What You Should Know: 

– Royal Philips, a global leader in health technology, has announced the interoperability of Philips Capsule Medical Device Information Platform (MDIP) with Philips Patient Information Center iX (PIC iX), providing hospitals with a first-of-its-kind, comprehensive patient overview. 

– Interoperability between MDIP and PIC iX gives clinicians a new clinical perspective that enables the capture of streaming data flowing freely from a variety of medical device manufacturers on an open, scalable, secure platform. 

– By disseminating this information through the Patient Information Center, clinicians have a single source, comprehensive overview of a patient’s condition that helps empower caregivers to make treatment recommendations confidently from anywhere throughout the hospital’s digital environment.

Eliminating Patient Data Barriers

Historically, data from medical device vendors has been siloed, leaving clinicians with the laborious task of referencing multiple sources to gain a complete clinical view of the patient. The inefficiencies caused by this disjointed process can impact a clinician’s ability to deliver timely diagnoses and treatments to patients. Philips is addressing technical obstacles associated with interoperability, such as device-specific connectivity protocols and security challenges across the organization, to help caregivers view, document, report, and analyze data before making care-related decisions.

Pulling data from a variety of different non-Philips devices, such as ventilators, infusion pumps, and third-party vital signs monitors, Philips presents and distributes the information in a single, standardized interface. Clinicians are then presented with a comprehensive picture of a patient’s health based on available medical device data. Access to this level of detailed information may minimize the time a clinician spends prioritizing data from multiple sources. With the goal of creating efficiencies associated with determining diagnoses and treatment decisions, this new interoperability may allow caregivers to spend more time providing direct patient care.

“Every day, clinicians make countless care decisions based on information from divided medical devices and systems. It’s time we start caring for the carers by making data more accessible,” said Christoph Pedain, General Manager, Hospital Patient Monitoring at Philips. “By ever-improving availability and accessibility of patient information, clinicians and patients benefit through enhanced workflows, insights, improved care delivery and safety measures that may lead to better health outcomes and the better use of staff and infrastructure.”

What You Should Know:

• Holon Solutions, the leading human-centric healthcare technology company, and HealtHIE Nevada, the nonprofit health information exchange (HIE) that provides electronic connection among Nevada physicians, hospitals, labs and other health care organizations, today announced a collaboration to radically improve open information sharing across the healthcare sector. 
• This initiative will enable care teams to improve care coordination and quality, while providing them with operations and administrative relief – all leading to better patient outcomes.

Enabling Improved Dissemination of Healthcare Information

As healthcare professionals face ongoing challenges stemming from an excess of complex systems and outdated tools that compartmentalize patient information, both organizations are committed to dismantling these barriers. Their shared goal is to facilitate the seamless flow of vital healthcare data throughout the medical community. By making data accessible to all and ensuring that care teams have timely access to pertinent information, healthcare workers can alleviate the administrative burdens that frequently accompany their roles. This initiative is particularly timely, as a recent report by Holon revealed that 77% of healthcare workers experienced burnout this year, with administrative tasks ranking as their primary source of stress.

To address this industry crisis, the new collaboration will offer healthcare teams: 

1. Easier care coordination: Holon and HealtHIE Nevada’s technology assists in the exchange of health information among disparate healthcare providers. This exchange enables better coordination of care, particularly for patients with complex conditions that require multiple providers.
2. Real-time access to patient data: This capability is critical during emergencies when quick access to a patient’s medical history can potentially save a life.
3. Prevention of healthcare disparities: Healthcare providers can help mitigate healthcare disparities by ensuring that the right patient information is available at the right time to all healthcare providers, irrespective of their location or affiliation.
4. Population health management: Through the aggregation and analysis of health data from a large population, this partnership will support public health officials in promoting health screenings and updating disease registries for better population health and disease prevention. 
5. Reduction in visits and readmissions: HIE networks have been associated with a 50% reduction in rates of hospital readmission, 26% reduction in Emergency Department admissions, 35% reduction in repeat imaging procedures, and 10% lower 30-day readmission rates among Medicare fee-for-service beneficiaries. This leads to better patient outcomes, improved quality of life and reduced healthcare staff burnout. 
6. Significant cost savings: Nevada could save over $153M each year in health care costs when the HealtHIE Nevada network is fully utilized. This not only offers significant health benefits but also promises substantial economic savings for the state and patients alike. 

“Holon was a natural partner to move the needle for making healthcare data more actionable,” said Michael Gagnon, Executive Director of HealtHIE Nevada. “Improving data integration will help healthcare workers derive the highest value out of their EHR systems, which makes their job easier and allows them to deliver the highest quality care for their patients. We’ve only scratched the surface of healthcare data sharing, and we’re thrilled to continue doing this work with Holon.” 

By facilitating secure and efficient health information exchange, HealtHIE Nevada and Holon are helping pave the way for a truly integrated and cost-effective healthcare ecosystem. This will empower healthcare workers to have the information they need from anywhere, right at their fingertips, so they can continue to deliver the best possible care for others. 

