Déjà vu All Over Again – Trends in Health IT and Information Exchange for 2018 Part 2

Written by: Brian Mack

Déjà vu All Over Again – Trends in Health IT and Information Exchange for 2018 Part 2

January 4, 2018

Brian Mack, Marketing & Communications Manager

 

Part 1 covered three trends in Health IT and Information Exchange that have been, and will continue to be a major focus of attention in the coming year. Part 2 unpacks two more trends, as well as highlighting several other prominent issues at play.

4. Recognizing the Value (and Challenges) of Big Data & Advanced Analytics

Healthcare is one of the fastest growing segments of the digital data universe.  Year over year growth of data captured is at 48%. The total amount of raw healthcare data available for analysis is projected to grow to 2314 Exabytes (1 Exabyte = 1 BILLION Gigabytes) by 2021!

But the last thing physicians need at the point of care is more data. Creating actionable information that informs the delivery, quality, and outcomes of care is where Big Data, Artificial Intelligence, and Advanced Analytics present an opportunity.

The analysis of these large data sets can reveal patterns, trends, and associations in human behavior.

Practical issues like security, structure, standardization, and storage must be addressed. Beyond those, healthcare delivery is a fundamentally personal subject. No amount of macro-level data analysis is capable of predicting human nature on an individual level.

Relative to Trend #3 “Redefining the Meaning, Role, and Value of Health Information Exchange”, organizations like GLHC are well positioned to capitalize on these technologies.

5. Continued Emphasis on Care Management and Integration

Care management programs apply structure, science, incentives, and information to healthcare delivery. They assist consumers in managing their medical, social, and mental health conditions more effectively. The goal of care management is to achieve an optimal level of wellness and improve coordination of care, while providing cost effective, non-duplicative services.

New approaches to integrated care delivery and payment reform, initiated since passage of the Affordable Care Act, have contributed significantly to broad acceptance of integrated care concepts that incorporate both the patient’s physical and behavioral health into their total wellness picture.

There is much that Health IT and Health Information Exchange can contribute to realizing a fully integrated approach to care delivery.

  • Data Integration – Value-based care requires that providers have the ability to synthesize patient health information captured at the point of care, with claims, quality, and outcomes data gathered after-the-fact by payers. The HIE has the ability to import, process, and parse this data into actionable reporting, and deliver it back to be applied toward performance improvement.
  • Quality Reporting – In a value-based care environment, the ability to accurately track metrics tied to required quality reporting is pivotal. As an independent “source of truth”, HIEs can offer an unbiased granular view of performance to goal at the provider, practice, system, and community levels.
  • Cost Control – The only way for healthcare organizations to reduce spending and improve profitability is to understand where the greatest cost centers exist and with which episodes of care. Health Information Exchange provides such insight.

 

Honorable Mentions

  • Data Security & Privacy remain a high priority – Research indicates that stolen health data has a market value 10X the value of a stolen credit card number. In such a climate, mere compliance with HIPAA will simply not cut it. A recognized best practice for assuring the highest possible privacy and security compliance is independent certification by a third party governance organization like HITRUST Alliance
  • Growth of Healthcare Consumerism –Tech giants Apple, Microsoft, Google, and Amazon all have healthcare related initiatives either underway or in development. CVS Caremark announced the acquisition of insurance giant Aetna in late 2017, and continues to expand their in-store clinic locations. Other traditional brick & mortar retailers also continue to refine and expand their walk-in clinic concepts. These dynamics present opportunities and challenges for Health IT stakeholders invested in achieving seamlessly interoperable access to every individual’s longitudinal health record.
  • Expansion of Telemedicine & Digital Primary Care – In 2017, 62 telehealth focused legislative initiatives in 36 states took effect. Eleven additional pieces of legislation are scheduled to take effect in 2018. This activity is an indication of the expansion of alternatives for in-person medical appointments. There is opportunity for Health IT and HIEs to integrate the health data from these encounters into an individual’s longitudinal record so that it is available across the community of care.

Conclusion

For the past decade, the Patient Centered Medical Home (PCMH) and the Chronic Care Model have been the driving forces behind healthcare practice transformation. Both efforts are supported and financed by payer-sponsored performance incentive programs, or state and federal quality improvement initiatives.

Primary Care Providers have largely been tasked with shouldering the burden of meeting these requirements, in addition to investments already made to convert to electronic medical records; systems that often require adjustments to operational workflow, and frequently carry additional costs and/or recurring fees if “custom” enhancements are necessary. All of these activities come BEFORE addressing their essential role in coordinating and enhancing the delivery of care for their patients and communities.

The investment is enormous. Since passage of the HITECH Act in 2009 & subsequent legislation, the Federal Government has invested $30 Billion to accelerate the adoption of Health Information Technology. That does NOT include the BILLIONS of additional dollars spent by providers and health systems across the country to maintain compliance. What is the ROI of that investment? Can we point to a dollar value or statistical data that demonstrates tangible progress toward achieving Triple Aim goals?

With so many demands and many conflicting priorities to manage, providers and organizations are forced to choose between doing what “moves the needle” at the point of care or doing what will maximize revenue while eliminating penalties.  This is especially true when those initiatives are tied to dollars that providers count on to support their practice and staff. These dynamics are not expected to change. If anything, regulatory requirements and downward pressure on reimbursement will only INCREASE.

As we look ahead, should there be less emphasis on Health IT development and implementation? No.

Simply put, you CAN’T realistically “unring” that bell. Healthcare delivery across the continuum of care must continue to evolve and help patients redefine health-CARE as an integral aspect of their lives, rather than “episode” oriented events that occur in a hospital or physician’s office. Health IT will continue to be an integral contributor to that transformation. But it reinforces the fact that Health IT professionals need to be hyper-focused on helping the people who help people. The concept of “Creating Care-Connected Community” is about recognizing the actual needs of the provider community, stepping out from behind the technology, and partnering to help them help their patients achieve and maintain optimal health.