Interoperability
A Key Strategy for Navigating Value-Based Care

Shyam Manoj K, SVP – Payer, CitiusTech

INSIGHTS

  1. Interoperability lies at the heart of value-based health care, enabling healthcare providers to harness the power of patient information and generate more excellent value downstream.
  2. By maximizing interoperability, care efficiency is optimized, redundant tests are minimized, and costs are reduced. In addition, it facilitates a holistic perspective of the patient's health data, which is vital for the success of value-based care.
  3. Electronic health record (EHR) data interoperability promotes coordination and accessibility, empowering preventive care and healthcare analytics.

As the healthcare landscape embraces digital transformation for better patient outcomes, seamless interoperability is pivotal in uniting diverse providers and systems to share patient information effortlessly. Based on the information provided by the Office of the National Coordinator for Health Information Technology (ONC), organizations leveraging interoperability technologies witness remarkable enhancements in patient care. These include increased rates of preventive care, decreased hospital readmissions, and improved care coordination. Moreover, hospitals with advanced interoperability capabilities report an 84% boost in patient safety and a 76% rise in patient satisfaction. A research study published in the Journal of Medical Internet Research highlights a notable 30% reduction in healthcare costs per patient when implementing interoperable health IT systems within a comprehensive US healthcare system.

By enabling healthcare organizations to share data across different systems and providers, interoperability helps identify high-risk patients who may require additional care and resources, leading to targeted interventions and improved health outcomes for individuals and populations.

THE CHALLENGES OF ACHIEVING INTEROPERABILITY IN VALUE-BASED CARE

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While the success of value-based care relies on interoperability, healthcare faces substantial hurdles in achieving seamless data exchange. In 2019, a Healthcare Information and Management Systems Society (HIMSS) survey revealed that only 30% of hospitals could exchange data with other hospitals. Furthermore, data blocking was reported by 93% of hospitals, as indicated by a survey conducted by Black Book Market Research, where healthcare organizations intentionally impede the sharing of patient data with other entities. Another critical obstacle is the need for more standardization in healthcare data. A National Academy of Medicine study found that over 97% of electronic health records (EHRs) had incomplete or missing medication information. These challenges underscore the need to enhance interoperability and standardization in healthcare data exchange.

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MAXIMIZING INTEROPERABILITY IN VALUE-BASED CARE

Maximizing interoperability can help healthcare providers improve patient outcomes, reduce duplicative testing, and lower costs. In addition, it provides a comprehensive view of the patient's health, leading to better-informed decisions about patient care.

Interoperability in value-based care ensures that healthcare providers can seamlessly exchange data in a standardized format, regardless of the technology used. This includes sharing information about patient health history, medications, allergies, and other relevant data. However, in a survey conducted by the Office of the National Coordinator for Health Information Technology, only 38% of hospitals in the United States reported being able to exchange and integrate patient health information from outside sources electronically.  This means that most healthcare providers still need help sharing patient data effectively. Here are six essential factors that can help healthcare providers maximize interoperability:

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Implementing standardized data formats: Healthcare providers can implement standardized data formats such as HL7 FHIR, allowing the exchange of data between different systems and providers to be standardized.

Use Application Programming Interfaces (APIs): APIs provide a standardized way for different systems to communicate with each other. For example, healthcare providers can use APIs to integrate different systems and exchange real-time data.

Investing in Health Information Exchanges (HIEs): HIEs exchange health information between providers and systems. By investing in HIEs, healthcare providers can ensure that patient information is available to all providers involved in the patient's care.

Ensuring data security and privacy: Providers should implement security protocols like encryption and access controls to protect patient information.

Adopting Electronic Health Records (EHRs): By adopting EHRs, healthcare providers can improve the accuracy and completeness of patient data while making it easier to share across different systems and providers.

Participating in value-based care programs: These include accountable care organizations (ACOs) and bundled payment programs, which can incentivize providers to focus on patient outcomes and reduce costs by promoting collaboration and care coordination.

Healthcare providers must leverage robust datasets and informed research from medical interoperability vendors to improve value-based efficacy.
The five key trends in healthcare data interoperability

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BENEFITS OF INTEROPERABILITY IN VALUE-BASED CARE

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Interoperability facilitates consistency and liquidity of data, allowing healthcare organizations to utilize it downstream to create value. Organizations that embrace interoperability ensure cost savings and care efficiency that directly impact occupational therapy. According to a report, value-based care performance reviews have found that interoperability improved outcomes, increased preventative care, and improved patient satisfaction in healthcare adoption.

The interoperability of electronic health record (EHR) data is also critical for the success of value-based care, as it enables coordination and accessibility necessary for providing effective preventative care and healthcare analytics. A report by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) states, inaccessible or incomplete patient information creates a barrier to coordinated care and makes providing effective preventative care nearly impossible.

Embracing a patient-centric approach where patients own their medical records is vital for boosting interoperability across all stakeholders in value-based care.

MOVING AHEAD

As the shift towards value-based care continues, healthcare providers must prioritize interoperability investments to optimize their operations under these new models effectively. Policymakers must provide more support by creating incentives for collaboration among stakeholders. This collaboration can promote technology infrastructure investments to sustain effective health information exchange between technologies used by disparate parties. The stakeholders must also ensure to implement security safeguards throughout the process.

By investing in technology infrastructure designed around seamless integration between systems using standardized formats within a secured environment that only authorized entities have access to (such as blockchain), healthcare providers can ensure that patients receive optimal care through efficient utilization of resources available today - without any added burden on already stretched finances and workforce required for upkeep.