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In healthcare IT policy circles, interoperability always dominates the conversation. But for the most part, those conversations have focused on access: Just getting hold of the data.
There is still room for improvement here, especially with an ever-expanding number of healthcare endpoints. But broadly speaking, access has improved tremendously in the past few years. Vendors and health systems are collaborating through groups like the CommonWell Health Alliance, Carequality Sequoia, and the Argonaut Project. The 21stCentury Cures Act created stiff penalties for information-blocking behavior.
And market forces will create more momentum for information sharing, since the shift to value-based care gives clinicians an increased stake in usable data.
So it's time to think much more expansively, and more creatively, about what interoperability truly means.
That's because improving care — and lowering systemic healthcare costs — will require more than the mere availability of healthcare information. Data means nothing if it isn't presented in a user-friendly manner, and if it doesn't actually help to improve patient outcomes.
When we talk about interoperability, utility and performance are the next frontiers.
Utility: The data you need, and no more
In order to tell an entire patient narrative, healthcare data must have context. A clinician doesn't just want to know a patient's cholesterol levels from the previous month. He wants to know what the cardiologist was thinking when she ordered the test, saw the results and modified a statin dosage.
In other words, clinicians need the same usefulness from their clinical information that consumers do when they mine information in Amazon, Uber, and Mint.com.
In addition, we need to be careful not to overcorrect for limited access to data in years past. There's a danger of data overflow: Every physician has received a 40-plus-page patient care summary, in which it's nearly impossible to find the information that's relevant to that day's visit.
Performance: Who sets the goals?
Right now, a remarkable amount of information is captured in and transferred between EHR vendors. But that data is meaningless if it doesn't serve a goal. And the ultimate goals of healthcare data, with respect to interoperability, should be reduced costs and improved outcomes.
So who will be driving that process? The private sector has the resources and tools to increase the value of shared healthcare information. And EHR vendors are positioned to listen directly to the experts — their clinician clients — about the information they need in the exam room to improve care delivery.
The federal government should be wary of getting in the way of those relationships. Specifically, Congress and the Department of Health and Human Services should promote policies that create room for private stakeholders to innovate.
And the federal government shouldn't attempt to regulate a solution for usability or data performance — which could slow progress to improve access, utility and performance of healthcare information.
As more information is shared among clinicians in seamless and useful ways, the insights to be gleaned are nearly limitless. But we need to understand that “interoperability" is more than a buzzword. It's a process.
Greg Carey is technology standards and policy manager at athenahealth.