Less than half of specialty provider organizations have health information exchange (HIE) capabilities and less than a third use clinical decision support tools or population health management tools (see IT Spending Follows The Money). Those low adoption numbers give me pause because these types of tools are critically important to success in any collaborative relationship or in any value-based reimbursement (VBR) arrangement (see The Cutting Edge Of Data Sharing For Population Health, The Impact Of Tech In The Future – & The Reality Of Tech In The Present, Value = ‘Whole Person’ Approach). And, VBR and collaboration are keys for future success of all specialty provider organizations.
Last month, the Centers for Medicare & Medicaid Services (CMS) increased the focus on interoperability by releasing finalized rules for hospitals under the Medicare and Medicaid Promoting Interoperability Programs. The new rules confirm the intent to improve hospital use of electronic health records (EHRs) and to emphasize measures that require the exchange of health information between provider organizations and consumers (see CMS Finalizes ‘Promoting Interoperability’ Rule For Hospitals). The rule is effective on October 1, 2018 and applies to 3,300 acute care hospitals and 420 long-term care hospitals (see CMS Shifting Data Control To Consumers: Are You Ready To Share?). The 21st Century Cures Act also increases the focus on interoperability with a ban on “information blocking” that may inhibit health information exchange; and mandates to publish application programming interfaces (APIs) and testing to assure interoperability (see Summary: 21st Century Cures Act Of 2016).
The market and these new developments are ushering in a new era in HIE—dubbed “HIE 3.0” by Dick Thompson, chairman of the Strategic Health Information Exchange Collaborative. In a HealthTech article, Health Information Exchanges Evolve to Boost Provider Interoperability, Mr. Thompson framed the advancements in HIE in two stages: First came HIE 2.0, which was centered on interoperability that is dependent on the cloud, apps, and the internet of things. Now, we are looking ahead to HIE 3.0, which Mr. Thompson explained is focused on consumer engagement; he noted that HIE 3.0 will demand “a level of trust that is less about technology than it is about people and process and building networks of trust between individuals.”
What does it take to build a system that can keep your organization competitive as we move into the era of HIE 3.0? Our team has put together five key elements to building an effective data strategy—an EHR with the ability to share data, the ability to build partnerships, data management capabilities, consumer education and engagement plans, and data security policies.
The right EHR system—Not all EHR systems have the capability of participating in two-way information sharing. Executive teams need to think about future interoperability needs, both exchanging data and using a wide range of data in the clinical management process (see The Future Of EHR-Collaborate, Connect, Communicate and The Nuts & Bolts Of Making A Health Home Sustainable.)
The ability to build partnerships across the care continuum—By definition, exchanging health information requires other organizations to exchange it with. Executive teams need to build relationships to participate in data exchange with other organizations, with the specifics depending on their market. There are formal HIEs (see Are We There Yet? A Look At Three State Health Information Exchange Initiatives); most accountable care organization (ACO) and integrated delivery systems have data exchange collaboration; and planning for participation in initiatives like medical homes and health homes, or entering into VBR arrangements, requires data sharing.
The ability to manage ‘exchanged’ data—It is not enough to share and receive information from other organizations. Competitive advantage comes from the ability to use that information. That requires planning and tradecraft to develop operating systems where data provides “actionable insights” (see There’s More To A Data Culture Than Just Data and Making Your Clinical Team Data Driven).
The right consumer education and engagement policy—With the focus on consumer transparency and consumer engagement, HIEs now need to consider how to involve consumers in accessing and using their own health information. The recent CMS policies give consumers more control over their health records, and require Medicare provider organizations to update their EHR systems to the 2015 Edition Certified EHR Technology (CEHRT), a version capable of providing consumers with data in a usable and secure electronic format. But for consumer engagement strategies to work effectively, consumers need to trust both the quality and the security of the health information (see CMS Shifting Data Control To Consumers: Are You Ready To Share? and Increasing Client & Staff Engagement Through Creative Use Of Technology).
A solid data security policy—Data security is important for two reasons: preventing the liabilities that come with data breaches and building consumer trust. Every organization needs a data management strategy and a solid data security plan (see Your Data Security Deserves A Second Look and Integration, Interoperability & Consumer Engagement).
Whether it has made it to your strategic plan or not, in a value-based care environment, the ability to integrate data from disparate sources—physical health, behavioral health, pharmacy, social services, and social determinants—is critical to survival. For more on the challenges of managing your data, check out these resources from the OPEN MINDS Industry Library:
- How To Be Operable In An Interoperable World
- CMS Clarifies Funding Streams For Opioid-Related HIT
- Success With Care Coordination? Bringing Order To Complication
- Is Your Organization Data Reactive – Or Data Predictive?
- Provider Organization Tech Investments Predicted To Double – What Tops The List & Why?
- Moving EHR Investments From ‘Must Do’ To ‘Must Have’
- More & Larger Health Care Databases Mean More Data Security Concerns
- IT Spending Follows The Money
- Population Health Demands Managing By Exception – With Data
- You Have An EHR, But Can You Share Data?
For more, join my colleague Joseph Naughton-Travers, Senior Associate, OPEN MINDS on October 24 at The 2018 OPEN MINDS Technology & Informatics Institute for his seminar, “How To Make The Right Tech Investments For Your Organization: An OPEN MINDS Executive Seminar To Technology Budgeting & Planning.”