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Can Interoperability Drive Value-Based Care?

Posted on December 14, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As the drive to interoperability has evolved over the last few decades — and those of you who are HIT veterans know that these concerns go at least that far back — open data sharing has gone from being a “nice to have” to a presumed necessity for providing appropriate care.

And along the way, backers of interoperability efforts have expanded their goals. While the need to support coordinated care has always been a basis for the discussion, today the assumption is that value-based care simply isn’t possible without data interoperability between providers.

I don’t disagree with the premise. However, I believe that many providers, health systems and ACOs have significant work to do before they can truly benefit from interoperability. In fact, we may be putting the cart before the horse in this case.

A fragmented system

At present, our health system is straining to meet the demand for care coordination among the populations it serves. That may be in part because the level of chronic illness in the US is particularly high. According to one Health Affairs study, two out of three Americans will have a chronic condition by the year 2030. Add that to the need to care for patients with episodic care needs and the problem becomes staggering.

While some health organizations, particularly integrated systems like the Cleveland Clinic and staff-model managed care plans like Kaiser Permanente, plan for and execute well on care coordination, most others have too many siloes in place to do the job correctly. Though many health systems have installed enterprise EMRs like Epic and Cerner, and share data effectively while the patient remains down in their system, they may do very little to integrate information from community providers, pharmacies, laboratories or diagnostic imaging centers.

I have no doubt that when needed, individual providers collect records from these community organizations. But collecting records on the fly is no substitute for following patients in a comprehensive way.

New models required

Given this history, I’d argue that many health systems simply aren’t ready to take full advantage of freely shared health data today, much less under value-based care payment models of the future.

Before they can use interoperable data effectively, provider organizations will need to integrate outside data into their workflow. They’ll need to put procedures in place on how care coordination works in their environment. This will include not only deciding who integrates of outside data and how, but also how organizations will respond as a whole.

For example, hospitals and clinics will need to figure out who handles care coordination tasks, how many resources to pour into this effort, how this care coordination effort fits into the larger population health strategy and how to measure whether they are succeeding or failing in their care coordination efforts. None of these are trivial tasks, and the questions they raise won’t be answered overnight.

In other words, even if we achieved full interoperability across our health system tomorrow, providers wouldn’t necessarily be able to leverage it right away. In other words, unfettered health data sharing won’t necessarily help providers win at value-based care, at least not right away. In fact, I’d argue that it’s dangerous to act as though interoperability can magically make this happen. Even if full interoperability is necessary, it’s not sufficient. (And of course, even getting there seems like a quixotic goal to some, including myself.)

Planning ahead

That being said, health organizations probably do have time to get their act together on this front. The move to value-based care is happening quickly, but not at light speed, so they do have time to make plans to leverage interoperable health data.

But unless they acknowledge the weaknesses of their current system, which in many cases is myopic, siloed and rigid, interoperability may do little to advance their long-term goals. They’ll have to admit that their current systems are far too inward-looking, and that the problem will only go away if they take responsibility for fixing it.

Otherwise, even full interoperability may do little to advance value-based care. After all, all the data in the world won’t change anything on its own.

iMPak Health with NoMoreClipboard – Healthcare Gadget Friday

Posted on April 27, 2012 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Our next entry in Healthcare Gadget Friday is the iMPak Health Journals from Meridian Health and NoMoreClipboard. You may remember that I called the iMPak Health Journals the most creative technology I found at HIMSS 12. As such I wanted to write more about how they worked.

Here’s a picture I took of the iMPak Health Journal:

It certainly looks pretty simple and it is. That’s done by design. You basically use the iMPak health journal by pressing down on the blue and red circles. Pressing these “buttons” kind of reminds me of the musical greeting cards you get. When you’d press it down the music would start playing. This works very similar. Although, you push the red button to start and then each of the blue buttons represent a response to a healthcare question. It’s as simple as that. You hold down the buttons and it records your answers.

Then, the next time you go for an appointment or through an NFC (near field communication) connection to your cell phone (almost all new cell phones will have this technology) the data is uploaded electronically to the NoMoreClipboard website. From there all of the data can be processed and seen by yourself and your doctor.

I’d hoped to have a video where you could see the use of the iMPak journal, but I wasn’t able to get one that did a nice demo. What I found so creative was how simple it was to collect data from a patient. They didn’t need to download an app. They didn’t need to buy an expensive device that they’re only going to use for a limited time.

Turns out that there are a lot of potential uses for these journals. Some areas that might find them useful are: Insurance Companies, Hospitals / Health Systems, Pharmacy Benefit Management, Pharmaceutical Companies, Employer Benefits Management, and Retail Pharmacies. Here’s a video which shows how it can be used:

One challenge that still exists with this device is getting patients to remember to use the device. A built in alarm that would go off to remind them to answer the questions could help to solve that problem. Although, the journal is so portable, I’d hate to have the alarm go off as you carry it around in your purse or something.

I’ll also be interested to see how many patients lose their iMPak journal or just forget to bring it to the office for their appointment. This isn’t an issue if they’ve been uploading their data using their own cell phone, but would be an issue in those cases where they’re uploading the data in the office.

The biggest competitor to this product is the various mobile health apps that are cropping up. One day I can see the mobile health apps really taking over this space. However, there are still many patients who don’t carry a smart phone or that can’t/won’t go to the hassle of downloading an app to track this stuff. In those cases, I find the iMPak Health Journal a really creative solution to getting the data to be able to provide better patient care.

Full Disclosure: NoMoreClipboard is an advertiser on this site.