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Interoperability in Healthcare

6 min read


Scott Fannin

This post is sponsored by Greenway Health.

Interoperability in healthcare isn’t just a buzz word these days; it’s a necessity. How well healthcare providers, including hospitals, ambulatory-based providers and clinicians share administrative and patient data in a seamless environment will determine the quality of our healthcare in the digital age. So says Scott Fannin, Greenway Health’s Vice President of Product Management for Interoperability. Fannin has been with Greenway since 1999 and worked in various parts of the business including EHR, consumer and on-demand services. SmartBrief caught up with Scott recently to get his thoughts and predictions on the state of interoperability in healthcare.

Question: Can you explain why interoperability is so critical in today’s healthcare environment for both hospitals and physicians?

Scott Fannin: That’s a great question. In the last five to 10 years, the healthcare industry has really been focused on electronic data capture at the point of care. Meaningful use and other regulations were focused on adoption and getting physicians to use electronic health records (EHRs). Historically, that’s been the big driver behind adoption of health IT. But what has happened is that now that vendors have captured that aspect of the market we have all this valuable clinical data ready to be used to improve care.

At the same time, we’ve seen a shift in the reimbursement model. It used to be exclusively “pay-for-service,” but the industry is seeing a shift with organizations being reimbursed on a “pay-for-value” model by an increasing number of payers. Data exchange between providers increases the value of every encounter so this has been another significant driver.

Meanwhile, patients are becoming healthcare consumers because they have to pay a much larger portion of their medical expenses. Before, they didn’t care so much about getting multiple, potentially redundant tests because it wasn’t coming out of their pockets. Now, because consumers have to pay a portion of each test, they have a financial stake in the decision if the doctor wants to take another x-ray or use the existing one.

In order for the information to be available across the entire care continuum, interoperability and data exchange are critical to success. The transition to data sharing to provide more-valuable care is the key to this shifting trend. Data exchange is the next frontier for improved healthcare delivery.

Q: How can providers take advantage of the government incentives to boost interoperability?

SF: At Greenway we’ve seen incentives such as meaningful use motivate and drive the behavior of our customers. Everyone wants to get these subsidies and it’s an effective “carrot” approach. The “stick” of course is that the federal government will begin to penalize reimbursements from Medicare if an organization doesn’t attest on meaningful use within published timeframes. But it’s not entirely inclusive. If you don’t have a lot of Medicare patients, the impact of meaningful use is minimal.

The good news is that a majority of Greenway customers are heavily involved in meaningful use. Indeed, across the ambulatory field, meaningful use Stage 1 has been very popular. Stage 2? Not so much. That’s partly because when an organization attests for Stage 2, it doesn’t get nearly the uptick in government incentives as it did from Stage 1, particularly to make up for the additional costs to meet the additional requirements. Meaningful use Stage 2 and 3 include various measures that can only be met with interoperability in place, and the incentives/penalties motivate providers to put data exchange high on the list of priorities.

Q: How can hospitals and providers work together to ensure that care is coordinated and their joint practice and hospital needs, including clinical, financial and administrative, are met?

SF: One of the most common requests we get from our customers is to exchange data with the local hospitals. When a customer comes to us with that request, we investigate the system the hospital uses for data exchange. Even if it’s a system we’ve never interfaced with before, we work closely with both organizations to build a new interface. But one of the biggest challenges is when one side, usually the hospital, doesn’t want to play ball. That can be for a variety of reasons: political, security or priority. You don’t always know until you start to work with that hospital.

But as everyone recognizes the benefits of data exchange, it doesn’t seem to be as big a stumbling block as it has been in the past. We should remember that interfaces aren’t traditionally quick to set up and there have been complaints from Washington that data exchange and interoperability isn’t moving fast enough. It’s important to understand that interoperability was not one of the key focus areas of meaningful use Stage 1 – so the incentives were not there. With Stage 2 & 3, data exchange has become a higher priority and we have seen the subsequent demand increase.

Q: What are some of the issues you’re currently working on solving?

SF: Across the board, there’s a huge demand for interoperability and the industry is struggling to get interfaces up fast enough to meet that demand. Everyone is data hungry and wants to exchange data and do it now! As an industry we need to innovate so we can accelerate the implementation of new data exchange. We need to do it securely with privacy concerns always at the forefront, but we need to make it easier. Greenway is a founding member of the CommonWell Health Alliance to find a common framework for interoperability and make it as easy as possible for all stakeholders to safely exchange health information

Q: How do you think current interoperability and EHR initiatives will have affected the industry in five years?

SF: There’s a lot of buzz right now about a HL7 standards framework called FHIR – which stands for Fast Healthcare Interoperability Resources. FHIR (pronounced “fire”) is all about looking at how other industries exchange data and what healthcare can learn from them, particularly around ease and speed to implement. Again, we want to make interoperability as straightforward as possible so that we can maximize the value of patient data across all care settings.

For more information, visit Greenway Health.