The Office of the National Coordinator for Health Information Technology (ONC) hosted its annual meeting last week. Netsmart attended this year’s event, themed “Tackling Barriers to Interoperability and Usability,” where we took part in conversations with other healthcare IT partners, clients and key ONC and CMS staff. The overwhelming takeaway is that interoperability is no longer an option, it is a critical component in the shift to value based care.
In his opening keynote, Donald Rucker, M.D., national coordinator for the ONC, made the case that health IT should be built on two main thoughts: relieving the burden for providers and end-users, and interoperability.
The ONC’s commitment to healthcare IT focused on three use cases. The first is empowering patients to own their own medical record and direct the exchange of their medical data amongst their treatment providers. This is a mobile first thought, where the patient directs and ensures that their data travels with them, electronically, as they see new providers, effectively removing the burden from the individual to provide their own records to their care team.
The second is around population health management. Using machine learning to inform care decisions will not only enable providers to use the data in the system, but provide dashboard views of population outcomes. Base measurements are a vital foundation to informing population health management, and that can only be accomplished through true interoperability; not just with physical health information, but with mental health and social determinants that will empower whole-person care.
The third is the need for open Application Program Interfaces, (APIs) to make data sharing easier and to remove any barriers from both a technology and cost perspective.
APIs also make it easier to adopt healthcare IT. With the shift to consumer-driven care, individuals are demanding that they have access to their data. Traditionally, data ownership has been fortified by a fee-for-service model, but in a value-based care world, that data will be liberated.
Accountable Care Organizations (ACOs) and bundled payments were also a topic of conversation among attendees. With the move to value-based payment models, data is no longer in silos. It will be ubiquitous and liquid across all care settings and the competition will be based on the services provided and how the data is being used.
The link to community care allows sharing of clinical quality measures and gives providers the ability to leverage a common clinical data set when sharing data.
CMS’ vision focuses on a “patient first” perspective as the value that drives everything that they do. What does the future of interoperability hold? Personalized health data so that providers can treat the whole-person. It is a world in which providers and payers are sharing data in real-time and moving aware from process measures to outcome measures.
We are excited by these conversations and are proud to be leading the way with our behavioral health, social services and post-acute communities. It is important to remember that just having an electronic health record isn’t enough. It’s just the beginning of a journey to complete integration and interoperability. The ONC has found that many of the usability issues surface after the EHR has been in regular use, and the organization has limited time and expertise to address these usability challenges. This is where Netsmart’s expertise and 50 years of experience come in. We start from the beginning of the implementation to ensure that we are focused on workflows, not just features and functionality. We do end-to-end testing, not just unit testing to make sure that the end users experience the entire workflow. The technology has to work in the real world, not just the testing lab. We also have experts from each client organization to help develop their configurable workflow processes. We have also invested in tools that can measure quantitatively the efficiency and effectiveness of different workflows, removing any friction, and ensuring users have a positive experience.