The recently proposed information blocking rule from the ONC and CMS has thrust interoperability into the spotlight like nothing has in recent years, making it a hot topic for media fodder, and a major concern for organizations — necessitating renewed attention to data-sharing practices.
The conversation surrounding this new rule has implied that information blocking is the result of healthcare organizations intentionally withholding data. However, more often than not, information blocking is a matter of “can’t,” rather than “won’t.” Organizations usually encounter financial and operational barriers that impede their ability to address and manage interoperability challenges.
That said, as hospitals and health systems look ahead to the next industry hurdle, they must be mindful of the expanding requirements of interoperability that are being driven by a growing focus on consumer-driven medical care and treating patients as cherished customers.
Patient-Generated Health Data Adds Complexity
Currently, the healthcare industry primarily deals with healthcare-related data (i.e. clinical information), which has presented its own challenges when it comes to sending and receiving information among disparate organizations. However, with the industry’s growing focus on healthcare consumerism, and the increasing availability of non-healthcare data (i.e. consumer data), healthcare organizations are being enabled to create rich customer profiles.
Consequently, today’s interoperability challenges will be catapulted to a whole new level. Knowing interoperability will only be further complicated by this shifting focus on consumer data, health organizations must take action to get ahead of this trend and the inevitable challenges that will come along with it.
Though daunting, the good news is that the industry has collected a lot of insights into interoperability and effective data integration, and many of the new non-healthcare data sources, such as customer relationship management (CRM) systems, are fairly mature and well understood. Additionally, many healthcare organizations already have great tools to help support these interoperability efforts.
Addressing a Range of New Data Sources
As the healthcare industry moves toward a more consumeristic model, health organizations will need to consider the range of data sources that are used for user customization outside of the medical world for large consumer-facing brands like Amazon and Walmart. User customization for brands such as these rely on highly sophisticated databases that create customer profiles and populate data from a variety of sources, including internet search history, online shopping activity and purchasing history, as well as in real life. These databases also pull information from public sources like demographic and geographic data, and from social media, to provide insight into personal preferences and inform the best way to interact with each specific consumer.
If we translate this to the healthcare realm, there are specific data sets healthcare organizations are currently accessing to learn more about a patient that can and should be leveraged to customize and improve each individual patient’s experience. Hospitals and health systems have access to patient clinical data via EHRs, and these systems compile valuable details about a patient’s conditions, allergies, recent treatments, claims data.
They also contain a wealth of insurance and behavioral information — down to how regularly a patient is refilling their prescriptions. On top of these medically related pieces of information, EHRs can also provide the same or similar data that consumer companies have access to (i.e. demographic, geographic, preferences, patient behavior during inpatient care, and social determinants of health).
Bringing CRMs into the Mix
The implementation of CRMs (which track consumer data) within healthcare settings will be important to maximize these pieces of data healthcare organizations already have access to. This could further complicate interoperability challenges as the CRM will be a new system that will need to learn to integrate and talk to relevant clinical and claims data sources.
With the introduction of a system like a CRM, security will be especially sensitive as patient privacy and data security are critical compliance issues within the healthcare industry. As such, it will require new kinds of professionals within organizations to leverage that data in order to provide patients with a more customized and improved experience.
While this may sound like a lot of work, the good news is health systems have been slowly transitioning to a consumer-first mindset and adopting the appropriate technology for some time now. Many organizations already have sophisticated data integration platforms that effectively work and interact with non-healthcare data sources, just as they do with healthcare data sources.
The Health Consumer’s Digital Experience
One of the first consumer-experience challenges for the healthcare industry to focus on will be creating a robust digital experience for patients on hospital websites and apps, also known as a “digital front door.” Forward-thinking healthcare organizations are starting to pay attention to all the different ways in which patients are interacting with healthcare data systems. Bringing together all of this data on patient behavior will allow hospitals and health systems to further improve patient experiences in a similar manner to prominent brands in the consumer-focused world.
The current government and industry focus on transparency promises to take the consumerism challenge to a whole new level for healthcare organizations rapidly. As consumers gain the ability to easily see pricing and quality data, as well as effectively shop among a range of provider options, these organizations will need to differentiate on the level of service and perceived customer value more than ever. Today’s challenges of integrating consumer data with healthcare data to relate with patients/customers based on richer profiles will become tomorrow’s existential imperative.
About Drew Ivan
Drew Ivan is the EVP of product and strategy at Rhapsody, a provider of healthcare interoperability and data connectivity. Drew’s focus is on how to operationalize and productize integration technologies, patterns, and best practices. His experience includes nearly 20 years in health IT, working with a wide spectrum of customers, including public HIEs, IDNs, payers, life sciences companies, and software vendors, with the goal of improving outcomes and reducing costs by aggregating and analyzing clinical, claims, and cost data.