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Why Healthcare Interoperability Must Meet the Needs of Data Recipients

Interoperability rules and regulations specify how providers should send information, but receiving actionable information is equally vital to patient care

At its most basic form, interoperability is the ability to send and receive information. Previously, we touched on the importance of enabling providers to use their method of choice for exchanging patient data — ranging from existing fax and email protocols to emerging application programming interfaces (APIs) and HL7 FHIR. But the recipient’s ability to act on shared information depends on the ability of their health IT systems to ingest and present data effectively to end-users. 

The 21st Century Cures Act and the rules it helped create to support “seamless and secure access, exchange, and use of electronic health information” and eliminate information blocking are instrumental to the healthcare industry’s ability to advance interoperability. However, the rules are put in place for how the sender must comply but lack details about how a receiver needs to get and act upon a message.

“This long-awaited rule is very prescriptive for healthcare providers and payers to send data. But, unfortunately, the rule doesn’t determine how the receiver should get the data,” says Bevey Miner, Global Chief Marketing Officer Consensus Cloud Solutions.

“The rules mention using standards to send data, which are also beneficial for the receiver. However, the biggest problem with a strong push to use HL7 FHIR standards is that many of the healthcare stakeholders, most specifically post-acute facilities, were not incentivized to use EHRs with the ability to digest information. In addition, many of them don’t have the resources or budgets to support these standards.” 

Across the care continuum, the health IT landscape is an uneven playing field. For example, internal data from a Consensus survey indicate that nearly two-thirds of post-acute facilities (61 percent) still rely on paper fax machines. This translates to patients in some areas receiving care at a slower pace and prognoses with less information than their counterparts in larger systems.

“They are on the receiving end of the burden because they don’t get the information in electronic formats. So that leads to a lot of data entry and people standing at fax machines,” Miner adds.

For received information to be useful in the hands of these clinicians, it requires an interoperability ecosystem that can output data in the recipient’s preferred format, allowing information to follow patients wherever their care journey takes them to ensure that they receive timely and appropriate healthcare services.

The ability to receive and leverage patient data to make informed clinical decisions is compounded by the fact that many providers are already receiving an alarmingly high number of messages per day. One recent study of a large ambulatory practice found that primary care physicians received nearly 50 messages each day on average. The result is providers working longer hours to keep pace with demand. Consequently, EHR usability experts are calling on the industry to rethink how providers manage the volumes of information being shared with them regularly, including enabling messages to be easier to process and giving clinicians sufficient time to process and respond to notifications.

With health data exchange set to increase in order to comply with federal regulation, providers need technology that streamlines workflows when receiving information from external sources to integrate this data into clinical decision-making.

“Due to the information blocking rule as well as the electronic admission, discharge and transfer regulations — eADT — providers are going to be inundated with messages,” Miner warns. “Ensuring that the information is received in an easy workflow process regardless of the digital maturity of the care setting is important. The data needs to be actionable and insightful and can greatly impact better health outcomes by getting patients on treatments earlier. That’s the challenge we must solve for.”

New technologies are available to bridge this divide and ensure that clinicians have access to actionable information irrespective of their technical capabilities. Providers across the care continuum will vary in terms of the sophistication of their health IT systems, but the availability of solutions for digitizing health data exchange has removed a critical barrier to entry.

Whereas some healthcare organizations can leverage their EHR technology for information sharing, others can replace paper fax with digital fax solutions that automate data extraction from exchanged documents and provide clinicians with real intelligence. Digitizing health data sharing will be instrumental to advancing digital maturity and the evolution of interoperability by unlocking data from previously unstructured formats and making information digestible to an increasing number of clinical systems.

Powerful tools already exist and are maturing in the capabilities to transform unstructured data into structured information. Two such examples are optical character recognition (OCR) and the application of natural language processing (NLP). Today, these technologies are transforming unstructured documents, such as fax images, into intelligence that receiving clinicians can easily incorporate into their workflows. OCR automates the extraction of printed text from the scanned document, then NLP makes sense of the text in context, which can then be converted into separate data elements in a JSON file that can be mapped, for instance, as a CCDA or separated for specific metadata such as patient demographics. 

The buzz around artificial intelligence in healthcare has often focused on futuristic applications in diagnostics and predictive analytics with varying success. However, when trained on healthcare and medical terminology, NLP can become powerful tools for extracting high-priority data points that clinicians need to assess and care for a patient properly. For example, NLP with a context-based understanding of healthcare terminology and the typical structure of healthcare documents can eliminate manual intervention, parsing through received documents to identify pertinent data.

The key to true interoperability includes support for not only an array of technologies for sending health data but also a growing number of systems for receiving this information. With new regulation looming on the horizon for more robust communication and data exchange between providers and payers, healthcare organizations need to consider their ability to act on timely clinical data.

Interoperability capabilities that reduce the burden on information receivers can level the playing field and ensure that the right information is available at the right time at the right place. Healthcare professionals can then use their clinical expertise to interpret and act on evidence-based data to provide appropriate, effective, and safe patient care.


Learn more about this at Consensus' EHRIntelligence webcast on December 9th! 

Consensus Cloud Solutions, Inc. leverages its technology heritage to transform simple digital  documents into meaningful, actionable information. Documents can be transformed through the application of Artificial Intelligence, (such as advanced Natural Language Processing and Machine Learning) into data that enables the extraction of meaningful insights. This data exchange technology can be used to accelerate critical decision-making processes.

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