What You Should Know:

• Health Gorilla, a privacy-focused health information network and interoperability solution provider, has announced the launch of its Patient Access solution, which allows healthcare organizations to access comprehensive health data by enabling consumers to submit queries to national health information networks under the Individual Access Services (IAS) purpose of use.
• Accessing comprehensive data seamlessly from national exchanges has traditionally been limited to specific use-cases, such as treatment. Organizations that provide healthcare services outside of treating patients, such as insurers and life sciences organizations, rely on time-consuming, manual methods of accessing consumers’ medical records, including direct outreach to the patient’s physicians, asking patients to recount their medical history from memory, or requiring patients to provide their EHR patient portal credentials.

Leveraging Patient Access to Enable Seamless Retrieval of Clinical Data

Healthcare support organizations can now leverage Patient Access to enable consumers to seamlessly retrieve and share their comprehensive clinical data from a nationwide network of clinics, hospitals, and EHR systems in near real-time. Patient Access is now available as an out-of-the-box software platform and FHIR-based API for custom applications. 

The Patient Access solution includes:

1. Real-time, IAL2 consumer identity validation
2. One-tap submission of IAS queries to Health Gorilla’s nationwide Health Information Network, CommonWell Health Alliance, and Carequality
3. Bi-directional data flows to support consumer-mediated sharing

“After years of planning, we are thrilled to release our Patient Access solution, finally enabling consumers to access their own data from our national health information network,” said Steve Yaskin, CEO & Co-founder of Health Gorilla. “Healthcare organizations can now access comprehensive data from a nationwide network of EHRs through consenting consumers. The launch of Patient Access opens a new chapter for how patient data will be retrieved and exchanged.”

What You Should Know: 

– The Sequoia Project, an advocate for health information exchange and health IT interoperability, was chosen by the Office of the National Coordinator for Health Information Technology (ONC) to continue as the Recognized Coordinating Entity (RCE) to support the implementation of the Trusted Exchange Framework and Common Agreement (TEFCA). 

– The non-profit was awarded a five-year contract to continue the public-private engagement in support of a nationwide framework for secure health data sharing.

TEFCA RCE Background

In 2019, ONC selected The Sequoia Project to be the RCE following a competitive process during which dozens of organizations supported The Sequoia Project’s application for the role. Since then, The Sequoia Project is committed to the core principles of transparency and broad stakeholder engagement while serving as the RCE. During the last four years, the RCE has engaged thousands of people and has hosted more than 70+ public stakeholder engagement events. These interactions are focused on obtaining input on TEFCA processes and work products and providing a means to share updates about TEFCA’s progress.

In 2022, ONC and The Sequoia Project released TEFCA, and later that same year, began accepting applications for the country’s first candidate QHINs. In February 2023, Secretary of the U.S. Department of Health and Human Services (HHS) Xavier Becerra recognized the first six candidate QHINs that were approved for onboarding. These candidates expressed intentions to complete testing and onboarding for a planned go-live by the end of the year. There are now seven candidate QHINs in various stages of testing and onboarding.

What You Should Know: 

– Azalea Health forms a strategic partnership with Particle Health to foster a seamless interoperability of vital healthcare data, streamline communication, and elevate the standard of patient care for the rural health market. 

– By integrating Azalea’s state-of-the-art ambulatory and inpatient solutions with Particle’s robust data exchange infrastructure, healthcare providers, even those in rural locations, will gain access to a unified platform capable of generating a complete patient health record seamlessly and securely. 

Interoperability Initiative Enhances How Rural Health Providers Deliver Care

With the growing demand for interoperability, the leading provider of fully-integrated cloud-based healthcare IT solutions and services, Azalea, turned to Particle for their intelligent data platform that aggregates and delivers actionable patient data and insights to healthcare companies. These advanced interoperability capabilities will reduce administrative burdens, minimize data redundancies, and empower healthcare professionals to make well-informed decisions promptly through real-time access to comprehensive patient records (medical histories, test results, and treatment plans). By combining data capabilities of Azalea and Particle, healthcare organizations will be better equipped to analyze patient health trends and manage chronic diseases more effectively. This data-driven approach will facilitate preventive care measures and promote overall community well-being.

“The Particle team is excited to enter a strategic partnership with Azalea to truly transform how care is delivered to patients in rural communities,” said Jason Prestinario, CEO of Particle Health. “Combining the insights available from our platform with Azalea’s solutions, we are able to put more advanced patient insights directly in front of the providers making important care decisions, ensuring that the right treatment is getting to the right patient at the right time.”

What You Should Know: 

• The Sequoia Project and AHIMA, today announced the launch of a new initiative called Data Usability Taking Root to make health data more useful.  
• 11 organizations have already committed to participating in the group and implementing and improving the best practices for data usability created over three years by 260+ Sequoia members. The organizations that have committed to implementing data usability include Azuba, Civitas Networks for Health, Epic, Foothold Technologies, HCA, Health Gorilla, HIMSS Electronic Health Record Association (EHRA), Kno2, MedAllies, New York eHealth Collaborative, and Optum.

Data Usability Taking Root Initiative

The Data Usability Taking Root initiative will improve the usability of data received by end users within their workflows by making data more computable and actionable. Participants of the new initiative will choose their implementation pathways and paces, selecting topics most meaningful to their organizations. The Sequoia Project will provide technical assistance, testing support, and facilitation of the data usability community of practice to support implementation. A series of virtual events this summer will culminate in a Data Usability Taking Root Summit on September 6, 2023, in Washington, DC.

