Healthcare Data Interoperability: More Valuable Than You May Realize

You would be hard-pressed to find a payer or provider that doesn’t believe healthcare data interoperability is essential; surveys of healthcare leaders have shown that interoperability is a top priority for a majority of organizations across the healthcare industry. Healthcare organizations largely agree about the importance of investing in interoperability—so why has the industry made only marginal progress towards a truly patient/member-centric health system? 

Understanding the significance of data interoperability is one thing; recognizing why it’s important is quite another. For too many organizations, the primary reason for investing in interoperability is to satisfy the CMS Interoperability and Patient Access final rule. But of all the potential benefits of investing in interoperability, compliance is just the tip of the iceberg.  

An Evolving Regulatory Landscape
Facilitating the secure and free-flowing exchange of patient data has long been a goal of the healthcare industry, particularly as organizations have moved to digital record-keeping and charting. 

Between 2004 and 2015, the ONC and CMS focused primarily on provider-to-provider interoperability. From 2015 to 2020, the ONC turned its attention to provider-to-patient interoperability: making it easier for patients to access their medical records and claims information. This phase culminated in the issuance of final rules from the ONC and, crucially, CMS (the Interoperability and Patient Access final rule mentioned above). 

By and large, healthcare organizations have implemented interoperability solutions to satisfy this mandate; however, they are often complying more with the letter of the law than its spirit. Ironically, the decision made by many healthcare organizations to build their own interoperability solutions has yielded a lot of data that can be connected, but isn’t. The result is not a connected healthcare ecosystem, but a scattered assortment of closed loops. 

A Member-First Approach to Interoperability
In a disconnected healthcare system, building an effective interoperability solution requires a significant investment of time and resources. It can also be a complex undertaking, so it is little surprise that many organizations have focused more on compliance and less on truly improving the member experience. This perfunctory approach to interoperability misses the forest for the trees: it may save money in the short term, but in the long run it’s an investment that pays significant dividends for health plans, providers, and members alike.  

Meet—and Exceed—Member Expectations
Modern consumers expect seamlessness and convenience throughout the customer journey. Why should their healthcare journey be any different? It is true that health plans need to overcome a number of technological hurdles in order to streamline data interoperability—but the ones who do so effectively will deliver a member experience that places them head and shoulders above the competition. 

Improve Care Quality
Research has shown a direct correlation between care quality and an organization’s degree of engagement in the four levels of interoperability. The more interoperable health plans and provider organizations are, the greater the amount of member information available at the point of care. And the more information that can be made available at the point of care, the easier it is to quickly identify high-risk members and engage in proactive outreach. All of this makes it more likely your members will receive high-quality care. And high-quality care leads to… 

Better Member Outcomes (and Lower Costs)
Members want to take a more proactive approach to their health. A recent Deloitte survey found that 60% of consumers are willing to share personal health data with their doctor to improve their health. But in order to share that data, they need to be able to seamlessly and easily access it—and it needs to move with them across the entire healthcare spectrum. 

By investing in a robust interoperability platform compatible with both existing legacy technology and external systems used by third-party developers, other health plans, and providers, health plans can help alleviate members’ frustration with the healthcare experience. A more positive experience can make members more engaged in their own care, resulting in better health outcomes and happier members. 

Isn’t that what it’s all about?
To learn more about how Edifecs’ interoperability solutions can help your organization enhance quality in value-based care, improve collaboration with providers, and deliver an unparalleled member experience, download our white paper True Interoperability: The Key to Transforming Healthcare.