Interoperability now needs to go beyond EHRs to include the larger digital health ecosystem

The Covid-19 pandemic spurred an evolution in care delivery, and as a result, healthcare stakeholders must expand their vision for what the next phase of interoperability will look like.

Dr. Nick Patel, chief digital officer of Prisma Health — who spoke on a virtual panel about interoperability at the American Telemedicine Association’s 5th Annual Conference & Expo on Thursday — believes that the new phase of interoperability must move beyond the EHR to include digital care services and care provided in the home.

For example, though patients are increasingly turning to telehealth, they still need to be brought in for certain services like laboratory tests or imaging. In these scenarios, interoperability is key to make sure providers — whether providing care using telehealth or in-person — have the required medical history and information about the patient, Patel said.

“It’s extremely important to look at how interoperability is going to have that data flow from one system to the other,” he said. This is especially true if patients are going to different entities that are not on the same EHR system.

The data flow considerations do not stop at telehealth alone. There are others, like deciding where data collected from remote patient monitoring devices or wearables will be stored and how that data will be shared.

“That integrated ecosystem for digital health is equally important [as it is for EHRs],” Patel said. “You have to think of digital health as a continuum of services that are tied into in-person visits.”

Further, ensuring safe data sharing can not only improve patient care and experience but can also aid providers in digging into population health trends. In fact, Greenville, South Carolina-based Prisma Health is using data gleaned from wearables to power a population health dashboard, Patel said. This enables them to more accurately identify patients who need additional support and find links between their health outcomes and socioeconomic status.

Breaking down silos to make patient data accessible across different care settings and available for analysis is what Serkan Kutan, chief technology officer at Amwell, is focusing on as well.

Due to the episodic nature of telehealth — the roots of telemedicine are in urgent care, after all — these visits can be left out of interoperability efforts. This results in patients meeting with physicians who have no context for the visit, Kutan said during the panel discussion. As telehealth grows in popularity, this needs to change.

In addition, what happens between patient visits is as important as what happens during the visit, he said. It is now possible to collect that in-between-visits information, but not being able to share it hampers the huge potential of analytics.

Interoperability standards and application programming interfaces have evolved greatly, which is good, but moving forward the focus needs to widen from the technology itself to the larger ecosystem supporting it. Essentially, stakeholders need to work together.

“The lesson learned for me in U.S. healthcare is there no magic interoperability wand,” he said. “It’s all about the ecosystem, and it takes a village [to achieve widespread interoperability].”

Photo: JamesBrey, Getty Images





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