In 2018, interoperability remained just beyond the horizon
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Health experts blame rapid expansion for vaccine shortages
      Profit up nearly 23% across U.S. community hospitals in 2019
      HHS freezes rule targeting community health centers' drug discounts
      Cerner names Erceg as new CFO
    • Health experts blame rapid expansion for vaccine shortages
      HCA launches joint venture to boost domestic PPE production
      Lilly: Drug can prevent COVID-19 illness in nursing homes
      Mobile labs take vaccine studies to diverse neighborhoods
    • Medicare ACO participants fell in 2021
      Louisiana gets reports vaccine providers are discriminating
      'We know this is real': New clinics aid virus 'long-haulers'
      The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
    • UnitedHealthcare operating earnings fall by $2 billion in Q4
      CMS approves rule forcing insurers to ease prior authorization
      COVID-19 still a big uncertainty for insurers in 2021
      Health insurers' outlook boosted after Dems' Georgia win
    • Health experts blame rapid expansion for vaccine shortages
      HHS freezes rule targeting community health centers' drug discounts
      Biden signs executive orders to reverse, pause Trump-era rules
      CMS finalizes blood-based colon cancer screening coverage
    • Providers await new HHS coronavirus grant reporting deadline
      Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
      Intermountain, Trinity, Memorial Hermann behind $300M private equity fund
      Operation Warp Speed to bump up McKesson's stock price
    • A man in a room with servers.
      Momentum grows to outsource hospital tech functions in 2021
      5 things to know about Google's $2.1B Fitbit acquisition
      Providence bets on machine-learning, consolidating data centers
      Mental health treatment was most common telehealth service during COVID
    • Mobile labs take vaccine studies to diverse neighborhoods
      As virus surges, states reporting shortages of vaccine
      Sticking to Mediterranean diet is good for the brain
      Chance of COVID-19 triage care looms over Arizona hospitals
    • Cerner names Erceg as new CFO
      Elizabeth Richter will serve as acting CMS administrator
      Providence names new chief financial officer
      Wisconsin's top health official departing for federal job
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Dr. James Hildreth
      How medical education can help fight racism
      Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Hospital divided into multiple pieces
      Health systems may be warming to offshoring, a mainstay practice for insurers
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
      A nurse holds up a phone with a message to a family member saying surgery has started.
      Texting, tablets help hospitals keep family updated on patient care
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
      Researchers: Hospital price variation exacerbates health inequities
    • MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
      CMS approves rule to encourage value-based drug pricing
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
      Healing healthcare: some ideas for triage by the new Congress, administration
      Dr. Sachin H. Jain
      Medicare for All? The better route to universal coverage would be Medicare Advantage for All
      Connectivity: a social determinant of health that can exacerbate all the others
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Next Up Podcast: Saving Rural Health
      Ceci Connolly
      Next Up Podcast: How to navigate the murky post-election waters
    • An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
      Beyond the Byline: How telehealth utilization has impacted investor-owned company earnings
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Chip Kahn
      The Check Up: Chip Kahn of the Federation of American Hospitals
      The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
      The Check Up: Dr. Thomas McGinn
      The Check Up: Dr. Thomas McGinn of CommonSpirit Health
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Technology
December 26, 2018 12:00 AM

In 2018, interoperability remained just beyond the horizon

Rachel Z. Arndt
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    Modern Healthcare Illustration

    Another year, another set of draft frameworks and rules, app releases and APIs, and the healthcare IT industry still hasn't solved interoperability. And yet leaders spent so much time talking about it over the course of 2018, a year punctuated by moments in data exchange that felt big but failed to deliver the holy grail of industrywide interoperability.

    Interoperability nevertheless remained top of mind in 2018, with players big and small, entrenched and untraditional, joining the cacophonous call for a health system in which patient data can move between providers and, sometimes, even move via the patients themselves.

    Over the year, the promise and potential of interoperability stretched from patient to provider, from consumers' step-counting to providers' electronic health record software. The industry struggled to connect the two, held up by questions of privacy and standards as well as by vendors and providers that still see a business case in not sharing patient data.

    “We've all been waiting for some way to connect medical records,” said OptumLabs CEO Paul Bleicher. “Morally, ethically, that should have happened a long time ago.”

    As the industry shifts, in theory, toward value-based payment models, information-sharing becomes paramount. “The premise in a lot of these arrangements is that a clinician is going to be held accountable for quality and total cost of care,” said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association. “They can't control the outcomes of these patients if they don't have the data.”

    The trickle rather than torrent of data has slowed the uptake of value-based models, Gilberg said. In turn, a closed-off system of data sharing seems less and less sustainable. And the industry knows it—as do those outside of the industry.

    A year of good intentions

    The year started out strong with both insiders and outsiders from both government and private industry making announcements about how to boost interoperability. The Office of the National Coordinator for Health Information Technology kicked things off with the draft Trusted Exchange Framework and Common Agreement, a plan for pushing interoperability among health information exchanges, with a to-be-determined private-sector organization leading the charge.

    The ONC released the draft in hopes of getting useful comments from the industry about how to improve it. It was not, in other words, a rule.

    “This year has been marked by an unprecedented amount of requests for information,” Gilberg said. “If 2018 was the year of information gathering, then 2019 almost has to be a year of implementation, or this stuff isn't going to happen.”