The organizations encourage implementers to adopt a data-usability-in-all-projects approach to make practical incremental improvements over time and to stop thinking of usability as a distinct health IT project.

The U.S. healthcare system has been in desperate need of modernization for decades. Thankfully, essential change is finally happening.

IT workers at healthcare organizations are now creating more efficient and effective electronic health records (EHRs), a process that requires integrating EHRs with new patient-access technologies. It also means that other healthcare workers – medical assistants, teletriage nurses, call center agents, etc. – need to change the way they work in response. 

The market for EHRs exploded in 2022 to nearly $28 billion, an increase of $11 billion over 2017. This means that healthcare organizations are starting to reap the benefits of EHR advancements and interoperability.

However, to maximize return on investment of EHR systems, IT departments must ensure their EHR platform is interoperable with third-party patient access software and open APIs. This interoperability allows providers to reap optimal benefits from their EHR platform.

The growing role of IT in patient access

Legacy EHR platforms – such as Epic and NextGen – have historically focused on optimizing in-person “bedside” functions and financial processes, a.k.a. the visit itself and the billing process after the visit. Existing EHR and practice management systems, therefore, have relatively little functionality outside of the doctor’s office or the hospital bedside. But things are changing. Innovations in patient access technology are rapidly expanding to include not just bedside tasks, but also scheduling, engagement, and communication.

The EHR is the core of this growing patient access ecosystem. And IT personnel have become vital to this transformation. IT departments must expand their focus beyond simply customizing EHR systems to their organization; they must instead commit to full operational transformation. This requires IT departments to focus on the entirety of their patient access system, rather than just on physician-centered clinical processes.

For example, legacy EHR platforms usually lack a number of important abilities that are crucial to this new patient-access ecosystem. This includes the ability to automate complex healthcare scheduling, provide call center agents with AI-guided call support, transmit appointment reminders and rescheduling links, analyze business intelligence, and enable ongoing engagement and marketing campaigns. 

Successfully executing and optimizing these abilities requires integration of EHR platforms with third-party patient access software or an open API. And that’s where interoperability comes in. Interoperability refers to the ability of different systems—EHRs, open APIs, and third-party software—to work together within health care organizations and between healthcare organizations. 

Interoperability is more than just sharing records. It means data is fully integrated into a single cloud-based system so that healthcare facilities can access information and utilize functionality quickly and easily on computers, laptops, mobile devices, and patient portals. 

This forms a symbiotic relationship that benefits the EHR vendor, the software vendor, and most importantly, health care providers, whose access system will then be able to perform a deep variety of clinical and non-clinical functions that improve care and service.

The benefits of interoperability

Again, interoperability means more than just IT systems working together. Interoperability also slashes costs by reducing hardware and software expenditures. It eliminates burdensome maintenance and upgrade fees, and it boosts revenue by streamlining the scheduling and payment processes.

Interoperability also leads to better relationship management and optimizes the use of resources. Most importantly, interoperability enhances the patient experience thanks to more personalized treatments and smooth communication. Combined, all of these patient and provider benefits engender a more efficient, collaborative, and patient-centered healthcare ecosystem that fosters innovation and ensures optimal health outcomes. 

But IT departments can go even further with this transformation by incorporating artificial intelligence (AI) into their EHR systems. Historically, AI in EHRs has focused almost solely on in-person physician support. In recent years, AI has expanded beyond the bedside and can now handle complex operational and telemedicine functions. 

For example, during telehealth visits, AI can assume scheduling and communication responsibilities that would ordinarily fall to overworked staffers. AI can also assess symptoms, generate a list of possible diagnoses, and create a personalized treatment plan based on the patient’s medical history and other data.

The ROI of interoperable EHR systems

ROI for healthcare organizations is determined by the cost of acquiring a new patient, and by the revenue that new patient generates. Key operational metrics for ROI include the cost to execute each patient scheduling request, the rate of first contact resolution, average handle time, and the percentage of appointments that patients self-schedule online.

Measuring and optimizing these metrics is essential, because what patients really want, more than anything, are simple and streamlined experiences. The Harvard Business Review recently published an eye-opening article called “Stop Trying to Delight Your Customers,” which argued that ease of service, even if that service isn’t flashy or unique, is the primary driver of consumer satisfaction and behavior. 

What’s more, Gartner’s customer effort score (CES) is predicated on the idea that simple, streamlined experiences engender the most consumer loyalty. Understanding and Improving this metric should therefore be the first priority of healthcare IT staff.

The upshot 

Fully interoperable EHRs ensure that healthcare staff has seamless and simple workflows and that patients have streamlined and satisfying experiences. The result: greater efficiency, stronger patient-provider relationships, and better health outcomes.

About Stephen Dean

Stephen Dean is the Co-Founder of Keona Health, a health desk that makes omnichannel patient access fast and simple.

We are at an interesting crossroads when it comes to pharma and digital health. Several years after the first iteration of digital patient solutions was initially launched, many pharma companies are taking a step back to strategically evaluate how they have performed in practice and the impact they have had on both patient and business outcomes.

