What Does Interoperability Mean to Patient Health?
Despite years of discussion and initiatives designed to improve interoperability in healthcare, not much progress has been seen. A set of industry standards for data elements would be almost impossible to implement, as it would require healthcare providers, payers, agencies and vendors to change current systems, reconstructing data models at a cost of millions, if not billions, of dollars.
For those unfamiliar with interoperability, as data is exchanged from one system to another, the fields must be easily translated. Items like date of birth of a patient may be an easier fix, although systems can be set up to report as: 1/1/60; January 1, 1960; 1-January-60; or countless others. Simple exchange rules can help interpret that data and make them consistent.
At the SXSW conference in March, former Vice President Joe Biden pushed the public agenda of the Cancer Moonshot by asking innovators to make data-sharing easier. According to the Los Angeles Times, Biden “pointed out how easily websites and apps had made it to buy movie tickets or cash checks at the swipe of a finger on a smartphone, then wondered why cancer patients like his son couldn’t just as easily send test results from one hospital to another.”
Yet the more complicated fields will require a framework of transparency, as well as security of a patient’s individual data.
For example, an oncologist may write that a patient has liver cancer and use the appropriate ICD-10 code for liver cell carcinoma; but in the ‘notes’ field may list the specific cancer as fibrolamellar HCC – a rare type of hepatocellular carcinoma that is more responsive to treatment. Payers may have in their records reimbursements for a surgical intervention for hepatocellular carcinoma and follow-up with a multi-drug chemotherapy protocol. A health system has an additional set of records for that patient when undergoing the surgical intervention, possibly including imaging results. The specialty pharmacy may have transactions for the patient with multiple chemotherapy drugs – time and frequency of dispense, but not have the specific reasoning behind this treatment path. The specialty distributor may only have the types of chemotherapeutic agents being delivered to the practice on specific dates and the cost, but not the specific disease attributes for that patient. Add in the recent introduction of patient-generated health information from wearable devices and apps, and you have expansive sets of data to interpret.
Understanding how to address those gaps in information and present an accurate snapshot of the patient, their diagnosis and treatment, is critical within a value-based care system. That accounting of the patient health story will be required to be timely, so more informed health care decisions can be made quickly. It can also help life sciences companies when an earlier intervention for a specific drug or device might be applicable.
“For more than a decade, we have understood the need to provide accurate and targeted information on a timely basis. We have developed over half a million business rules which quickly distill our data fields to create a consistent and valid representation of the patient journey,” noted Susan Weidner, senior vice president at IntrinsiQ Specialty Solutions. “It is that integration of patient care intelligence that allows us to understand treatment patterns, physician behaviors, as well as market trends.”
Driving transformation in the healthcare system with information technology, tearing down those data silos, will only help to move closer to more informed decision making around a patient’s health.