There’s a connect-a-thon happening in health care.
Just ten years ago, nine out of ten doctors updated patient records by hand (or dictation); paper records were stored in color-coded files and shared via fax between clinicians—like the primary doctor and the ear, nose and throat specialist doing the tonsillectomy.
Five years ago, the government offered financial incentives for physicians to go digital, which stimulated an explosion in the manufacture and sale of electronic health records (EHR) technology. But instead of one robust system that could be adopted uniformly to connect health care systems, pharmacies, payers, and government health registries, hundreds of proprietary EHR technologies were born and sold creating a Babylon of languages that cannot be interpreted between proprietary systems.
By the end of 2017, about 90% of office-based physicians nationwide will be using electronic health records. Fundamentally, digital patient records include patient history, demographics, health issues, physician’s clinical notes, lists of medications and allergies, prescription orders, and the ability to view lab and imaging results—in the clinic or hospital where records originated—but not among the broad “network” of providers.
EHR built silos, not synthesis
A recent interoperability study by the American Hospital Association, showed only a quarter of all hospitals are able to functionally exchange (find, send, receive and use) clinical information with external providers. Further, a Journal of the American Medical Association study found that only 34.8 percent of specialists receive information about a patient from their referring primary care physician (PCP), even when the PCP attempts to share patient records.
The U.S. has made progress in modernizing the collection and storage of health information through programs such as the HITECH Act and Meaningful Use, but unlike other industries that have unlocked data to power innovation, health care is yet to fully utilize the data sealed inside EHRs. In addition to improving individual health care, the use cases for big data in health care are rapidly proliferating as organizations move deeper into population health management and accountable care, and consumers amplify their demand for cost-effective services and convenient, digital communication.
For health-care organizations to successfully integrate data-driven insights, they need the ability to move information wherever it needs to go.
The platform is on FHIR
The chronic interoperability issues that have plagued health care are under fire.
The Fast Healthcare Interoperability Resource (FHIR), pronounced like the word “fire,” is a protocol showing great promise for joining data from disparate systems via a read and write application programming interface (API). In plain English, developers have created a standard that normalizes and unlocks data in EMRs—rather like a web browser reveals pages on the Internet upon query.
When patient data is readily available to care teams, no matter where they are, clinicians and researchers can use the data from across systems to administer better, more coordinated care of the individual and over time, groups of individuals with similar health-care needs. As health care reimbursement by Medicare shifts from fee for service to a value-based care model (which rewards positive outcomes rather than volume of services), the ability to use data to improve population health management (and reduce costs) is imperative.
It’s estimated that the API ecosystem will expand from $162.4 million in 2015 to $243 million by 2024 as providers, payers and other members of the care continuum invest in technologies that draw on existing datasets to enable clinical decision support and predictive analytics, patient-provider communication, and big data visualizations.
With apologies for the pun, FHIR ignites a secure solution to exchange digital health records among authorized parties. In doing so, it also meets patient expectations, which are far ahead of health care providers’ current digital prowess. Today, 97% of patients believe a health institution regardless of type or location should have access to their full medical history in order to deliver high quality care. These consumers bring a modern sensibility to data accessibility, despite what is available today. Of course, there are many dependencies in the journey toward industry-wide interoperability: technology maturity varies widely among providers, facilities and systems—with some still using faxes to communicate. But the final mile is in sight as health care catches up.