Unfortunately, many platforms that pharma companies have either integrated within existing platforms or built have failed to meet those needs – for instance, only about 3% of patients currently take advantage of digital solutions. One possible reason is that when pharma companies first developed solutions, many bought a pre-constructed platform with a generic infrastructure, or tried to build solutions on their own. This resulted in programs that were poorly integrated and too broad, ultimately creating a clunky user experience, among many other challenges like taking a long time to build, being non-compliant with regulatory standards, and overall functionality issues. 

Many pharma companies are turning to vendors who can create more customized, personalized, and interoperable solutions to support patients throughout their medication journeys. As you reevaluate your current program and consider working with a partner, here are the five questions you should be asking to ensure your investment will be worth it. 

1. How many platforms/solutions have they built thus far? 

Knowing the level of experience of your partner organization is key to understanding the value they bring to you. Asking how many customers they have worked with, in addition to how many integrations they have done, will give you insight into whether or not they can seamlessly work within your existing system and the technologies your team is already using. 

2. Are they willing to be flexible? 

Every pharma company has their own goals, and each therapeutic requires a different level of patient support. Working with a partner who understands these needs and can offer customizable solutions will be key to creating an effective platform. 

3. How do they handle scalability? 

The number of customers they have worked with is one thing, but understanding how they have been able to scale those programs is perhaps even more important. Can they provide examples of programs that they have scaled globally? You should also inquire about how many patients are coming into the backend of their system every day. If they are able to handle high and growing volumes of patients, you’ll get a good idea of whether or not you’ll be able to work with them in the long term. 

4. How are they monitoring the integrations? 

A bad user experience can completely destroy a digital program, so you want to work with a partner who is constantly checking for bugs and glitches – and catching them before the users. You should always ask what their monitoring process looks like, and how often they are doing it. 

5. How fast can they get the integrations up and running?

Without the proper documentation, regulatory background, and infrastructure in place, it can take a long time – sometimes years – to develop a program. Working with a partner that can put a program together on time, not to mention on budget, is critical to a program’s success. 

The value of good partner 

In addition to the back-end benefits that a good technology partner can provide, like seamless integration, go-to-market efficiency, SaMD capabilities, customization, and meeting regulatory standards, there are also many benefits for the front-end user – the patient – too.

The first of which is that patients can get started in programs more easily and quickly. Getting patients to sign up for these programs in the first place can be a hurdle, so making the onboarding process simple is key to encouraging participation. Interoperable programs also allow for easier document sharing, speeding up the approval process for patients to get started in these programs. The quicker patients can get started, the more motivated they will be to participate. 

Integrated programs also allow for more frequent and comprehensive communication between patients and support staff. This ensures all patient questions are answered and their needs are met, leading to better engagement and adherence, and ultimately healthier patients. Working with the right partner can help you greatly improve patient outcomes. 

At the same time, support staff will have more insights into the patient’s behavior. They’ll know if a patient forgot to fill a prescription or missed a dose, enabling quicker interventions to help patients stay on track. This information can also be used by pharma companies and providers to provide more personalized care, and even guide future treatment plans for other patients. 

Conclusion 

Digital pharma solutions can be incredibly valuable resources for pharma companies, patients, and providers. Working with a highly experienced technology partner that can create a well-integrated program will be key to capitalizing on their value. Investment in a good partner will not only drive revenue, but it will also increase patient engagement, improve patient adherence (thus increasing Rx revenue), and can even provide a synergistic patient experience with patient support services or patient monitoring – ultimately contributing to improved patient outcomes. By asking these questions, you can ensure your investment will reap the benefits. 

About Rotem Shor

Rotem Shor is the co-founder and Chief Technology Officer at Medisafe, a leading digital health company specializing in medication engagement. At Medisafe, Rotem leads the product and R&D teams in the development of innovative solutions for the Medisafe platform, while also collaborating with the business team to align our technical capabilities with the company’s overall strategy and objectives. 

What You Should Know:

• U.S. Virgin Islands (USVI) Governor Albert Bryan Jr. signed a Letter of Intent with CRISP Shared Services to participate in a health data interoperability pilot program that will lay the foundation for OHIT’s Health Information Exchange in the Territory. 
• The pilot establishes the initial phase of the Territory’s Health Information Exchange (HIE), which will enable the instant sharing of health information among doctors’ offices, hospitals, federally qualified health centers, Department of Human Services Medicaid Division, Department of Health clinics, labs, radiology, identified community-based organizations and other health care entities. 
• CRISP Shared Services will help build the islands’ infrastructure for a health data utility (HDU) using federal funds from a number of federal health agencies. The HDU will function through the local government to be used by healthcare professionals to enhance patient care, public health officials to support the community, and the Medicaid agency to treat vulnerable individuals.

Why It Matters

OHIT Director Michelle M. Francis said the pilot program will build the necessary infrastructure to enable USVI healthcare institutions and key government agencies to prove out the minimum necessary data elements needed to create secure workflows between providers across the Territory’s health system. 

“This pilot is a win for the USVI as it gives us a safe and funded space to make the first tangible, technical steps in building our HIE with a nationally recognized, pre-certified, innovative technology organization,” Director Francis said. “We have already begun the behind-the-scenes work of building out a governance structure, and along with creating local policies and agreements that comply with federal privacy and security standards to support the secure electronic exchange of health information, brings it all into focus and sets it into high gear now.” 

