Views from the Top: Demystifying Interoperability, Information Blocking, and APIs

The proposed rule addressing the topic of Information Blocking caught the full attention of the healthcare industry at HIMSS19. With the anticipated release of the final rule in the future, its implications relating to information blocking and API certification criteria has providers and health IT developers preparing for how to use the ruling as a guide toward improving patient outcomes and experiences without increasing the burden on providers. As with Meaningful Use and related regulations, provider organizations will need to consider operational, technological and patient experience solutions to implement these new requirements. This session will help explain how to determine your specific impacts and opportunities and ways to activate solutions at scale to further enhance your current interoperability efforts.

No matter what your role in health information and technology — or what your challenges — HIMSS20 has you covered. Get inspiration from our world-class speakers and thought leaders.

The speakers:

Join these changemakers Tuesday, March 10, at their HIMSS20 Views from the Top, Demystifying Interoperability, Information Blocking, and APIs: Clear guidance on improvement opportunities.

Genevieve Morris, Founder Integral Health Strategies and former Deputy National Coordinator for the ONC

Paul L. Wilder, Executive Director of CommonWell Health Alliance

Gautam M. Shah, VP, Change Healthcare

Shez Partovi, Director, Global HCLS BD, Amazon Web Services

We asked the speakers to share their inspiration for change.

How do you view the intersection of healthcare and technology?

Guatam Shah: The ability to leverage and make “quantum leaps.” We have the opportunity to learn how other industries have used technology to solve the problems we have in healthcare and then apply those solutions through our unique lens. Industries like financial services have made great strides in aggregating data, applying innovations in workflow and creating customer engagement models that we can leverage to better meet the needs of patients and providers.

Genevieve Morris: From an interop perspective, the goal of using technology in healthcare is ultimately to improve the quality of care patients receive because providers have a full view of their healthcare information. People's memories are faulty, so having the ability to share their full care summary electronically can go a long way toward improving their care.

Paul Wilder: Technology intersects with just about every industry, and fortunately, healthcare is more digital than analog — something we couldn’t say just 10 years ago. I believe the adoption of technology is the biggest shock event for healthcare in decades and that the ability to exchange data between providers and other healthcare entities will be one of the biggest drivers for us to make a massive leap in how well we care for patients. While we still have many challenges to overcome to make exchange seamless, CommonWell and our partners in the industry are here to solve the challenges that come our way to make data exchange simple, accessible and accurate to the benefit of all.

Shez Partovi: High quality, affordable care depends upon three factors: People, Process and Platform. I view the intersection of healthcare and tech as an opportunity for the right platform to support the right person to journey easily through the right care pathway at the right time. This nexus occurs both at the patient level and the clinician level. Whether it’s a AWS-powered technology like Propeller Health that helps patients with asthma manage their lives, or AWS Services such as Transcribe Medical that enables providers to speak to the EHR, each is meant to support an individual interacting with a healthcare journey.

What emerging trend do you see in your area of health information and technology in the next year?

Gautam Shah: More data being captured across a wider variety of care locations driving the need for greater data access and interoperability and creating opportunities to apply AI, improve patient experiences and optimize workflows in safe and secure environments. I expect to see the broader healthcare technology ecosystem pursue enabling the expansion of care locations to retail and to the home and creating the ability to capture more data while maintaining privacy and turn that data into usable insights.

Genevieve Morris: Because of the regulations and the need to demonstrate that you're not an information blocker, I believe we'll see the development of health IT that will help individuals demonstrate that they did not information block. Think about all of the reports that were necessary under Meaningful Use to demonstrate compliance. I think we'll see that on a much larger scale.

Paul Wilder: Practical standardization. Maybe we should call it normalization. While exchange is happening and increasing exponentially daily, there is still a need for common rules and expectations. Technical standards help us create movable data payloads, but we still have work to do. TEFCA, for example, is at its core an opportunity to standardize the underlying trust framework so we don’t end up with siloed exchange networks that we can’t put back together. Imagine if we still had ATM cards that only worked at ATM machines owned and operated by only a couple banks? Additionally, data quality improvement efforts are in their infancy, but that is trending up, too. Existing standards help us move the data around, but improved data quality inside the records and in the transactions between systems will make the data more usable.

