Oracle’s $28.3 billion deal to buy electronic medical records company, Cerner, could address a major challenge in healthcare, that of datasets that don’t communicate with one another, through the creation of a cloud-based platform. Fragmentation and interoperability are two core issues that have to be resolved for even a cloud-based platform to work. The effective and efficient sharing of healthcare data is a critical issue for anyone associated with the healthcare industry.
A McKinsey study found that 20-25% of U.S. healthcare spending is wasted, and 50-75% of that waste could be eliminated by a better utilization of data. In the U.S. healthcare system there are tens of thousands of different organizations using thousands of different IT platforms, with an almost infinite number of different standards and different privacy controls. The complexity and fragmentation of the healthcare system in the U.S. is not seen anywhere else in the world.
A country with a National Health Plan and a smaller population, the U.K., tried for nine years to link patient data from all parts of the National Health Service finally shutting down the effort in 2011 saying the initiative couldn’t deliver on its original intent of effective and efficient sharing of healthcare data.
Adding to the complexity and fragmentation there is identifiable health care data and de-identifiable health data following HIPAA standards. Health care providers what to access and compare data from all aspects of a patient’s care to be as effective as possible. Datavant, a health data connectivity solution company, has a method of implanting a linkable token that says patient X at CVS Pharmacy is the same as patient Z at Emory Healthcare system. This tokenization retains confidentiality but allows a central technology to decode that data to identify these two as the same patient as needed by their doctors and approved by the patient, without any personal details being shared.
The 21st Century Cures Act supports a “seamless and secure access, exchange, and use of electronic health information.” It is meant to eliminate information blocking and is instrumental to the healthcare industry’s ability to advance interoperability. Facilitating interoperability between legacy health care systems making it easy to provide information to health care providers and individuals on a wide variety of devices from computers to tablets to cell phones and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.
Unfortunately the rules are clear for the sender but lack instruction and details about how a receiver needs to get and act upon a message. A Consensus survey found that nearly two-thirds of post-acute facilities (61%) still rely on paper fax machines. Someone has to receive this information and then put it into a more shareable system. This translates into patients in some areas receiving care at a slower pace and prognoses with less information than patients in larger systems.
Fast Healthcare Interoperability Resources (FHIR) is a standard describing data formats and elements and an application programming interface (API) for exchanging electronic health records (HER). This standardization is facilitating the use of even more advanced methods to transform unstructured data into structured information. Optical character recognition (OCR) automates thing extraction of printed text from the scanned document and then natural language processing (NLP) makes sense of the text in context, which then can be converted into separate data elements in a file that can be mapped.
Natalie Schibell of Forrester Research says that the lack of interoperability “is an unsolved dilemma that continues to cripple workflow efficiency. It ultimately escalates healthcare spend and impedes data-driven healthcare.”
Interested in diving into these sharing of healthcare data problems? Contact Smith Hanley Associates’ Biostatistics and Clinical Data Management Recruiter, Nihar Parikh at firstname.lastname@example.org.