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How The Sequoia Project is promoting health data usability

The Sequoia Project's Taking Root Initiative is looking to address health data usability issues across the industry, ranging from human factors to technical challenges.

While interoperability continues to grow nationwide, health data usability remains a challenge. According to Health Gorilla's 2023 "State of Interoperability" report, 60% of health systems reported health information exchange (HIE) challenges, including duplicative or incomplete data, and 69% of digital health executives said there were gaps in their HIE data.

The Sequoia Project, a nonprofit organization that promotes nationwide health interoperability, is seeking to help healthcare organizations overcome challenges to data usability through its Data Usability Taking Root Initiative.

"Interoperability is critical, but there's a lot more to interoperability than just getting information from point A to point B," said Holly Miller, MD, chief medical officer at MedAllies, a health IT network participating in the Taking Root initiative.

The initiative aims to support the implementation of data usability guidance, which was published by The Sequoia Project's Data Usability Workgroup and includes input from 486 participants and 391 organizations.

"The data usability guidance leverages existing standards to address pain points from end users on the front lines, so those would be HL7 standards, IHE standards and others that have already been developed," Miller said.

Data usability barriers

According to Miller, data usability barriers fall into two categories: technical challenges and human factors.

"Technical challenges include enhancing electronic health record end-user interfaces so that the system is actually helping make the right thing to do the easy thing to do," she explained.

On the other hand, human factors impacting health data usability include clinician documentation hygiene, which refers to documenting patient data accurately and appropriately.

For instance, entering start and end dates for medications is important to ensure accurate records and patient safety.

"I've heard stories and complaints about times when clinicians receive a record, and an antibiotic is prescribed, but no dates are associated with it, and no infections are in the record," Miller said. "So they're scratching their heads, like, do I continue this antibiotic? Is there a reason for it?"

Interoperability is critical, but there's a lot more to interoperability than just getting information from point A to point B.
Holly MillerMD, chief medical officer at health IT network MedAllies

Additionally, suppose a primary care physician (PCP) refers a patient to a specialist and queries for the patient record maintained by the specialist. In that case, the PCP would need to update their patient chart with any new diagnoses and medications that the specialist documented.

"If I prescribe a medication that has a drug-drug interaction with the medication that the specialist prescribed, it's important that it is in my record so that I would get that alert," Miller explained.

Coded data for interoperability, patient safety and efficiency

What's more, The Sequoia Project's data usability guidance underscores the effective use of codes to drive semantic interoperability and ensure data is machine-readable across different systems.

Without properly coded health data, providers often must rely on transcribing paper records when sharing health information, which can have big implications for patient safety.

"I can't tell you how dangerous transcribing information is," Miller said. "I've seen medication dosage errors and inaccurate diagnoses because of transcribing errors."

Properly coded health data is also important for care efficiency. For instance, access to a patient's longitudinal health record eliminates the need for providers to order duplicate tests, which is a persistent issue across the care continuum.

Experts estimate that between 20 and 30% of the $65 billion spent on lab tests in 2015 was used to perform unnecessary duplicate tests, according to a 2022 study. While duplicate testing adds significant costs to the healthcare system, Miller pointed out that avoiding duplicate testing is key to improving the patient experience.

"The most important part of duplicate testing for me is not the cost," Miller said. "It's that the patient would have to potentially get stuck for another blood draw or go through a very uncomfortable test for a second time and be inconvenienced in their life to have to do that."

Improving data usability through the adoption of health data standards for interoperability is also critical for decreasing provider burnout.

"Having to re-document and re-enter and try to understand unusable data or trying to find data is really a great burden," Miller said.

Miller emphasized that as the industry continues to move toward value-based care, which puts a greater emphasis on integrated care delivery, it will be exceedingly important for healthcare providers to maintain accurate patient records in appropriate standards.

"When we think about maintaining a care plan in an interoperable environment, it's almost as if you are virtualizing an electronic health record that everyone is sharing so everyone caring for an individual is aligned," she said.

She noted that participation in The Sequoia Project's Data Usability Taking Root Initiative is open to all healthcare organizations that want to aid in the development of the second version of the Data Usability Guide.

"I really would encourage anyone that has struggled with pain points in using data to get involved," Miller said.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.

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