Sometimes, when I’m trying to explain interoperability, I feel like I’m in a Mastercard commercial.
Annual transactions by physicians and other clinicians: billions.
Number of documents available: countless.
Saving a life because the physician had the information they needed, when they needed it: priceless.
In the health care industry, transaction numbers are often thrown around by competing health care organizations to prove they are interoperable. But is that really the right thing to measure? And if so, what do these numbers or any other transactional number mean? The answer should be simple, but unfortunately, it’s not.
These days, a “transaction” means something different for every health care organization reporting on it. Some measure documents and others count narrative summaries, but most leave the details to the imagination. Is it every piece of data queried and data retrieved? What counts as a document exchanged?
It’s bad math and, frankly, not easy to quantify due to a lack of industry standards to measure interoperability. Numbers are a good quantitative measure to gauge the progress of interoperability, but if we are not comparing the same thing, how can we truly measure success?
Actually, that answer may be easy to find. There are other, oft-overlooked measures that can help to demonstrate the true measure of interoperability success. We can reduce clinical errors by preventing duplicate testing. We can save time spent on finding patient information – faxes, phone calls and other communication – because all the data are available, empowering physicians to make quicker, more informed decisions. We can decrease the amount of patient rehospitalizations and lower the chances of overmedication or mismedication. In short, with better data, clinicians can drive better patient outcomes.
For health IT (HIT) providers, the bottom line is about accessibility. Are we providing the clinicians the right information at the right time, regardless of where the care is occurring?
If one life is saved because the health care provider has access to the critical fact needed to complete the patient’s real health story – giving the clinician the information they need to make a lifesaving decision – that is when interoperability has knocked it out of the park. That is one measure of success that means more than any number of documents.
During the Cerner European Collaboration Forum in March 2017, Robert Fearn, consultant gastroenterologist from Homerton University Hospital in London, spoke to the importance of having access to all of a patient’s data:
“There are countless episodes I can think of over the years where a patient will tell us they’ve had a scan or a test, an investigation and they don’t have the report with them, and we can’t get ahold of those reports – and in those cases, often we’ll repeat the tests. If that’s something straightforward like a blood test, then you could argue that’s in their best interest; if it’s something more invasive like a CT scan with radiation, or an endoscopy that involves a physical procedure done to the patient, then the impact on the patient is huge, and every one of those procedures comes with risk. So, by having access to that data we can reduce the number of times we’re repeating unnecessary investigations, we’re reducing risks to the patient as well.”
These are they kind of stories we want to continue hearing, but patients can only benefit if the entire industry works together to exchange information. No one company will have an “advantage” if we’re truly interoperating. By definition, being interoperable means HIT providers and health care organizations alike are collaborating with each other – and, in some cases, with competitors – to share patient information. In turn, we are collectively improving the delivery of health care – and that is what truly matters.
Neal Patterson once said that interoperability is too important of a mission on which to seek a competitive business advantage, admonishing those who aren't working toward it. "I tell you what, you're immoral [if you’re working against interoperability]," he said. "That is wrong. There is a right and wrong thing. Compasses are not always aligned."
More HIT providers could stand to build on Neal’s vision. We need to continue breaking down the silos that have restricted data exchange across electronic health records. As an industry, we must look to compete on the superior functionality of our software, not the data it holds, so that we may empower health care organizations to provide the best patient care possible.
Let’s not get bogged down in numbers of documents. Rather, let’s continue to help physicians, nurses and other clinicians have those “priceless” moments with their patients.
Sharing data is foundational to Cerner’s patient-centric interoperability. We’re focused on strengthening patient experiences and clinical workflows. Learn more about our innovative, open platforms.