We began traveling down the road to integration and collaboration by noting the importance of this journey; severe mental illness (SMI) impacts both lifespan and quality of life. In addition, fragmented care drives higher costs. Along the way we’ve been witnesses to the practical use of applications including referral process automation, integration with Acute Care Organizations (ACOs), and synchronized systems across Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCS). But any successful journey involves looking not only at the road directly in front of us but the landscape on the horizon. In this case the landscape we must look to is one marked by technology that can move us beyond just basic information sharing.
To enable true interoperability, we need to make use of technologies and platforms that integrate directly into the EHR. But there are further requirements. They must make use of standards-based transactions and data elements to support broad scale connections. Without visibility across systems we can’t pave the way for network-to-network connectivity in the future. So, what’s so important about network-to-network connectivity and what are its requirements?
This type of integrated connectivity requires tools that can aggregate information for segmentation and stratification. That opens a myriad of possibilities including:
- Populations can be defined by relevant attributes
- Data can be segmented by diagnosis, gender and utilization of services
- Risk-based factors can be ranked based on outcomes, workflows and treatment
- Assessments can be made spanning high risk/cost vs. low risk/cost
The ability to synchronize across systems and aggregate information for segmentation and stratification holds great promise because everyone benefits. Not only can an individual be treated holistically, the treatment outcomes of groups of people can be monitored and analyzed so care can be optimized and applied to communities elsewhere.
These are exciting times that hold much promise but there’s a final stop we absolutely must make on the road to true collaboration – without that stop we won’t ultimately arrive at our destination. We’ll examine that signpost in Part IV of Integrating Care: Moving Beyond Interoperability to True Collaboration.