The Interoperability Light Goes On. Now What?

In our last conversation, we talked about your readiness for interoperability as an essential tool in driving better healthcare access, operational clarity, and reduced patient and provider cost.

Let’s assume the interoperability switch is on. Now, when patient Jones comes in for an appointment, your IT system receives data for the patient from 15 facilities. Some of the data domains are in standard formats. Reports and documents have various metadata and labels; much of the data still is not standardized or structured (typical of various aspects of notes and reports).

Some facilities received data on patient Jones from your EHR and are now sending that information back to you, but with processes that occurred before it was added to their EHR data. What automated processing and data management rules is your system going to apply? In your workflow, what happens next? What changes? If patient Jones sees another clinician in your facility after his visit, does that clinic benefit from the time you spent reviewing the data with the patient?

Perhaps it is too hard to imagine full data interoperability, so just consider medication and allergy reconciliation. Are the duplicates and conflicts from all the facilities evident and how exactly are you taking action to reconcile the list? It’s likely you are still looking at multiple lists of what has been prescribed to the patent, and not what the patient is actually taking. Assuming you reconcile meds and allergies within your 15-minute appointment, what data from that works gets updated to your EHR and how?

Now go back and think about all medical data domains and various documents and images that are available:

• When do you need that data, and in what format do you need it?

• What action do you need to take because of it?

• How is the data being stored/processed for meaningful interoperable uses now and later?

• How do you want to receive and interact with the data?

• Thinking about how your EHR works, do you see this going well?

• Are you more efficient?

This process and your efficiency would benefit from proper planning and work that ensures impacts to your work processes from data being interoperable provide value not just data (and therefore more work for you). Regardless of technology and standards adoption and their rate of maturity, there is much work to be done today to create effective business rules, and a process to handle and present the data received through interoperability. Applying this strategy will prepare your organization to leverage full data interoperability and achieve outcomes aligned to the Triple Aim.

Fortunately, much of this work is the same work that should be happening for data migration from legacy systems and for handling of both patient-provided data from their health records – for example, BlueButton -- and patient-generated data from various mechanisms.

Remember: not all data has value, but all data has cost. What data is essential to each situation as well as when and how does it need to be presented to improve decision making, efficiency, outcomes, or patient engagement? These are questions you should be asking of the user.

Accenture is deeply engaged in finding solutions to those particular challenges. These challenges are manageable. The firm’s focus is assisting clients in achieving better results from accessible data. Our research and the level of interaction we’re having with our clients tells us we’re on the right track to providing the kinds of solutions needed for a more efficient, streamlined system.

So, after this blog and my recent piece on preparing for interoperability, what’s your take? What have your interoperability experiences been to date? Do you feel ready? Please share with me your ideas, your stories, your frustrations and successes.