A Modern Industrial Revolution: Electronic Health Information Connectivity

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A Modern Industrial Revolution: Electronic Health Information Connectivity

Editor’s Note: Buff Colchagoff is the CEO of RosettaHealth, a cloud-based health messaging and exchange platform. Colchagoff has over 16 years of health IT experience with large projects, including building the VA’s PHR MyHealtheVet, as operations manager for the Nationwide Health Information Exchange (NwHIN) which grew into the Sequoia Project.

The industrial revolution has shaped life as we know it today.  Historic inventors, explorers and entrepreneurs paved the way to economic and social transformation from the end of the Eighteenth Century all the way through to the middle of the Nineteenth Century. 

Fast forward 200+ years, and we have entered an era of Industry 4.0, in which computers and robotics are coming together in an entirely new way.  This period represents the combination of cyber-physical systems, the Internet of Things and the Internet of Systems.

While the fourth industrial revolution is normally associated with automation and data exchange in manufacturing technologies, there is also a modern industrial revolution occurring within healthcare – in the form of electronic health information connectivity. 

With the incentives in recent years for creating and exchanging digital health data, there is finally a clear business advantage to share, exchange and use this data in innovative solutions. These offerings have great promise to improve patient care, manage costs and help develop breakthrough treatments.

However, many in the HIT market still treat connectivity as a cottage industry when it concerns challenging, specialized areas such as interoperability and data ubiquity. Industry participants often believe it is more effective, efficient and economical to create their own clinical data transportation solutions, when, in reality, exchange platforms already exist that offer low-risk, low-labor and low-cost alternatives. 

Unfortunately, this “I can build it myself” perception can hinder forward momentum and value-based outcomes.  There are real costs – and sometimes, detrimental consequences –associated with inefficiencies and the widening gap in health information exchange.  

So, that leaves a question to ponder: Can concepts that were innovated centuries ago help advise and shape the modern revolution occurring within healthcare information connectivity?

Lessons Learned from the Industrial Revolution That Are Pertinent Today

Let’s focus on the results of one notable visionary, Eli Whitney.  Inventor Eli Whitney revolutionized cotton production by greatly expediting the process of removing seeds from cotton fiber. Based on his success with creating the cotton gin, he later secured a significant contract to build muskets and promoted the idea of interchangeable, standardized parts enabling faster assembly, and easier device repair.

Adoption did not happen overnight.  There was significant resistance to standardized manufacturing – many thought the only way to have a quality firearm was to custom craft it from a gunsmith. Ultimately, standardized manufacturing produced firearms cheaper, faster, and of a higher quality than a local gunsmith.

Whitney’s creations made life easier, boosted productivity and produced higher quality products ― but it took a new way of thinking beyond the status quo.

Today, we are faced with a similar challenge in clinical information connectivity.  Even though there are components of health IT that are complex and difficult, vendors often resist standardization and industrialization.  Doesn’t it make sense to do to health data exchange what Eli Whitney did for mass production?  Not only are there efficiencies to be gained, but also the ubiquity of health data will make all health systems more valuable and effect positive health outcomes.

Many organizations involved in the healthcare ecosystem still maintain a cottage industry of building point-to-point, custom connections versus moving to the ubiquity of standardized services.  They continue the “custom build” mentality for interoperability despite real time, money, resource and outcome challenges associated with this viewpoint.  But, why?

Benefits of an Industrialized Solution

Health data lives in any number of different systems managed by various parties. Some HIT vendors are reluctant to make data sharing (via standards or any other means) easy because they see it as their ecosystem.  Additionally, many healthcare organizations rely on diverse systems to help deliver care – further complicating exchange architectures.   

When needing only a few connections, building custom point-to-point connections may not be difficult.  But with the incentives for using shared clinical data across care sites precipitated by Meaningful Use, ACA, MIPS and MACRA – it’s not just a few connections; it’s more like having many channels with room to grow. 

What happens to your cottage industry when you have to exchange data with a number of practices (both in-network and out), the regional HIE and a referral management system?  Or worse, your population health effort needs data from 700 sites?  Trying to build each connection by itself is costly, resource intensive and time consuming – and simply won’t scale to “industrial” needs.  

To meet the expanding demand for clinical data, you not only need a high degree of expertise in different and evolving HIT interoperability standards and interfaces, but it also requires the competencies and resources to scale the infrastructure.  And, you must be prepared for the long-term care and continuous feeding of the different components.  This results in significant human capital to support all of these activities.

In summary, what was once a fairly negligible task of maintaining a few interfaces has quickly transformed into a complicated, skilled effort requiring an experienced team to build, maintain and monitor messaging capabilities.  Additionally, as the number of connections, and amount of bandwidth grows, the task of tracking and troubleshooting data exchange issues grows exponentially.  Not only do you have to have auditable tracking of all PHI per HIPAA, you must also be able to quickly debug suspected errors and problems.  This can represent an increasing load for technical teams.

If this isn’t your core business, is it worth the extensive time, money and resource investment to staff these activities?  And, at the end of the day, are you better off focusing team members on your core business, and having an efficient, effective service address this connectivity?   

SaaS Exchange Platforms as Modern-Day Connectivity Pioneers

Modern-day pioneers exist in today’s health information connectivity revolution. But, rather than inventing the cotton gin or standardizing assembly processes, these SaaS pioneers are offering healthcare organizations low-risk, low-labor and low-cost alternatives to building an internal, expensive and brittle messaging infrastructure.

Specific cloud-based solutions provide a tremendous opportunity for industry participants to seamlessly and securely access, engage and exchange health data in real time. These SaaS exchange platforms deliver on-demand capabilities when needed, offer flexibility to incorporate new requirements rapidly and eliminate the need to obtain/retain experience in all of the different disciplines required for effective HIT interchange. 

These solutions offer resilient scaling, meaning they handle high bandwidth exchange of records 24/7, with redundant systems and monitoring.  The platforms can also handle cases of increased demand or instances when things don’t quite go according to plan, without interrupting other exchanges.  Additionally, new systems and feeds can be added without extra effort or additional capital investment. 

SaaS interoperability providers offering a single interface to send, receive and automatically update medical information while also maintaining connections with the entire healthcare ecosystem will dramatically transform clinical records exchange and health data consumption. 

Just as Eli Whitney transformed manufacturing, cloud-based exchange platforms are accelerating clinical information exchange and challenging our notion of how healthcare information really can fuel improved outcomes.     

A modern industrial revolution is occurring within health information connectivity – it’s history in the making.  How will you participate and shape the future of full interoperability and data ubiquity?