The shortage of physicians in America is a growing concern, with serious consequences for our nation’s hospitals. The Association of American Medical Colleges (AAMC) estimates a shortage of between 21,000 and 77,100 non-primary care physicians by 2034, including surgical and other medical specialists. Already, 50% of hospitals are short coverage for three or more specialties, and 90% are short at least one. Half of the nation’s hospitals ended 2022 in the red, and for many Americans, getting access to physician services is becoming increasingly difficult.

Virtual Care’s Potential

On the surface, virtual care is poised to solve the problem. With telehealth, we have the ability to mitigate the growing challenges of local staffing. Physicians can see and treat patients, regardless of their geographic location. Additionally, we can save precious physician time by removing the need to commute long distances or sit in traffic to get to the beside. 

But a deeper look at the digital healthcare landscape reveals a problem. 

While the health tech industry has found tremendous success over the past few years with consumer-centric healthcare innovations (last year the global market for wearables alone exceeded $61B), our industry has been less successful in developing the tools for seamlessly integrated, digitally enabled care for hospitals and health systems. 

If you attended this year’s VIVE conference, you know that there are literally hundreds of start-ups dedicating themselves to solving this problem. Hospitals themselves are investing in tech more than ever before, with an average of $7.76M annually. Yet solutions often fall short of their expected impact on addressing the most important problems facing healthcare providers today. While interoperability has been top of mind for our industry for quite some time, providers are still burdened with having to adapt to an ever-changing technology landscape that complicates their ability to practice medicine. Health tech has often increased complexity instead of reducing it, and as a result, we’re contributing to the problem instead of solving it.

Digital Fatigue Increases Burnout

Take EHRs for example. A report published by NIH in 2022 identified six causes of physician burnout related to the use of EHRs: documentation and related tasks, poor design, workload, overtime work, inbox alerts, and alert fatigue. The study went on to identify the impact of this burnout: lower-quality care, career dissatisfaction, and turnover among others. And an earlier NIH study found that physicians who used more EHR features and functions felt more time pressure and experienced significantly more burnout, dissatisfaction, and intent to leave medicine.

In many cases, telehealth point solutions have merely added to the digital fatigue. According to a McKinsey report last year, only 36% of physicians agree that telehealth is more convenient for providers than in-person care.  Frustrations cited by physicians included multiple logins and disparate systems, poor integration with electronic health records, and audio-visual failures during encounters. The pandemic drove hospitals to incorporate virtual care into their staffing models without running pilot programs, issuing an RFP, or following other standard procurement practices. While these point solutions addressed critical needs during the pandemic, the rushed adoption and implementation may be inadvertently contributing to provider burnout today.

What Health Tech Should Do 

Those of us building health tech solutions, especially those of us focused on supporting hospitals, need to take responsibility and do our part. We have the expertise to make a difference in the day-to-day physician experience by reducing burnout with technology that makes practicing medicine more efficient, more productive, and more enjoyable. We can do this by committing to: 

1. Build solutions with interoperability in mind from the foundation. This means standard data models and robust API endpoints to systems that work seamlessly together and remove reliance on users to bridge integration gaps. This means truly living up to some of the legislation that has been passed, not addressing it with superficial compliance.

2. Design with a focus on the remote physician as a first-class user. While this may sound obvious, more and more systems are designed with administrators as the primary audience because they make purchasing decisions.

3. Create solutions that can scale everywhere, from the smallest critical access hospital to the largest health system, by ensuring systems are highly configurable and scalable with a low up-front investment. Right now, most software companies have decided to ignore a large portion of hospitals because only the largest health systems can afford ballooning implementation costs and large capital purchase requirements.  At the same time, the largest opportunities are often inverse, with rural and community hospitals struggling the most with staffing shortages and poorly integrated technology.

Hospital and Health System Leaders Play a Vital Role 

Change at scale is not possible without leadership buy-in and support. Leaders must prioritize solving technology problems and address overly complex legacy platforms, disparate point solutions, and the consequent burden on providers by agreeing to:

1. Implement technology that simplifies the provider experience without leading to a proliferation of narrowly-focused, disconnected solutions. Demand reliable integrations and eliminate overly complex tool sets that place an additional burden on physicians

2. Adjust care delivery workflows to support both in-person and remote providers in a way that supports collaboration and builds trust over time. In-person teams need to adjust how they communicate to fully utilize the digital platforms that enable remote collaboration. 

3. Focus success criteria for new technologies around patient and financial outcomes, not utilization and adoption. Investing early in the ability to measure the lagging metrics that drive the adoption of virtual care platforms in the first place is important to appropriately assess and continuously improve program health. 

4. Find partners that are aligned with your goals and are willing to hold themselves accountable for your success. 

The physician shortage may be coming, but technology gives us the potential to solve this problem if we all commit to doing our part. 

About Nijay Patel

Passionate about achieving the full potential of digitally enabled healthcare, Nijay Patel serves as Chief Technology Officer for AmplifyMD where he leads R&D for the company’s groundbreaking virtual care platform. Nijay began his career at Epic, and most recently served as SVP of Product for Redox Engine. He earned his degree in Biophysics with a focus on Computational Biology from Johns Hopkins University.

