“We’ve got this window where the provider strength from Nashville, plus the national nature of board, can really do some historic things,” says Ed Cantwell, executive director of the center, which was launched earlier this year.
Balser and Carpenter answered a few questions for the Post about their organizations’ approaches to interoperability and their involvement in the Center for Medical Interoperability. For more on the bigger issue of getting medical information systems to talk to each other, click here.
What are the biggest interoperability challenges for your specific organization?
Balser: The challenges facing VUMC when it comes to large-scale data sharing outside our system aren’t that different from those of other health systems. To help address issues of interoperability, we are making a substantial investment in new information technology that, when fully implemented, will enable providers, hospitals and health systems from across the Vanderbilt Health Affiliated Network to efficiently share data. This investment is a necessary step in the process to scale up and sustain our population health initiatives.
Carpenter: Like any provider organization, our greatest challenge is ensuring that our clinicians have access to all the information they need when, where and how they need it. This includes data from disparate sources, including electronic health record systems and data generated from various medical devices and equipment. However, just pulling the data together in one place isn’t enough. It has to be available and presented to clinicians in a way that makes sense and fits within their workflow as they care for patients.
How should patients think about interoperability?
Balser: While the average citizen may not be familiar with the term our industry has adopted to characterize perhaps the most pervasive problem confronting health care delivery today, they’re very familiar with the issues of interoperability from a consumer’s perspective. Who hasn’t experienced difficulties with the portability of their medical records? A task as simple as seeing a specialist for the first time or visiting an out-of-town emergency department can be frustrating or perhaps even dangerous if vital medical information can’t be obtained.
A majority of the public wonders why physicians and hospitals can’t communicate with each other more effectively when you can get a mortgage or do just about anything else online. However, I think the public should understand that regulations intended to ensure the privacy of their health information make the challenges we face even more difficult.
Carpenter: For patients, interoperability is really about improving care. It is a vital part of expanding patient-centered care models. Most people see many health care providers working across many settings — annual appointments with a primary care doctor, consultations with a specialist or two, that unexpected visit to an ER. Interoperability ensures that each of these providers has the best, most up-to-date information on a patient and that that patient is receiving informed, optimal care.
Interoperability also can give patients and families ways to be more engaged in the care they receive through technologies like patient portals. If we share information with patients, we improve their ability to be an active member of their care team. This is an important step for empowering patient accountability and encouraging better health.
How are the physicians in your organization approaching this issue?
Balser: Because we are a tertiary referral center, the physicians at VUMC are more frequently encountering issues related to access of patients’ prior records. There is no lack of awareness among our providers about the difficulties surrounding the transmissibility of health information. Having long been the beneficiaries of IT tools that were created in-house which afford an array of options and conveniences in the clinical setting, our clinicians understand the institutional priority we place on having the best of these offerings. And many are actively engaged in making our capabilities more interoperable and available across the country and around the world.
Carpenter: For providers, interoperability means a timely, comprehensive view of a patient’s health status. It can improve a clinician’s ability to make the best possible clinical decisions and enhance their ability to engage patients in care. By breaking down barriers that exist, it also can enhance provider collaboration.
What is the impact of the Center for Medical Interoperability on the industry and Nashville?
Balser: The center brings a national voice and focus to the problems we all need to work together to solve in order to move health care forward in a way that will fully deliver on the imperatives of improving service and controlling costs. I’m proud to have a role on the center board and believe that VUMC and the center can work together in many ways.
For example, we are working with the center on a project to upgrade our wireless network to medical-grade for all mobile devices. The center’s presence here in Nashville is logical. In addition to a top academic health system, we have a host of other large, successful nonprofit and for-profit hospital systems based in our region. As a city, we are an incubator that represents all aspects of health care. The center will thrive in Nashville due to the many favorable conditions and diversity of perspectives that will contribute knowledge toward solving interoperability’s challenges.
Carpenter: The Center for Medical Interoperability really exists to improve the safety, quality and affordability of health care. This means that its work is important to the success of provider organizations as well as health IT and device innovators across the country. We are fortunate that many of these health care provider and technology organizations are based in Nashville. These organizations, including LifePoint Health, benefit significantly from being in close proximity to the center. It allows us to actively participate in the center’s activities and influence their work and how it takes shape.
We all understand the great potential for technology to transform patient care and make our health care system more efficient and effective. But there are a lot of barriers to this potential being achieved right now. Health care is rife with records systems that can’t share data and devices that can’t communicate with one another. We have to fix this. To achieve its full potential, technology needs to be developed with the perspective of those who provide patient care. And it needs to be developed with some kind of industry standard in mind. The Center is making sure that this happens.