Interoperability: the next chapter

As health leaders navigate our transition from life living in a pandemic to a world where COVID-19 is an endemic disease, interoperability will likely be top of mind. Collecting, perfecting, sharing, and analyzing health data in an expedient manner to create real value for patients is the essential prerequisite for anticipating any impending COVID-19 surges.

Optimizing the resources of our industry, both human and capital, to effectively distribute future booster shots and track patient status, as many people continue to use both in-person appointments and digital health tools, is critical if we are to safely and effectively normalize the “new normal.”

During the first two years of the pandemic, consumer demand that we return to normal pushed the health system to adapt existing technology to quickly ensure that patient health information could be shared safely and with speed. We saw pharmacies step up to track and distribute vaccines, technology companies fast-track COVID-19 verification solutions, and transportation and travel organizations automate data exchange even across international borders.

As we enter into our third year of the pandemic, we can expect four new drivers to propel interoperability forward:

Trust will be the next input for advancing interoperability
Interoperability and the recent surge in support from health care leaders for Fast Healthcare Interoperability Resources (FHIR), spurred on by federal mandates, has unlocked previously siloed data stored behind propitiatory internal enterprise systems. By mandating that patient data be made accessible via Application Programming Interfaces (APIs) and standardized data formats, health care is effectively liberating data resources to create value on behalf of patients by third parties beyond payers and providers.

Now data has the potential to flow freely between stakeholders in the health care information ecosystem, but the question remains: Is the data verifiable and can we trust it? In health care, the concept of trust is a foundational element as it impacts the health, quality of life, and cost of care for millions.

In order for governments, plans, and providers to use the data that is now accessible, the data pipelines providing the infrastructure for transport and aggregation must be verified and certified. The expectation is there will be a push to develop and implement a nationwide fabric of policies, technologies, and governance mechanisms to guarantee trust in the quality of the information, as well as the dependability of its delivery to and from digital endpoints. This will be done with the fully articulated consent of patients.

Like never before, the industry will be able to deliver on the vision of value-based care because the ability to accurately report on quality of care and the impact of decisions upon payments and premiums is now a reality.

The rise of digital health applications
Consumer applications that verify negative COVID-19 test results and vaccination status are quietly gaining significant support across political lines for many practical reasons. Already these apps have proven useful for international travel, cruises, and increasingly for access to public event venues, conferences, and even weddings or private affairs. Domestically, and to some extent internationally, most of these apps are adopting the HL7 FHIR standards promoted by the VCI^TM Initiative and using the SMART Health Card framework.

Rapid adoption of these digital tools by consumers and vendors will inevitably accelerate interoperability and the use of FHIR. Payers, providers, and other stakeholders will continue to expand the use of SMART Health Cards as easy methods for patients to be true agents of interoperability and literally carry their information with them to any and every encounter where their electronic health information can add value.

Generation Z’s demand for a more personalized, data-driven health care experience
GenZ health care consumers are the first generation to only know a world with the internet, smart devices, and apps. As a result, they have radically divergent views about privacy and trust in the digital world, as well as the understanding that convenience is often based in transparency. Having grown up with Google, Facebook, Amazon, Instagram, and Yelp, Gen Z has become accustomed to the instant availability of information about anything while having seemingly little compunction about sharing their own.

With these consumers, there is an emerging quid pro quo relationship between sharing information and receiving better access to great care. Add big data, machine learning, artificial intelligence, ubiquitous cloud access, and REST APIs, and the expectations on behalf of Gen Z will be much higher than any we have seen. Gen Z is pushing the industry to mirror the same consumer-centric experience as e-commerce at large. Interoperability will be key to reaching that level of personalization.

More sticks to build on carrots

The dangling carrots for interoperability have increasingly been the real dollars associated with reduced burden, reduced cost, and fully engaged consumers—all within the context of increased quality of and better access to patient care.

Legislation from Congress in the form of the No Surprises Act, and the 21st Century Cures Act rules from the United States Department of Health and Human Services broadly covering payers, providers, and technology vendors, seem to be arriving regularly. These sticks banging on the industry serve as a drumbeat of their own to promote interoperability.

More than ever before, payers, providers, and patients are realizing the value in interoperable data exchange. In 2022, we can expect interoperability discussions to transition from how we share the data to how we trust the data. We can also anticipate consumers continuing to drive the interoperability agenda through increased use of digital health tools and a heightened demand for a more on-demand consumer health experience.

Kelly provides strategic consulting to Edifecs customers, specializing in information exchange and applying the principles of supply chain integration to the healthcare delivery lifecycle. His wide-ranging experience includes serving as CIO of healthcare network provider NaviNet, director of eBusiness Architecture at Harvard Pilgrim Health Care, and managing director of his own health IT consulting firm.