References

https://www.ama-assn.org/practice-management/sustainability/doctor-shortages-are-here-and-they-ll-get-worse-if-we-don-t-act

https://www.definitivehc.com/resources/healthcare-insights/average-it-expenses-us-hospitals#:~:text=Based%20on%202020%20data%20from,a%20hospital’s%20total%20operating%20expense.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134123/

https://www.mckinsey.com/industries/healthcare/our-insights/patients-love-telehealth-physicians-are-not-so-sure

What You Should Know: 

• AWS announced the addition of three new capabilities to Amazon HealthLake’s managed FHIR API offerings. 
• The launch of these three new capabilities benefits EHR system providers, ISVs, SIs, and IT teams working with healthcare organizations, by allowing them to simply leverage managed FHIR APIs to build interoperability applications or systems that conform to ONC and CMS patient access rules, reducing the burden of building and managing the underlying FHIR APIs and data store. 

Amazon HealthLake’s New FHIR API Offerings

1. SMART on FHIR

SMART on FHIR provides reliable and secure authorization for applications integrating with the OAuth 2.0 standard. Customers and partners building SMART on FHIR applications can control access to data and deploy fine-grained access control to ensure authorized access to resources. ISVs can empower a community of third-party developers building clinical applications that enhance user experience without compromising security. App developers can innovate and provide their users with the right information at the right time, such as notifying clinicians when patient laboratory results become available so that they can provide better care.

2. Patient Access API

Customers can use Amazon HealthLake to share data securely by implementing APIs like Patient Access API to build patient and provider facing applications that foster information exchange and improve patient care while reducing costs. Amazon HealthLake validates FHIR resources according to US Core, CARIN for Blue Button profiles, which enable a broad set of interoperability capabilities. ISVs and their customers can take advantage of these APIs and FHIR resource validation to facilitate efficient exchange of health information to coordinate care, provide timely and correct reimbursement, and empower patients to fully participate in their care.

FHIR Bulk Data Access APIs

When customers need to transfer a large number of resources, like facilitating payor to payor data exchange, they can utilize Amazon HealthLake’s FHIR Bulk Data Access API to securely export data for all patients, a subset of patients, or all FHIR data stored in Amazon HealthLake. Payors can take advantage of this feature to transmit large data sets to support population health management, and health systems can use Bulk Data Access to populate their analytics and research data stores to inform better clinical decisions.

Availability

Amazon HealthLake SMART on FHIR, patient access API, and FHIR bulk data API export capabilities are currently available in preview.These new capabilities will be available in all regions where Amazon HealthLake is generally available, including US East (Northern Virginia), US East (Ohio), US West (Oregon), and Asia Pacific (Mumbai) regions with revised pricing. 

What You Should Know: 

• The Interoperability Institute (IOI), a non-profit 501(c)(3) organization focused on scaling interoperability for the health information technology (HIT) sector, today announced that it is working with Amazon Web Services (AWS) to launch Interop.WORLD, a Virtual Innovation Center designed to accelerate critical advancements within the industry. IOI was created by the Michigan Health Information Network (MiHIN) to tackle the challenges around healthcare interoperability.
• Interop.WORLD will institute a common business architecture on AWS to address the lack of interoperability and provide participants an opportunity to test new ideas, collaborate on pressing challenges facing the sector and establish shared resources for the next generation of HIT.
• In addition, Interop.WORLD will host a series of virtual challenge events in which participants, including individuals, organizations, or companies that develop and implement technology-driven solutions, will use cloud technology to solve relevant healthcare issues and accelerate innovation. A special emphasis will be placed on electronic consent processes, sharing of maternal health data, health equity, and training the next generation workforce. For each challenge issued by the Interoperability Institute, AWS will provide up to $125,000 in AWS credits to offset the use of AWS services in Interoperability Land™, IOI’s cloud-hosted HL7®FHIR®-based test bed.

We take for granted that we can seamlessly send money to another person regardless of where they bank, or that we can easily text someone who uses a different cellular network. It’s called interoperability, where disparate systems can seamlessly connect and share data with each other and it’s almost always in real or virtually real-time. 

This ease of data sharing across systems may be a reality in most areas of our lives, but it still eludes healthcare. Initiatives to improve interoperability in our industry began in the 1960s with the push for electronic data interchange for claims adjudication. Since then, there have been initiatives such as the American Recovery and Reinvestment Act (ARRA) which was signed into law in 2009, and from which came the Health Information Technology for Economic Clinical Health (HITECH) Act to promote the adoption of electronic health records (EHRs) among providers. 

More recently, we have seen the 21st Century Cures Act, which was signed into law in 2016 and is meant to “accelerate the discovery, development, and delivery of 21st-century cures.” The act also pushes for increased interoperability and EHR adoption. Now we have the Trusted Exchange Framework and Common Agreement (TEFCA) program, which focuses on enabling the “secure, nationwide, interoperable health information exchange across health information networks by providing a common trust framework and standardized rules.” TEFCA is based on the use of qualified health information exchanges (QHINs), a network of organizations that work together to share information. We have seen these “outside-in” initiatives make progress, but usually the initiatives place industry participants – meaning payers and providers – in a reactive mode which, sadly, has resulted in two steps forward (better data access) but at least one step back (increased technology debt and reliance upon data intermediaries and/or walled gardens).

