4 Actions to Bring Banking-Like Interoperability to Healthcare

Perhaps lost in the buzz of HIMSS was the new report Advancing Interoperability, Information Sharing, and Data Access: Improving Health and Healthcare for Americans from the Bipartisan Policy Center and the Health Leadership Council (HLC).

It’s a short report that complements the HIMSS buzz around interoperability, cybersecurity, artificial intelligence, and consumer engagement. The report includes key recommendations that can advance access to clinical information for both consumers and providers — achieving a truly interoperable, patient-centered, more cost-effective healthcare system. 

I loved that the organizations challenged why don’t we have the interoperability in today’s health data that we do with banking and telco, which are highly competitive, consumer-oriented industries.

I commend them for interviewing 100+ organizations and individuals, and for naming the organizations (unlike the recent GAO report, which did not identify their 37 interviewees). This transparency should lead to greater collaboration and strategic execution that benefits all parties. 

These are four things we need to do to bring interoperability to healthcare:

Strengthen the Business Case

Interoperability becomes crucial as payment moves from volume to value. But many interviewed felt that the lack of widespread, easily understood financial incentives inhibits interoperability progress. Other industries (banking, telco) used clear incentives to advance their interoperability years or decades ago. However, we need to start by agreeing on baseline expectations and measurable outcomes, particularly for interoperability and data sharing. Only once we have agreed on these basics can we build a truly compelling business case.

HLC has committed to convening providers, EHR vendors, and other stakeholders to accomplish this key recommendation. Engaging individuals/consumers to ensure alignment with their expectations will be part of these efforts. 

Improve Technical Infrastructure

Standardizing data elements for patient record matching is called out and in line with Pew and Sequoia reports which I’ve blogged about previously. HLC recommends initiatives led by the private sector (given the Congressional ban on HHS funding) that focus on developing a coordinated strategy for a patient matching solution that takes a patient-centered approach, perhaps in line with the RAND report sponsored by Pew Charitable Trust. And, the report promotes real-world testing to assure conformance with interoperability standards and rapid adoption of FHIR. 

Improve Policies and Regulations

Consumer information access can be promoted through the common “Notice of information access practices” method currently being explored. This, along with harmonizing privacy laws across states and HHS work to align consent policies for substance use disorders would aid data sharing. The report acknowledges the efforts underway for fine-tuning HIPAA. 

Support Governance and Leadership

The Trusted Exchange Framework and Common Agreement (TEFCA), once finalized, should provide the governance needed for many interoperability activities. Additional measures to monitor, track, and initiate interoperability will be aided by TEFCA. Measures should be small and impactful to assure adoption and accurate, efficient reporting. Measurable, insightful suggestions include prescriptions filled, access to independent labs and radiology systems, and information sharing between long-term care, behavioral health, and the more mainstream hospital, physician practices and health plans. 

Much of the HLC report complements and reinforces recent interoperability, data sharing and patient record matching work by the Pew Charitable Trusts, RAND Corporation, Sequoia Project, and others. 

As Mary Grealy and Neil de Crescenzo of the Healthcare Leadership Council stated in their opening letter, interoperability is already a given in banking and telco, and,  “It’s time to bring that same 21st century interoperability to healthcare.” I grow ever more hopeful that widespread interoperability — including better patient record matching — is coming….and soon.