    What's more, the release of the draft, to be followed by the release of another draft, left the industry uncertain about what the provisions laid out actually mean. “It's really done a disservice, because it's caused a lot of confusion in the market,” said Micky Tripathi, CEO of the Massachusetts eHealth Collaborative.

    Another source of confusion is the CMS' MyHealthEData, an initiative to give patients more control over their health data. After announcing the initiative at HIMSS, CMS Administrator Seema Verma still hasn't provided details about how it will work.

    The private sector steps in

    Meanwhile, consumer companies forged ahead, driving toward interoperability where those in the industry fell short. Notably, Apple announced it would allow people to download their health data from participating organizations (now more than 100) to their iPhones via the Health app, thanks to the FHIR standard. It later expanded the capability to let people share the information they'd collected with third-party apps.

    Apple's work can't end with these two capabilities of the Health app, though, Tripathi said. “If it ends up being an endpoint, this is nothing,” he said. “It's about being the gateway to a rich and thriving app ecosystem.”

    Other companies unveiled apps too, with Epic pushing its App Orchard and Cerner its Open Developer Experience for developers to build using their open APIs.

    The promise of interoperability also brought organizations and companies together in 2018. Google, Amazon, Microsoft, IBM, Oracle, and Salesforce joined together to push for increased information exchange for cloud- and AI-based tools. Lyft and Uber formed partnerships with providers dependent on the flow of information. And, notably, the Veterans Affairs Department and Cerner finally signed a contract for Cerner to replace the VA's homegrown EHR, VistA.

    The replacement is expected to take 10 years, the two organizations said. And it would take $10 billion—a number that grew, by year's end, to over $16 billion. The contract process was drawn out by disputes over the system's potential interoperability with the Defense Department's EHR (also made by Cerner) and with community providers.

    “It could really be a positive force for interoperability and standardization, assuming the VA doesn't force Cerner into all sorts of dark nooks and crannies of customization,” Tripathi said.

    Alongside partnerships were mergers and acquisitions of the sort hitting the rest of the industry. American Well acquired Avizia, and Allscripts acquired HealthGrid for $60 million, to name a couple. And after months of drama, Athenahealth sold itself to Veritas Capital and Evergreen Coast Capital for $5.7 billion.

    A growing risk

    As these companies grow, so do their datasets. Whether the data will be useful depends in part on standardization and the degree of interoperability. “You do have to ask yourself: Is it interoperability that is the most important thing, or is it the ability to combine data into a single format?” Bleicher said. “What's particularly complex about medical data is the longitudinal nature of it.”

    But that doesn't mean that at least some of the data aren't ready for analytics and AI. The industry has been rife with companies promising the latest and greatest in AI-based tools. Some work as promised, others don't. One that does is IDx-DR, a retinopathy-detecting software made by IDx, which received the first FDA marketing approval for an autonomous AI-powered medical device—meaning it can make a diagnosis without a physician's interpretation. These kind of applications will proliferate, Bleicher said.

    The FDA sped the product through the regulatory process, using the de novo premarket review pathway for low- and moderate-risk devices. The agency is working on a new regulatory framework for AI-based devices, which sometimes complicate current regulatory processes because the devices can change over time, learning as they're fed more data.

    As more data move around and multiply, there are more opportunities for hackers to get their hands on them. “2018 was not a good year for breaches in the U.S.,” said David Finn, executive vice president of strategic innovation for CynergisTek.

    Between Jan. 1, and Nov. 30, 2018, there were 333 data breaches reported to the Office for Civil Rights, which tracks breaches. These attacks can be expensive, costing each affected organization $4 million on average, according to the Ponemon Institute.

    The year was marked by both data breaches and settlements. In June, HHS announced that the University of Texas MD Anderson Cancer Center must pay a $4.3 million fine to the agency for several data breaches. And in October, the OCR announced Anthem would have to pay $16 million for a 2015 data breach that exposed information on 79 million people—the largest breach ever reported to the OCR.

    More and more, hackers are getting in through phishing emails, Finn said. No technology alone can stop this kind of attack, he said. “We're not yet training people well enough.”

    And as the industry inches closer to greater interoperability, with data flowing between providers, patients and payers, that kind of training will become all the more important.

    As the year drew to a close, the industry got antsier and antsier about the ONC's information-blocking rule, which spent weeks held up at the White House Office of Management and Budget. The rule is meant to define information-blocking and set out exceptions to it.

    RELATED YEAR IN REVIEW STORIES:

    • Healthcare organizations turned to unexpected partners in 2018
    • Dealmaking stayed hot in 2018, with a focus on physician practices
    • Greater flexibility, new alliances define insurance industry in 2018
    • Medicaid expansion battle shifted in 2018 to the executive branch and the states
    • Bookended by Obamacare, 2018 was the year of policy change
    • Absence of government action on public health issues pushed industry to act in 2018
    • CMS amps up value-based payments in 2018 as other quality issues fall by the wayside
    • Back to main page

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Momentum grows to outsource hospital tech functions in 2021
    Momentum grows to outsource hospital tech functions in 2021
    5 things to know about Google's $2.1B Fitbit acquisition
    5 things to know about Google's $2.1B Fitbit acquisition
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing