- Timed to coincide with the release of a new report by the Healthcare Leadership Council (HLC) and Bipartisan Policy Center (BPC), a broad-based panel of public and private sector representatives at HIMSS on Thursday tackled the thorny issue of healthcare interoperability.
The panel was moderated by Tom Daschle, BPC cofounder and former Senate Democratic Leader from South Dakota.
In kicking off the discussion, Daschle said that “information sharing is essential not only to improve care for individuals but also laying the foundation for payment and delivery reforms that reward better outcomes. In addition, it is increasingly recognized as a vital element of the efforts to improve population health.”
“Our report calls for a number of private and public sector actions that we believe could accelerate interoperability and information sharing in the United States. There is wide recognition that it is an essential foundation for improving the quality, cost, and patient experience of care,” he observed.
The HLC/BPC report is the result of a year-long effort involving more than 100 leaders representing clinicians, hospitals and health systems, health plans, life sciences organizations, technology and data analytics companies, and patients.
The report stressed that action to improve interoperability should initially focus on bringing information to the point of care to support care delivery and meeting the information needs of individuals to support their healthcare.
Several recommendations in the report align with proposed rules recently released by ONC and CMS.
Report recommendations include:
- Strengthening the business case for interoperability by aligning incentives among payers and providers, as well as providers and health IT vendors, to implement shared expectations for interoperability, which can include model contract language or other mechanisms
- Improving the technical infrastructure for interoperability by adopting baseline standards to improve patient matching across systems, pursuing rapid adoption of HL7 FHIR APIs to accelerate information sharing, and including testing of interoperability in future ONC Health IT Certification Program requirements
- Adopting a common “notice of information access” for patients and aligning consent policies for substance abuse treatment under 42 CFR Part 2 as well as state privacy laws with HIPAA to make it easier for individuals and providers to gain access to health data
- Expanding public and private sector collaboration on measuring interoperability progress and developing and executing private sector actions to drive improvements
To kick off the panel discussion, HLC President Mary Grealy said that the “time is here, the time is now to achieve full nationwide interoperability of health information and to have secure, seamless access to data for clinicians, patients and healthcare consumers.”
“Interoperability is critical if we are to reach our consensus goal of high-value, high-quality, safe, cost-effective, patient-centered healthcare,” Grealy said.
Change Healthcare President and CEO Neil de Crescenzo, who is also the HLC chairman, said that the healthcare industry has reached a “tipping point” in terms of understanding the importance of healthcare data interoperability.
American College of Physicians EVP and CEO Darilyn Moyer told the panel that “practical interoperability is getting clinically relevant data to the point of care that is up to date and isn’t going to result in cognitive overload for the patient and those who are taking care of the patient.”
National Health Council VP of Policy and Government Affairs Eric Gascho observed, “All these healthcare systems are not talking to one another. One of the best ways to be able to do this is to bring the data to the patient and allow them to be their own best advocate.”
“We would like to bring all of the information out there together and be able to determine what is the right course of treatment for the right patient. The data is there; we just need to get the systems to talk with one another,” he added.
AdventHealth President and CEO Terry Shaw commented that third-parties need to be incentivized to provide smart AI embedded in the healthcare process. “Today we don’t have that, and we don’t have it working the way it should,” he added.
“Our most notable progress has been in the hospitals. Almost 90 percent of hospitals send and receive information one to another. That’s a good success story. The gap comes in the form of 600-page reports that doctors at the point of care have to sift through. It just doesn’t work,” said Leidos Health Group President Jonathan Scholl.
Surescripts CEO Tom Skelton said: “Let’s sit down together, public and private, and create that partnership, make sure we understand what we are targeting, and let us coalesce around that and make that progress happen that all Americans require today.”
National Coordinator of Health Information Technology Don Rucker identified two key concepts in the ONC proposed rule and the HLC/BPC report: using standards-based APIs and guaranteeing security/privacy.
Rucker stressed that most of the interoperability work happens in the private sector. “I see the role of the ONC as smoothing out the rough spots … and as serving as a proxy for the patient in all of this,” he said.
Cerner VP of Interoperability Kashif Rathore said that “incentives in today’s healthcare environment are not based on the outcomes, but more on the volume … Interoperability needs to be a priority and not just a ‘nice to have’. All of the stakeholders can influence this to move thing forward.”
Patient matching standards are a key aspect of improving interoperability. “If you can’t match up the patient, exchange of information doesn’t occur,” Rathore noted.
Hearst Health SVP Jeff Rose stressed that “doing the right thing is not always financially advantageous.”
“The business case for interoperability is where it gets dicey. That is because of the difference in reason why I want to get to interoperability. It might benefit you, but it doesn’t benefit me. So, the levers to be pulled related to the macro business case, which is, we want to provide value-based care at the lowest cost across the continuum and centered around the patient. You can’t do that without interoperability,” Rose said.
“There is a need for public and private collaboration on identifying and measuring those key metrics that allow us to evaluate national progress on interoperability toward information sharing,” concluded American Academy of Family Physicians SVP Shawn Martin.