If smartphones can connect us to the world, why can't our EHRs?

Pull the smartphone out of your bag or pocket and take a look at it (maybe you are already holding it while reading this blog). Now imagine you can only call or text people who use the same brand of phone, or who rely on the same wireless carrier as you. It would be incredibly limiting, right? But this isn’t an issue because smartphone manufacturers and wireless carriers use an interoperable platform. Interoperability technology allows for the unrestricted sharing of secure data between a variety of sources. It makes it possible for my phone to connect to your phone—or to other mobile devices—to share information, or to interact with apps, fitness trackers, and other devices regardless of the operating system or manufacturer.

In health care, interoperability is in the nascent stages, but significant progress is being made. There is an acknowledgement among stakeholders that interoperability is both essential and inevitable. The technology needed to digitally connect systems and devices across disparate systems in health care already exists. So, what's holding it back? Data from health systems, physician offices, health plans, medical technology firms, biopharma companies, and government agencies still exist in their own siloes. All of these data sets are disparate, disconnected, and not standardized. Bringing everything together in a useful manner to produce actionable insights in real time is difficult and costly. But understanding how investments and time and money would likely lead to dramatic clinical and business improvements could help to justify the costs.

The Deloitte Center for Health Solutions recently released the results of its interoperability survey, which is based on responses from 100 technology executives from health systems, health plans, biopharma companies, and medical technology companies. We also interviewed more than 20 technology experts to find out how close we are to interoperability today…and what it might take to get there tomorrow.

Survey respondents agreed that interoperability would likely lead to lower care costs, improved care coordination and outcomes, and a better patient experience. They also acknowledged that interoperability will likely become increasingly important as value-based contracting becomes more prevalent.

Our participants were most concerned about what they saw as a misalignment of data standards, how to define short-term returns on investment, and the lack of a national patient identifier. Organizations use a variety of standards to define data elements. One executive told us their organization had two coders—one of them used the word “medicine” and the other used the word “medication.” A lack of even intra-organizational data standards is surprisingly common, and it can lead some executives to raise concerns about “semantic interoperability.” While some participants said it was fine to use multiple standards as long as they can map to each other, few of them said they were working to map these elements.

Our ability to gather various bits of data from electronic health records (EHRs), claims, apps, clinical trial databases, wearable devices, and sensors—and connect them to each other—could lead to a far deeper level of insight into our health. Radical interoperability of data is the idea that bringing disparate sets of data together will lead to a 360-degree view of a person's well-being. This real-time information might help encourage consumers to be more proactive about decisions that affect their health and well-being or enable care teams to nudge patients to make healthier choices.

While competitive self-interest and a lack of trust among stakeholders might be deeply engrained in the health sector, just 23 percent of our respondents saw trust as being a barrier to interoperability. Executives agreed that they collectively share the responsibility to solve the interoperability puzzle.

Most of the executives we surveyed agreed that interoperability would be extremely important to their organization over the next three to five years. Stakeholders that want to emerge as leaders in their use of data and analytics in the future of health should:

1. Prioritize interoperability at the leadership level by developing a clear understanding of how important it is to the organization’s overall strategy, what interoperability will enable for the business, and a vision for interoperability in the future.
2. Invest strategically rather than tactically by seizing the opportunity to focus on next-generation solutions and ensuring that all key business strategies (population health, M&A, value-based contracts or pricing strategies, precision medicine) align with the organization’s interoperability strategy and future vision.
3. Establish a competency center that is responsible for the organization’s interoperability technology stack, data and interface standards, and leading architectural practices and patterns to drive adoption, increase competencies, and accelerate value.
4. Include interoperability in partnerships. Stakeholders should be active, open, and curious. Interoperability could lead to new opportunities to collaborate with traditional competitors, large technology companies, start-ups, or community organizations.
5. Leverage upcoming compliance, privacy, and security regulations as a catalyst to drive enterprise momentum. Organizations that seek to leapfrog their interoperability capabilities can use these opportunities strategically to create momentum, visibility, and competency.

When we meet with clients, we try to explain that interoperability is quickly becoming a necessity in health care and life sciences. Being able to share data internally and externally—and in a timely, useful, and cost effective way—is going to be table stakes a few years from now. By 2040, we might not remember a time when our health and personal information wasn't right at our fingertips. It might be like trying to remember what it was like when our phones were big, clunky, and anchored to a wall in the kitchen.
 

Innovation starts with insight and seeing challenges in a new way. Amid unprecedented uncertainty and change across the health care industry, stakeholders are looking for new ways to transform the journey of care. Our US Health Care practice helps clients transform uncertainty into possibility and rapid change into lasting progress. Comprehensive audit, advisory, consulting, and tax capabilities can deliver value at every step, from insight to strategy to action. Our people know how to anticipate, collaborate, innovate, and create opportunity from even the unforeseen obstacle.

Learn more at www.deloitte.com/future.