by Staff Writer
HIMSS 2019 Was on Fire!
If you were fortunate enough this year to attend the 2019 HIMSS—the annual conference for the Healthcare Information and Management Systems Society, no doubt you came away as inspired as we did. The HIMSS floor was alive with new systems, new regulations, new technology, and a many opportunities. For those who couldn’t make it, here are three big takeaways important to Ogilvy Health and forward-thinking for the health care business.
The Holy Grail and by all accounts, the new default in interoperability promises to be the patient. Yes. It will be the patients and the apps they will choose as the destination for their health information. Patient-centric interoperability has always been the aspiration, but now we are seeing an economic model where patients opt-in, with a no-cost/no-obligation burden to access data. Think of this like the new Ubering of health data except there are no fees to the rider or in this case, the patient. Future steps will allow patients to download their own medical records from any and/or all providers onto their smartphone through a secured app in real time and during the point of care.
HEALTH PLANS REGULATION
When it comes to the regulation of health plans, the buzz at HIMSS points to employing standards end-to-end. The groundwork for combining standardized claims data and standardized clinical data, as per FDA mandates, is pivotal. The international push to interoperability is starting to show signs of success with a series of regulations and new product innovations that free claims, medical and personal data, and unleash them for consumers and clinical decision-making. Therefore, digital technologies, particularly artificial intelligence (AI) and predictive analytics, will have a profound effect to convert Big Data into Small Data as there will be universal consensus in its language. This creates a push for unencumbered health care data available to consumers through application programming interfaces (APIs).
AI and cloud computing will hasten the opportunity by cleansing the data. Further, AI-enabled clinical decision support, for instance, can be layered on top of the electronic health records system to guide attending physicians toward evidence-based care decisions, alert them to data and research they may not have seen, or catch potential safety issues, such as duplicative treatments or medication interactions. The comprehensive standardization will stimulate innovation and positively influence both an organization’s bottom line and human health by making the clinical development process faster, easier, more informative and more productive.
THE ERA OF NET NEUTRALITY FOR HEALTH CARE DATA BUSINESS MODELS
This topic is one that we’re particularly excited to share, as the opportunities to deliver value-added service for our clients are abundant. We all know that data are only as good as the information that goes in and the information that is made accessible. For those in health care, this has been a gray area for the API-based interoperability marketplace because having access to the data has been a consistent challenge.
On February 12 of this year, Centers for Medicare and Medicaid Services and the Office of the National Coordinator released proposed rules governing interoperability, health-data blocking, the use of APIs, and the expanding role of Fast Healthcare Interoperability Resources (FHIR [“FIRE”]). With the release of these rules, there is a good deal to unpack but the ultimate intent is for consumers to be able to choose any application to retrieve their complete health records and coverage information from any provider or plan in the country via APIs. Once the standard is set, innovation technology companies should be able to tap into health data without the need for Business Associates Agreement (BAAs), data use agreements, etc, because the individual consumer will have the right to pull the data out of a HIPAA covered entity, i.e., hospital or physician practice and move it into a trusted (and secure) application to use however they choose.
An app gallery, such as www.smartplatform.org allows an open platform to run across the health care system. Patients, doctors, and health care practitioners draw on this library of apps to improve clinical care, research, and public health. Using the FHIR interface engines, consumers would have access to channels of their own health data, which would include notes, unstructured data, and other essential information on their smart phones. In the United States, the CARIN Alliance, (a collaborative of providers, payers, consumers, pharma, consumer platform companies, health IT companies, and consumer advocates), is unified in their intent to overcome the obstacles to advancements related to the consumer-directed exchange. The group is a driving force behind these new policies and opportunities.
To look at the challenges from another point of view, hospital CIOs agree that the data of today are considered stuck inside the enterprise EHR. The general complaints? Data are a challenge to access (and, in some cases, are inaccessible), lack internal analytical skills, have high costs associated with the move into value-based care and extend to a clinical integrated network, and don’t do a good job at engaging patients. The real problem is the systems are not maximizing the value of their lofty technical infrastructure that has the FHIR technology already baked-in.
1. As a patient, you will soon have access to your health data: Be it medical records from 5 different hospitals, 2 nursing homes, 6 pharmacies, new (possibly historical), images like MRIs, clinical notes, (as an example). So, think of it as an app on your phone. You tap it and gain access to any record from any medical facility, secured, protected and free.
2. As a data user (Ogilvy, its partners, and its clients), beyond insurance claims data, clinical data that are anonymous information will be made available for a standard pricing structure allowing for more usage an expanded service opportunity we can bring to our clients. Until now, this wasn’t always easy access and/or very selective.
3. The technology, referred to as FHIR, is built into all electronic health record software, ready and available for app developers to do their magic, build those apps and make them available to us. BUT many issues have prevented the builders from getting access until this new rule (law) has been proposed.
4. It should pass soon. Once passed, the way health care transmits information to the clinicians, pharma, and patient will change. The information available will also become more robust.
5. This blog will be a part of potentially larger discussion coming soon. FHIR is about to change health care’s model and Ogilvy is on its cutting edge.
With these collaborations across the continuum of care—new regulations driven by a growing sense of urgency, new business models, actors, infrastructure, and technical advances (FHIR), opening the data accessibility to the regulated and secure API technologists, with a standard language and pricing model, is a wonderful example of true interoperability in practice.
As the saying goes, change is the only constant in life. Nowhere is that more on display than in the health care market.