Simplifying Healthcare Delivery through Interoperable Systems

Muhammad Chebli, Senior Interoperability Product Manager, NextGen Healthcare and Zachary Sherburne, CIO & SVP, NextGen Healthcare
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Muhammad Chebli, Senior Interoperability Product Manager, NextGen Healthcare

As Interoperability Matures, Knowledge Grows

The past five years have seen an extensive growth in healthcare technology. Although emerging innovations stand to reshape how providers deliver care, end users are not always experiencing these benefits as quickly as they would like. A 2015 survey from Accenture notes that healthcare providers sometimes struggle to see the impact of technology in areas such as improving the quality of their decisions, reducing medical errors, and elevating patient outcomes.

The disconnect between usage and satisfaction serves as a rallying cry for advancement amongst both providers and vendors. One area on which many technology organizations are focusing currently is interoperability. There is consensus around the idea that facilitating smoother information exchange will help health IT reach its true potential.

 The industry has certainly progressed in terms of information sharing. When providers first implemented electronic health records (EHRs), the goal of the technology was to communicate information between clinicians within the same organization. These capabilities were then extended to share medical data across other organizations within the same system. Now, vendors have reached—and surpassed—those initial objectives with the ability to push and pull data to and from disparate organizations; however, there is still substantial room for growth when it comes to data sharing between non-affiliated providers.

  With a fully interoperable system, the primary care provider can pull the necessary data from the specialist’s system and import it directly into the patient’s medical record 

Benefits of Interoperability

As interoperability matures, physicians will start to reap the benefits of its capabilities, particularly in terms of knowledge management. For example, as it becomes easier to exchange critical data rapidly, providers will be able to optimize workflows and improve efficiency. Consider how much time a primary care provider without an interoperable system spends tracking down information about an existing patient who received care from a specialist outside the primary provider’s network. The physician may have to rely on the patient to bring documentation from the specialist, or the doctor may have to pick up the phone and call the colleague’s office. With a fully interoperable system, however, the primary care provider can pull the necessary data from the specialist’s system and import it directly into the patient’s medical record. Instead of wasting cycles hunting for information, the provider is able to move to the next phase of treatment quickly, fully informed about the patient’s care.

In addition to reduced wait times, when physicians have access to a patient’s complete health picture, they can reduce the likelihood of duplicative tests, unnecessary treatments and incompatible therapies. This prompts better, more efficient care, which not only improves patient quality of life but also takes costs out of the system. This is especially true for chronic condition patients who are seeing multiple providers.Zachary Sherburne, CIO & SVP, NextGen Healthcare

There are some positive trends that are already poised to change providers’ perceptions about interoperability. One is the increased use of direct messaging. Through this straightforward interface, more than one million providers and organizations have been able to exchange standardized clinical documents actively. This exchange has been enabled by Direct Trust - the collaborative non-profit connecting EHR, healthcare technology vendors, and provider organizations. In fact, more than 24 million secure healthcare transactions were sent through Direct messaging in the second quarter of 2016, a 79 percent increase over the same period one year ago. With this type of solution, organizations can push data out to one another—sharing critical care information in the form of standardized documents that detail a variety of patient information. As organizations increase their use of this technology, they will continue to enhance efficiency, lessen waste and elevate outcomes.

Looking ahead, there are evolving infrastructure advancements that support a “pull” of data, enabling providers to query and retrieve information as needed. These models show significant promise in that they support information exchange in a way that delivers relevant and timely information to physicians at the point of care. Unlike push technology, which delivers standardized content, pull systems allow providers to seek and retrieve only the data they require. Older pull models typically involved a central data repository that aggregates information from inside and outside health networks and provides longitudinal views of patient records across disparate systems. Newer integrations support a federated model where no centralized data repository is required because patient information can be located through an identity management system like the Surescripts National Record Locator. Physicians and other clinicians can then query and retrieve specific patient information directly from the source system to support more targeted patient care.

Interoperability is not a single end point to which organizations strive, but a journey that entails collaboration around standards, infrastructure, permissions and so on. To achieve fully comprehensive information exchange, providers and vendors must work together to proceed further down the path to seamless information exchange. On one hand, provider organizations must commit to exchanging information, and all levels of the organization must be on board with the concept and understand what it means to truly share data and how it can impact workflows. On the other, vendors must continue to advance interoperability systems to make them more efficient and approachable, as well as cost effective. As both sides work together to advance interoperability, health organizations will be able to leverage this interoperable knowledge to remove cost barriers, improve decision making, reduce errors and enhance patient outcomes.

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