Why Is Interoperability Important?

Interoperability is the most persistent and fundamental challenge the healthcare industry faces today—and the industry spends tremendous energy trying to solve it. But interoperability discussions that focus solely on how to connect system A to system B miss the point. The real challenge is not just creating a free flow of data between systems, but figuring out how to move information in a meaningful way so that it is useful in a different context, and merging workflows so that people can do their jobs more efficiently.

Interoperability requires providers and managed care organizations to share information with multiple systems—all with different owners, different processes, and different underlying methods of assembling data. This data needs to be normalized to support the population health management goals, and delivered to the right people at the right time in the right setting so they can take the right actions. Any friction that prevents information sharing among these disparate systems and settings means that critical data doesn’t get to the people who need it in time to make decisions that will efficiently affect care.

True interoperability means not just focusing on data exchange, but on creating interoperable workflows, so that the act of participating in new activities is not disruptive. This means that the workflows must be harmonized so that users avoid inefficiencies such as double data entry when participating in broader population health management activities that require collaboration with organizations outside their four walls. It means making the user experience better, finding ways to notify users of key information to improve their ability to follow through on the care delivered in time to make a difference, and even blending the functionality of disparate systems at appropriate junctures. If we do it right, teams can efficiently work together to achieve their mutual goals and we’ll be a step closer to solving healthcare.

As a provider of care management software-as-a-service, we encounter the challenges of interoperability every day. Integrating care management tools with critical systems such as EHRs, HIEs, data warehouses, external analytics and business intelligence tools, Direct HISPs, and claims and billing systems—and minimizing friction by focusing on how the information is integrated into the workflow—is critical to successful population health management. We believe that data sharing for transparency alone is not sufficient and that the exchange of data should not just be ubiquitous, but also be harnessed to improve the quality of care that is delivered. We’ve found that when this more comprehensive approach is taken, more interoperability goals are achieved, and population health management just works better.

Our industry has made progress in developing interoperability guidelines to facilitate data exchange, but previous failures have lowered our standards. It is time to raise the interoperability bar and move beyond rhetoric to embrace a more open data exchange mentality and make a commitment to workflow harmony, which better supports our ability to manage population health. Our patients deserve better.

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Healthcare Solved.

When people need healthcare, they need to receive it in a way that is optimized. Optimization encompasses many things—not only delivering the appropriate care to help patients get healthy, but also finding the organizations and care providers that will provide the shortest path to success for the desired patient outcomes. When there is an intersection between the right care at the right time with the right organizations reaching the right patients, the experience and efficiency of care is optimized, and you take a major step toward Healthcare Solved.

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At-Risk Populations—Understanding Who We Serve

Delivering effective care to high-risk populations is challenging. As the costliest patients to treat, at-risk patients—typically those with some combination of tough chronic diseases, complicated behavioral health issues, and adverse social conditions—strain the entire healthcare system, requiring treatment from many different providers and a large investment of time and resources. If patients are unemployed, uninsured, or uneducated, the impact of their conditions is magnified. These forces result in an epidemic of poor health in our disadvantaged communities.

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Developing Evidence-Based Care for Social Determinants

While we know that outcomes can be materially impacted by non-clinical factors like social determinants of health, the industry’s strong focus on medical factors have long pushed social determinants to the backseat. It is clear that population health management is most effective when it is comprehensive and community-based, extending beyond the walls of a single care establishment to encompass all relevant services, including medical, behavioral, and socioeconomic factors. But what will truly make a difference to patients is being able to prescribe how to address the social determinants in a normalized manner that will consistently improve patient outcomes.

Read more “Developing Evidence-Based Care for Social Determinants” >

Addressing the Healthcare Crisis in Philadelphia’s Poorest Neighborhoods

How the Digital Health Initiative of Philadelphia Began

Named the “poorest big city in America,” Philadelphia has plenty of challenges, and one of the most damaging is the impact on our poor communities in the area of healthcare. Philadelphia County has more than 500,000 Medicaid enrollees, and care for these vulnerable populations strains the entire healthcare system, diverting resources from other areas of investment that would otherwise benefit our region. Poverty costs us jobs, new business development, tourism, and other growth opportunities.

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Value-Based Care—The Future of Health Care: Part 2 of 2

This blog is part 2 of a discussion of value-based care—the new paradigm in which care is no longer delivered only by doctors and nurses, but by an entire community of providers that treat the “whole” patient rather than just treating the disease. The focus is on treating the entirety of a patient’s needs to bring about better health outcomes—which means that communication and care plans no long reside solely within a doctor’s office. To achieve this objective, the industry is migrating to a de facto set of standards that it is believed will take us down the right path. Read more “Value-Based Care—The Future of Health Care: Part 2 of 2” >

Value-Based Care—The Future of Health Care: Part 1 of 2

Value-based care creates a new paradigm—one in which care is no longer delivered only by doctors and nurses, but by an entire community of providers that treat the “whole” patient rather than just treating the disease. Communication and care plans can no longer live inside the four walls of a doctor’s office, but must integrate information from the community to fully address the needs of the patient and of the population. Further, those members of a patient’s care team must work together to deliver an effective and coordinated treatment experience. This blog—part 1 of a 2-part series—introduces the idea of value-based care, and discusses how integrating care coordination with robust analytics into a single platform provides the big picture of patient care, enabling efficient, collaborative care for diverse teams to treat complex populations. Part 1 is an introduction, intended for those starting to explore the idea of value-based care. Stay tuned for Part 2, which will be a deeper dive into some of the key issues facing the industry.

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Care Coordination and Analytics Together

Remember the days when you had to use two different platforms for phone calls and for calendaring and task management? In today’s iPhone/Android laden world, such a separation seems heretical. Yet in healthcare’s hot new niche of population health management, we see that same heresy in the artificial, and suboptimal divide between care coordination/management software and analytic software. Read more “Care Coordination and Analytics Together” >

Care Coordination Automation: Tracking Success, Part 4

Collaborative Care technologyOur previous posts have discussed the details of managing care team assignment and composition that’s customized for the whole patient as well as managing patient and population care systems. Now, we move onto the fourth and final discussion topic in this series for supporting a care coordination program using technology: measurement & reporting.

The last step in any effective process is to monitor progress, analyze results and make adjustments accordingly. But in order to track program success, you must start by implementing a measurement strategy that’s unified. Read more “Care Coordination Automation: Tracking Success, Part 4” >