Shez Partovi: We see trends along three vectors: 1. Use of AI/ML to predict patient health events (see above), 2. Use of voice to transform both the patient and clinician experience, and 3. Move from data interoperability to semantic interoperability. The first was mentioned above and the second is rather self-evident. The third is interesting because there is a growing desire that systems to exchange semantically normalized data so that it is more usable. For example, conversion of free text medical notes into discrete ICD-10 and RxNorm codes via Comprehend Medical allows for health systems to exchange free text along with its meaning. This allows the receiving systems to more easily embed that information into the EHR and use for care delivery or, where authorized, for machine learning.

Can you share a quote or reflection that inspires you every day in the work you do?

Gautam Shah: “You can’t use old logic to solve today’s problems,” and “To serve patients is the greatest privilege.” The one thing that drives me every day is the ability to create solutions that have an impact on our children, families and communities. I can think of no greater calling than to serve that population and find ways to make things better. Actively challenging the “way things are done” allows us to break the paradigms that prevent us from achieving that goal.

Genevieve Morris: "Far and away the best prize that life has to offer is the chance to work hard at work worth doing," Theodore Roosevelt. In health IT, we get to work hard at work that is worth doing because it affects our daily lives and the lives of those we love.

Paul Wilder: “Free the data.” Who said it first in the context of healthcare? I don’t know, but it is still an appropriate and often necessary rally call. Sure, we have to do it safely with high levels of security. Yes, we must be transparent about when and where a person’s health data moves. And of course, individuals deserve the right to control that flow if they want to. Individuals also deserve access to their own data, and we have work to do there, too. While we have electronic health records in nearly every health setting and can successfully exchange health data, it is still much easier for two providers to exchange my data than it is for me to gather all my data for myself. Free the data!

Shez Partovi: There are people all over the world (including the U.S.) who — despite the need — are born, live and die never having seen a physician throughout their lives. Technology offers a means of globally scaling access to care. Each day I come to work, I ask myself how I can use AWS and Amazon as a platform to help elevate the human condition.

Can you share one take-away from your presentation at the HIMSS20? What will attendees learn that they can use in their work setting or on the job?

Gautam Shah: Regulatory forces like the 21 Century Cure Act and the forthcoming Information Blocking rule will create the impetus to drive greater data sharing, but a shared implementation of simplified, standardized and secure ways to access data across the healthcare ecosystem are the keys to creating the insights and workflow enablers that will ultimately lead to more better patient outcomes and greater financial and operational efficiencies.

Genevieve Morris: Attendees will learn how information blocking rules are likely to affect their organization. Everyone thinks they aren't the ones information blocking, it's everyone else, but the regulations may make folks information blockers who think they're aiding data exchange.

Paul Wilder: The key takeaway is that exchange and accessibility of health data is possible TODAY; there is no need to wait for the next standard, network or technology to be developed. At CommonWell, as we see our members onboard more practices and as more data is made available, we see an increase in usage and desire for more data types and ways to use the data. For example, we have members who now offer individuals access to their own health data via PHRs, patient portals and consumer apps. Now is a great time to be in healthcare and continue toward newer, more effective ways to treat patients with technology as a willing and able assistant. In tandem, consumers are looking for ways to be better informed about their own healthcare.

Shez Partovi: There is a lot of buzz about machine learning (ML) and artificial intelligence (AI) and for those intending on exploring its benefits in their health system, here is a beneficial framework for considering AI/ML work. We see AI/ML applied to three types of problems: 1. Operational Forecasting (e.g. number of patients visiting ED on a Tuesday evening), 2. Clinical Prediction (e.g. likelihood a patient will develop heart failure over the next 6 months) and 3. Clinical Diagnosis (e.g. does this chest X-ray reveal a lung puncture). We find the media tends to focus much on No. 3, while our customers seem to see great advances in enhancing clinical and operational workflow with No. 1 and No. 2. I would suggest organizations start with No. 1 and move forward as they develop deeper expertise in AI/ML.

Calling All Changemakers

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