Why does healthcare need interoperability?

The problems caused by the inability of healthcare organizations to share information are increased costs and poor outcomes – medically, financially, and with poor consumer experiences.

The back-office administration of healthcare—which includes processes such as eligibility verification, prior authorization, claims submission, claim edits, payment integrity, and charge capture—is fragmented and full of manual, error-prone processes. These inefficiencies are estimated to cost the U.S. nearly 250 billion dollars or more each year, with billing, coding, physician administrative duties, and insurance administration being primary drivers. 

These administrative inefficiencies also have a significant impact on patient care. The prior authorization process is a great example. In a 2022 survey by the American Medical Association, 94% of providers said the prior authorization process had caused delays in patient care. Thirty-three percent said those delays in care had caused a serious adverse event. One in four said that a prior authorization had led to a patient’s hospitalization, and nearly one in five said a prior authorization had led to a “life-threatening event or required intervention to prevent permanent impairment or damage.” And this is all because of delays in care because payers and providers can’t share information seamlessly. Think about the potential to turn real-time data access and insights into a care management asset rather than a care barrier to care in so many cases today!

Lack of data sharing also impedes financial transparency. Complex payer agreements and the wide variety of healthcare coverage make it difficult for providers to tell patients with any certainty what they will owe, or even likely owe, for any given service. This lack of transparency limits a patient’s ability to make informed decisions about how, when, and where to get their care. It can also cause patients to delay or skip care, which then further impacts outcomes.

What will it take for us to finally move across the interoperability finish line?

The answer is not more of the same. Payers, providers, and third-party vendors have spent billions building legacy infrastructure. To date, most interoperability solutions merely sit on top of these behemoth systems. And while Fast Healthcare Interoperability Resource (FHIR) provides a common set of protocols and standards to streamline connectivity, FHIR alone does not magically create data fluidity if used over a web of single-use, point-to-point connections based on legacy technology debt and rigid file exchange processes.  

What will get us across the finish line is innovation—an entirely new way of thinking about information sharing, data transparency, and collaboration in healthcare. Am I saying we need to throw everything out that’s already in place and start over? No, I’m saying we need to look at things from a different perspective—one not reliant upon multiple point-to-point connections, inclusive EHR networks, and third-party intermediaries. We also can’t wait for government subsidies, initiatives, programs, or penalties to drive this innovation. It is incumbent upon all industry stakeholders to work together to re-invent how we do business from the inside out.

What if payers and providers had a way to work together directly without the need for multiple APIs or data aggregators? What if sharing data were as simple as a single query on a single network? And what if that data is constantly refreshed and accurate without having to be aggregated and validated each time it’s accessed by a party? And what if the data always remained where it resides and under the control of the data originator? 

Think about a world where eligibility verification, coverage discovery, claims adjudication, and prior authorization takes seconds. Think about a world where healthcare insights and AI could be derived “at the edge” rather than through aggregated, centralized, complex, latent data lakes. Would you call that a pipedream? I call it a reality because it’s starting to happen today, on a network designed and built from the inside out with support from a handful of industry stalwarts.

The future is now

Today, payers and providers can use decentralized, peer-to-peer networks to collaborate, communicate, and transact directly with each other through a single connection—without having to create and maintain multiple APIs, multiple communication formats, and multiple third-party agreements.

How is this different than a health information exchange (HIE)? First, a decentralized, peer-to-peer network allows unlimited reach and is open to any healthcare payer, provider, or innovator that wants to participate. Another difference is that most HIEs are limited to clinical transactions, whereas a decentralized peer-to-peer network can include both administrative and clinical transactions. In addition, with an HIE, data must be requested, aggregated, and validated each time it’s used. With a decentralized network, data remains where it’s housed, under complete control of the originator, and can be accessed in real-time by those on the network who are permissioned to use it. This eliminates the need for data to be aggregated or validated. It also means the information is always current and accurate, erasing immutability issues.

Another significant difference is that a decentralized, peer-to-peer network promotes innovation and helps vendors bring solutions to market faster, easier, and cheaper. Today, many startups enter the market with innovative solutions that could bring significant improvements to healthcare. But once they realize how difficult it is to navigate and connect to the right stakeholders, they exit the market just as quickly. A decentralized, peer-to-peer network removes the complexity of connectivity—moving the entire industry forward.

About Stuart Hanson

As CEO of Avaneer Health, Stuart leads the team in building an inclusive network that solves the problem of interoperability by ensuring all stakeholders have equal and easy access to patient data when it’s needed most. Prior to joining Avaneer, Stuart served as head of healthcare payments and served as a senior healthcare executive at JP Morgan Chase. He identified, led and negotiated the firm’s 2019 acquisition of InstaMed. 

Previously, Stuart served as general manager of consumer payment solutions at Change Healthcare. Stuart has also served in leadership roles for healthcare solutions at Citi and Fifth Third Bank. He chaired the HIMSS Revenue Cycle Improvement Task Force (FY15-16), focused on creating a vision for the next generation of revenue cycle management tools and processes to drive administrative cost containment, interoperability, and a better consumer experience.

