Keys to Interoperability May be in Consumers’ Hands

Via HealthLeaders Media »

Making patients the stewards of their own health data could result in better access, despite a business environment where health systems do not make sharing a patient’s data with each other a top priority.

The barest outlines of the Trump Administration’s healthcare policy were not yet clear on the morning after Donald Trump’s upset presidential victory, but the CIO of a New York City health system was already looking forward to resolving issues unresolved by the election.

“If we were all on a common shared data platform and could easily access one another’s patient data, I think we would do a much better job of keeping people healthy,” said Daniel Barchi, senior vice president and chief information officer of New York Presbyterian Hospital in New York.

Speaking at the inaugural Techonomy Health conference last week in Half Moon Bay, CA, Barchi expressed hopes that the industry can agree to make patients the stewards of their own data moving forward.

In this way, he believes, patients can be at the center of sharing data in a business environment where health systems still do not make sharing a patient’s data with each other a top priority.

“The standard [in the 2009 American Recovery and Reinvestment Act] was so low,” he said.

“I can send a couple of packets of data. You can send me a couple of packets of data and check the box. That’s it. It’s not really interoperable in any way. And the EMR vendor was really not incented in any way. They were just helping everybody get live on all these new systems.”

No Incentive to Share Data

As a result, healthcare CIOs find themselves having built “really great complex systems within our own health systems, but aren’t incented to share data in any way, and so we’re doing it through a lot of back-door work,” Barchi said.

He equated continuity of care (CCD) documents to “electronic faxes, a couple-of-page PDF version of somebody’s care. Sure you can shoot it back and forth electronically, but you’re not going to interact with it.”

Barchi said he forward to accelerating innovation on the care coordination front.

“There’s an expectation in the technology industry that we have absolute huge airplane hangars full of people at desks making phone calls and checking up on people at home,” he said.

“Even in a $7 billion health system, I might be able to introduce you to our 17 care coordinators individually by name, so we’re not at the level where large health systems have these workforces that are incented to keep people healthy.”

Rooting Out Inefficiencies

Speaking at the same event, another speaker said technology is showing promise to squeeze inefficiencies out of back-office work.

“The provider is the main deliverer of healthcare,” said Jim Dougherty, who serves as CEO and co-founder at Madaket Health, a cloud-based service startup, which automates provider enrollment in payer plans.

“We’ve said we’re going to focus on making their lives better,” said Dougherty, a former member of the board of directors of Beth Israel Deaconess Medical Center in Boston.

Such enrollment still relies too often on laborious fax-based workflows. Via Madaket, a process that used to take a provider and payer 45 days “now takes two days, which benefits everybody,” he said.

Such cloud-based technology platforms can also be extended to accelerate other workflows.

“We at New York Presbyterian have this issue,” Barchi said, commenting on Madaket’s technology. “Mass General has this issue. Mayo has this issue. We all have this credentialing and payer issue with vendors. This is the kind of solution that will get in and solve a problem that occupies anywhere from 10 to 30 full-time employees on this kind of issue.”

One concern is whether to implement such point solutions in a piecemeal fashion, or to looking “to change the way that we’re running the healthcare system.”

Barchi said part of the answer will come from the next generation of electronic medical records.

“There are always upgrades that are happening to get better and better at sharing data,” Barchi said.