A Prescription for the Health Industry: Interoperability

A Prescription for the Health Industry: Interoperability

Brian LeClaire, CIO, Humana

Brian LeClaire, CIO, Humana

At this year’s Healthcare Information and Management Systems Society (HIMSS) conference, Humana CEO Bruce Broussard identified interoperability as fundamental to transforming the health industry.

Interoperability has been successfully applied in other industries, such as manufacturing’s supply chain delivery and e-commerce’s online marketplaces. In both of these industries, interoperability paved the way for more integrated and seamless consumer experiences. While not a new concept, a real opportunity continues to lie in health care, where interoperability remains a challenge.

Although more than 60 percent of U.S. physicians have introduced electronic medical records (EMRs) into their practices, those EMRs are not generally interconnected with other providers. Consequently, the patient experience across physicians and other medical providers is not seamless. Today, it’s generally the patient who has to coordinate among multiple offices and providers to ensure their records reach the right hands. They must seek, retrieve and deliver information to the various people and businesses assisting with their care.

For example, if a patient receives a flu shot at a retail clinic, he or she must request that record to take to share with his or her primary care physician and/or wellness program. In essence, the patient must work around the system. This fragmented approach forces the consumer to wrap themselves around a health care system that isn’t easily navigated, and where the full power of analytics cannot be leveraged because the health care industry lacks the automated sharing of data.

Like in manufacturing and e-commerce, interoperability will bring a much more connected experience for doctors and patients. True interoperability will connect doctors, patients, caregivers, gyms, groceries, pharmacies, social networks, families, and anyone else involved in an individual’s personal health ecosystem. With interoperability, individuals and doctors are at the center of the health ecosystem and care is built around them. Interoperability encourages innovations in treatments and engages people more deeply in their journey to personal health because the process of getting and inputting data is automated and simplified. Data is captured based on individual and medical professional interactions and shared appropriately through the system. The value of this data is unlocked by four main technology trends – mobility, social, the cloud and analytics.

Mobility is the ease of entering health data and accessing the information when and where it’s needed. The ability an individual possesses–even through mobile devices–to access and share information is almost limitless with today’s technology. Social is the way people connect with other people–not only with friends and family–but doctors with patients, patients with caregivers, caregivers with other caregivers or patients with similar conditions. Social drives the interactions and is the reason individuals are inspired to act. Cloud is where secure delivery of data, across a city and around the world, happens, and the cloud does not exist without interoperability to organize and share the data. And with interoperability, analytics comes to life and is multi-dimensional. Clinical Analytics seeks to understand people as patients, and Consumer Analytics seeks to understand people as consumers. By utilizing both of these, the health system identifies health opportunities and can improve health across the entire population via easy to use, consistent experiences made possible through mobile devices.

Take the example of Mary, a patient living with congestive heart failure. With an interoperable health system, Mary can weigh herself each morning on a Bluetooth-enabled scale (cloud), which is connected to a phone app (mobile). If her weight fluctuates (analytics), the app sends an alert to her doctor, who will place a call to Mary to discuss what may be impacting her health (social), and whether interventions may be needed.

The good news is the technology to empower analytics and deliver on interoperability already exists. We are taking ground in an area that has the potential to completely change how health care is delivered and received.

One example is Humana’s Transcend Insights, which connects 20,000 doctors across 600 hospitals. It ensures multiple EMR systems can exchange health information securely and in real-time. In 2014, Transcend Insights successfully identified more than 36 million opportunities for care improvement, including 557,000 opportunities to impact drug safety, and 2.5 million opportunities to increase medication adherence.

In order to continue to improve health outcomes and make a difference in population health, interoperability must also enable the creation of virtual care coordination. When doctors– especially primary care physicians–are supported by technology, they are able to focus on personalized care and its delivery in a way that’s productive for their practice and meaningful for each patient. As interoperability helps enable patients to live their healthiest lives, they are more likely to engage with their doctors and the health care system.

Interoperability is an ongoing effort. By continuing to build bridges between doctors and patients and health information, the promise of virtual care coordination and population health will improve–one person at a time.

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