As hospitals and health systems continue to be stretched thin by negative operating margins, competitive pressures, and workforce shortages, decision-makers must do more with less and make strategic software investments to reduce costs and increase efficiencies in both the short and long term. Decision-makers agree that now is not the time to pull back on software investment: according to research from Bain & Company, 45% of providers have increased their software investments over the past year, and 95% expect to make new software purchases in the coming year. The right healthcare software investment can be the difference between surviving challenging times and thriving during them.

Healthcare operations, or the nonclinical processes that help keep hospitals and health systems running, are one area where software investments can provide significant value. The shift from fee-for-services payment systems to value-based care requires healthcare institutions to consider the potential impact of any software investments on patient outcomes and operational efficiency. Health system decision-makers must ensure that new software investments simplify their existing operations and provide a return on investment (ROI). The right software investments will add value, optimize efficiencies, and drive key outcomes across the organization. However, measuring the value of a potential software investment can be complicated. Here are five questions to consider when making a healthcare software investment:

1. Does the software fit within the current workflows and integrate with other systems or technologies across the organization?

A recent survey of 132 chief information officers (CIOs) at top U.S. health systems revealed that interoperability, or the ability of software to connect and exchange data with other organizational systems and software, is the number one priority of CIOs. The proliferation of point solutions for healthcare operations in the past decades has led to health systems having an excess of siloed, disconnected systems: 60% of Compass Survey respondents reported that their organization used 50+ software solutions for healthcare operations alone. These disconnected solutions create additional work for clinicians and staff, ultimately reducing efficiency and contributing to staff burnout and turnover. Healthcare decision-makers must consider the effect potential software investments will have on administrative burden and seek solutions that will integrate with the health system’s existing processes and technologies.

2. Is the software user-friendly, time-saving, and easy to learn for clinicians and staff?

Recent data highlight the importance of investing in software that streamlines workflows and makes healthcare workers’ jobs easier, rather than adding additional administrative burden. According to the Compass Survey, 88% of CIOs find that working with disparate IT systems and applications complicates their job, and 84% said that having a streamlined IT structure was important in their ability to retain clinicians. The current shortage of healthcare workers in America necessitates that decision-makers do things differently. By investing in software with a human-centered design that reduces duplicative tasks and administrative burdens, health systems can improve employee satisfaction and efficiency and decrease burnout and turnover. 

3. Does the software address more than one process, specific problem, or challenge?

As we’ve established, many health systems have an excess of point solutions to manage their healthcare operations. To reduce costs, increase efficiency, and reduce the administrative burden created by mastering and utilizing these disparate systems, there is an urgent need to consolidate healthcare operations software and provide enterprise-level solutions for healthcare organizations. Investing in solutions that address multiple needs or challenges enables healthcare organizations to streamline and consolidate their operations and avoid adding another point solution to the pile. For example, an enterprise-level solution for healthcare operations that can address workforce management, provider data management, compliance and safety, and more. 

4. Does the software have the necessary security and regulatory compliance measures in place to protect patient and staff data?

Security is a must when it comes to healthcare software—the most cost-effective and efficient software in the world is worthless if it leaves your organization at risk of costly compliance and security violations. Healthcare operations software can help organizations assess risk, mitigate regulatory penalties, and prevent cybersecurity and patient privacy breaches, ultimately protecting both the patients and the organizations’ data. 

5. Are the projected ROI and long-term costs associated with the software, including maintenance, updates, and support clear? 

Finally, it goes without saying that health systems want to invest in solutions with demonstrated financial value. While a leap of faith might sometimes pay off, investing in solutions with a positive track record, customer testimonials, and proven ROI is the best way to ensure your investment is well-placed. 

Invest in Key Healthcare Outcomes

The adoption of human-centered healthcare software that is built on a standardized enterprise-level architecture will ultimately help healthcare organizations reduce costs, improve clinician retention, mitigate risk, and optimize patient outcomes and experiences. The best software investments are ones that deliver financial value through improved efficiency and efficacy while causing the least disruption. By focusing on the impact potential software investments will have on financial health, administrative burden, and organizational risk, hospitals and health systems can improve employee satisfaction while containing costs, enabling them to thrive amid existential pressures and continue providing quality patient care. 

About Brian Fugere

As Chief Product Officer at symplr, the leading enterprise healthcare operations company, Brian Fugere leads all product management and user experience (UX) design efforts, corporate strategy, and cross-functional go-to-market alignment. During the past two years, he also served as symplr’s Chief Marketing Officer (CMO) and led the engineering organization. Bringing almost 30 years of go-to-market experience in software companies of all sizes, Fugere was previously the CMO of Virence Health, a carveout from GE Healthcare.

What You Should Know:

• Verato and Redox today announced a partnership that will combine Verato identity data management solutions with Redox’s composable technology ecosystem to enable improved data access, better interoperability, and higher-quality information gathering across a growing digital ecosystem.
• The integration will allow healthcare organizations to access a single source of truth for identity, including a complete and trusted 360-degree view of their patients, members, providers, and communities, which enables them to better understand who is who™ across the entire care continuum.
• The partners have already launched a new solution to Redox customers: Redox Chroma EMPI powered by Verato. Redox Chroma EMPI powered by Verato leverages leading identity technology and easily integrates into organizations’ existing technology suites, enabling them to create a full, accurate identity record for each person they serve.