Getting to Nationwide Interoperability
Free Flow Data Sharing
Unfortunately, the existing healthcare system incentives behavior that is in opposition to the goal of scalable, nationwide, vendor-neutral interoperability. Our model has multiple groups who have a vested interest in the control and ownership of data (for example Payors, Providers, Patients). Each has their own economic and commercial drivers and in many instances, these do not coincide with the open sharing of data. In a system that is driven by activity and delivering care (Fee for Service) sharing data could mean a reduction in work and income. Until our reimbursement system moves to a more holistic care model that focuses on wellness and outcomes and incentivizes behavior that delivers better health and outcomes for patients through cooperative and coordinated care and ultimately equitably rewards all the contributors to these outcomes we will remain stuck in the quagmire of limited interoperability.
The Patient at the Center of Data Exchange
Free Flow Data Sharing
I believe as do many others that the patient is at the center of everything we do and deliver in healthcare. By placing the patient and their information at the center of care we empower them and enable a model that moves away from the historical paternalistic delivery of healthcare to patient-centered and enabled care. It does come with challenges since many people contribute to that care and the current administrative and financial configuration focus the management and ownership of data with providers, healthcare systems and payors. While many patients want access to their data and some even want to own and manage it, many do not and are ill-equipped to be responsible for this data. What may emerge are independent services and providers who aggregate, manage, secure and service patient data on behalf of patients – much as banks do with our money. There are many technologies on the horizon that offer a potential path to achieve this and blockchain represents an interesting innovation of decentralized secured data that offers individualized control and dynamic revocation options for access.
Frictionless Data Flow
The key to an interconnected care model is the free flow of data between all the various areas that are responsible for delivering care. We moved away from the single index card medical record held by your personal physician who was the focal point of your care and care coordination to a distributed team-based model of care that encompasses multiple areas and people. The only way this team can deliver excellent care is through the frictionless flow of enhanced data and knowledge. This information flow must include the patient and all their family members that are authorized, interested and engaged in their care. Data should be shared with the patient’s consent with everyone concerned and available for as long as it is needed to deliver care but this access should be flexible enough to allow it to be revoked or removed when it is no longer needed or necessary
