it called for comments on the availability and utility of health care data. Based on the responses received, it’s a topic that many health care organizations are already considering.
Consistency is Key
The Senate committee’s action followed on the heels of a report by the Office of the National Coordinator for Health IT. In the “Patient Identification and Matching Final Report” published earlier this year, the findings emphasized that a lack of standardization in disparate EHR or EMR systems — including something as basic as the formatting of names and addresses — prevents accurate record-matching in health information exchanges. Moreover, inconsistencies in state and federal privacy laws related to health information also impede health information exchange.
In its response to the Senate committee’s call for comments, the EHR Association (EHRA) said, “Patient identification that ensures accurate patient record matching across provider sites is a primary concern when aggregating patient information from multiple organizations. Error rates in existing technologies that manage patient identification are sufficiently high to cause concern about medical errors, redundant testing and inefficiency.”
The inability to match up records represents a serious failing.
CHIME (College of Healthcare Information Management Executives) also weighed in on the topic, suggesting that standardization and testing requirements need to be established for the various components of health care IT. EHR versus EMR, mobile versus web-based applications for providers or consumers– regardless of the type of IT, without consistent, accurate data input, the tools are useless.
According to Healthcare Informatics, CHIME suggested three areas critical steps:
- Implement a national patient matching strategy.
- Pass uniform privacy laws to enable more seamless data exchange among providers.
- Facilitate patient engagement with personal health records.
Right now, hospitals and other health care providers are addressing interoperability within a very narrow scope, which still results in a siloed health care system. As the EHRA and CHIME point out, interoperability must progress beyond simple EHR integration to realize the true value of patient data.
Why Data Fragmentation Matters
As long as patient data matching is inconsistent, health care providers will be unable to fully benefit from health IT. The EHRA notes that the goal should be to “… reduce fragmentation in patients’ health information and to more effectively support collaborative care delivery and data analytics.”
Nationally harmonized patient data will support more effective population health management, a critical part of reducing the national spend on health care. And that’s not the only advantage.
As consumers take on more of the financial burden of health care, they will become more discerning about the quality and cost of their care. That means that the path to purchase for health care — particularly on ‘big ticket’ items — is going to change.
Consumers will be looking for more than a physician’s recommendation when it comes to having a knee surgery, for example. What if shopping around leads a consumer to an out-of-state provider? Having access to an accurate health record will be critical for the health care provider and the patient.
Consumer-driven health care will also drive development of mobile health apps.
The Patient-Centered Outcomes Research Institute (PCORI) has a study underway already. The Mobile Apps (MAPPS) project is investigating the “needs, attitudes, knowledge and behavior of stroke survivors and their caregivers toward mobile technology for health management.”
One participant, Julie Singer, said she would love a single mobile app to help her manage her role as a caregiver for her husband who experienced a stroke. And theoretically, it’s a realistic goal. Data tracked — from medication and appointment compliance to blood pressure, cholesterol, weight and activity monitoring — could be integrated with the EHR if standardization, data matching and privacy laws are addressed.
Ultimately, interoperability needs to scale nationally, across a multitude of health IT systems, to achieve lasting benefits. Even with a perfect data matching system in place, health care providers need to be more tuned into the needs and motivations of patients in order to compete in a consumer-driven health care marketplace.
Psychographic segmentation, one of the tools offered by c2b solutions, empowers health care providers and other organizations with the information they need to develop more effective patient engagement strategies. In January 2015, c2b solutions will field its next national study on U.S. healthcare consumers, and this will include a comprehensive look at their use of apps, websites, and other technology to enable self-management.