Empowering Value-Based Care Through Interoperability

Health IT adoption has accelerated rapidly during the COVID-19 pandemic, with hospitals, health systems, and patients turning to digital health technologies for care delivery. This shift lays the groundwork for ongoing growth and innovation in 2021, as well as advancements in electronic health record (EHR) interoperability and standardization. With the Health and Human Services’ finalization of its interoperability rules—aimed to help patients gain better control of their health data via smartphone apps—interoperability is expected to increase between providers, payers and health tech developers.
 
Connected medical devices have become both a focus of great potential and source of concern for hospitals during this time of upheaval and transition. Medical devices and digital solutions generate critical clinical data to ensure timely and life-saving interventions. At the same time, they also bring implications about safety and security, especially if they are not properly configured.
 
Healthcare providers looking to optimize EHR interconnectivity, as well as medical device connectivity, should consider how to meet the full data requirements of clinicians, researchers, IT security, and clinical engineering.
 
While many hospitals and health systems have integrated a small percent of medical devices into the EHR, the actual amounts of data kept in the patient’s record represents only a fraction of information generated by these devices. When health-related medical devices are not interoperable, such as infusion pumps and pulse oximeters, they can create a significant added burden on healthcare professionals.
 
In this environment, medical device manufacturers, healthcare providers, and other stakeholders should focus on finding new ways to tap into operational efficiencies and focus on innovative interoperability solutions geared toward an increasingly data-oriented, value-based environment. For example, an optimized EHR should provide information on what medical devices a patient uses in near real-time.
 
Effective EHR Interoperability
When implementing a new EHR, typically medical device integration exists as a required portion of the EHR implementation, but it can leave the provider with the task of managing the vast data pulled from different medical devices. The challenge is to apply best practices in optimizing this integrated system. Organizations that partner with a value-based care enablement solution are more likely to hit their metric goals for medical device integration.
 
EHR interoperability has the ability to improve patient care; enhance patient-centeredness and communication; and advance programs related to education, timeliness, efficiency, and equity. Effective interoperability also enables healthcare professionals to promote preventive medicine initiatives and better coordinate care, as well as reduce waste and redundant testing.
 
While current federal rules require providers and payers to free patient data from behind their organizational walls for use with patient apps and broader data sharing, only 24 percent of providers and health plan executives surveyed by PWC view this as an opportunity and only 44 percent said their organizations are heading into 2021 with a solid interoperability plan in place.
 
Medical device manufacturers and other healthcare stakeholders should view this discrepancy as an opportunity to provide long-term sustainability and enterprise-wide resilience for these organizations, and provide robust interoperability capabilities to help them meet the shift toward a value-based healthcare system. When patients are empowered to make better choices related to their own health, the investment in interoperability solutions and connected devices can lead to lower costs, improved quality of care and better patient engagement.
 
Focus on Value-Based Care
Value-based care models rely on massive amounts of patient information to be collected and organized in a meaningful way between systems, all of which must be standardized. Synthesizing this data will allow for more guided care that also addresses social determinants of health (SDoH)—socioeconomic factors that affect and result in more proactive “upstream” healthcare to prevent health problems from developing.
 
About 30 percent of healthcare resources are wasted, but when records and data are properly organized and able to be analyzed, providers can identify areas that need more financial support, and others that might be wasteful. In turn, this helps providers create a better and more efficient system designed to deliver honest and useful healthcare to its patients, as well as being financially accessible for the providers.
 
When health information and interoperability solutions are designed to deliver a personalized and integrated experience to consumer patients, they have the potential to increase provider productivity, better engage caregivers, improve outcomes and enhance affordability. New technologies also have the potential to foster care that can be delivered in any setting (including the home) to support continuity of care and curb rampant healthcare costs, which is especially critical for chronic conditions.
 
Value-based risk analytics, quality measures management, risk scoring, and financials in a single-source, cloud-based platform represent the wave of the future for many healthcare organizations. But it’s important to combine these capabilities with advanced clinical connectivity designed to help payers and providers close gaps in care, recapture hierarchical condition category codes (HCCs), and manage utilization to reduce the cost of care.
 
Optimizing Interoperability
Value-based care enablement solutions have emerged to help hospitals and health systems to effectively empower providers to identify open care gaps for proactive closure and provide payer-agnostic data to inform clinical, quality, and risk adjustment programs for improvements in quality and risk adjustment scores and patient outcomes.
 
Look for a value-based care enablement solution that is meaningful-use certified and offers real-time data insights captured from disparate sources, allowing 360-degree visibility into the patient’s health status based on information from EHRs, HIEs, claims, labs, pharmacy, and hospital sources. Some solutions enable users to see a medical device has been assigned to a patient from these data sources.
 
Through the aggregation of data, users gain real-time data transparency and patient-level drill-down dashboards. The solution should also provide improved workflow and collaboration opportunities to break down departmental silos across the organization.
 
The key to value-based care is to tap into meaningful data and technology applications to efficiently manage patient-centric care that results in improved outcomes and lower costs. Optimized interoperability enables healthcare organizations to leverage data, better manage their providers, improve performance, and deliver better patient care and outcomes.
 

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Josh Hetler, EVP of Business Intelligence at DataLink, is a customer-focused, healthcare technology leader with more than seven years of experience in building software products to improve the workflows for healthcare professionals in value-based arrangements. He onboarded two of the nation’s three largest Medicare Advantage health plans onto DataLink’s Evoke360 platform, which currently includes over ten thousand active users, managing over six million members. While at DataLink, he has held the positions of account manager, director of account management, director of product and software development, vice president of product, and vice president of customer success. Before joining the DataLink team, Hetler was a territory manager for MicroDose Sales and spent three years as a high school math teacher and basketball coach. He is a graduate of the University of Florida.