Cambia Grove Interoperability Summit Follow-up

Insights from Summit Speakers

Dataflow’s watershed moment

2019 marks a hallmark year for data exchange and interoperability, as the ONC restructures the flow of health data, drafting rules and laying the pipes of tomorrow’s system. Before rushing to implement value-based care and other platforms fueled by free data exchange, we need to step back to examine how these dataflows will work in practice, and how we can design thoughtfully to prevent silos akin to those hampering care delivery today. 

To that end, Cambia Grove hosted the two-day Consumer’s Interoperability Summit June 20-21, featuring Susannah Fox, former CTO of the U.S. Department of Health & Human Services (HHS) and Cambia Health Solutions Board of Directors member, Christine Bechtel, Co-founder of X4 Health, and Aneesh Chopra, former CTO of the United States and President of CareJourney. 

Expanding the data pipeline 

Susannah Fox spoke of expanding our health data horizons and a new taxonomy of health data, one including grocery and gym habits. In Japan, for example, if a senior hasn’t used electricity by the standard morning time their records routinely show usage, help is dispatched.

Perhaps the most well-known example of health data access is Blue Button – a 2010 initiative to boost health record access. At the summit the first U.S. Chief Technology Officer, Aneesh Chopra, touched on his time in office and his mission to continue broadening consumers’ access.

Breaking down barriers with a FHIR hose

The Summit showcased use cases of interoperability, demonstrating the future of health care when we have working data sharing practices. Featured use cases are list here with links to their website.

Guests also heard about four recommendations to advance interoperability from Tina Olson Grande from the Healthcare Leadership Council and Neal Neuberger from the Bipartisan Policy Center, who co-developed the report Advancing Interoperability, Information Sharing, and Data Access:  Improving Health and Healthcare for Americans. There are initiatives are already in place working on these recommendations that presented their work

1.Recommendation: Strengthen the Business Case

  • Initiative: The DaVinci Project

The Da Vinci project enables providers and payers to positively impact clinical quality, cost, and care management outcomes by demonstrating how HL& FHIR can create scalable solutions to exchange critical data to fuel value-based care models

2. Recommendation: Improve Technical Infrastructure

  • Initiative: Adoption of HL7 FHIR API

Intersystems customers use HealthShare to bring together patient and population data from EMRs, insurance claim systems, and other sources across the healthcare ecosystem.

  • Learn more about Intersystems
  • Learn more about HL7 (Health Level Seven International)

3. Recommendation: Improve Policy and Regulations  

  • Initiative: CARIN Alliance

The CARIIN alliance aims to rapidly advance the ability for consumers and their authorized caregivers to easily get, use, and share their digital health information when, where, and how they want to achieve their goals through consumer-directed exchange. 

4. Recommendation: Governance and Leadership 

  • Initiative: Bringing the Consumer to the Center of Interoperability Measurement

Interoperability affects and enables diverse stakeholders, including the patient. When talking about interoperability, it is important to consider the potential to measure nonclinical sources of data and social determinants of health data.

Where do we go from here?

There’s much work to be done as technology upends health care. Consumers are becoming more involved in their health care decisions, and deserve to be just as informed as their counterparts in the 5 Points of Health Care™.  Maura Little, Cambia Grove Executive Director, brought the discussion full circle from the human element in interoperability by underscoring the need for building trust with all parties– the first step - before creating thoughtful data flows. As we have heard time and time again, the technology is available.  Partnerships are key in turning possibilities into practice and Cambia Grove will continue to bring together these essential connections.

On the second day of the summit, guests selected breakout sessions to participate in conversations around the recommendations and complimentary initiatives to advance interoperability. The key takeaways from these conversations are identified here:

*Strengthen the Business Case

  • There needs to be a champion in all health organizations advocating for interoperability in order to advance value-based care.
  • Consumers will benefit from interoperability at the payer and provider relationship improves through enhanced data sharing, communication and collaboration.
  • Value based care systems are only sustainable with a set framework for data exchange and interoperability.

*Technical Infrastructure

  • Consumers need to be in control of their own data.
  • Although data entry is the largest pain for providers (leading to problems in clinician burnout and poor clinic workflow), they are often not at the table during big data discussions. They need to be more present.
  • There is increasing interest in using FHIR and how to use it to look inside big EHRs. 
  • Goals and policies need to be established for data initiatives including sharing with other health systems, sharing with patients, data with other purposes like research and analytics, and data for application development. These four separate areas should be thought through and planned. 
  • Start working with the FHIR capabilities of your EHR vendor. They all have something, and a health system should understand what their vendor can and cannot provide in order to plan around this.

*Governance and Leadership

  • Interoperability needs to be measured by individual organizations and at a national level. There should be a standard framework for these measurements.
  • There needs to be involvement of consumers and community health centers regarding big data and interoperability to incorporate their perspective around how interoperability is used and measured.
  • We need to be able to incorporate what happens outside of the clinic into patient health data (including SDOH).

*Policy and Regulatory

  • Consumers need one way to identify themselves that can be authenticated and shared across systems.
  • There needs to be more patient advocacy.
  • Pharmacy needs to be at the table for input and accountability.
  • CARIN Alliance is collaborating on several workflows that could serve as the foundation of an article or whitepaper that will be drafted to offer solutions for how the industry could use open standards and these workflows as an approach to federating IDs.

 

Cambia Grove’s Interoperability Summit met 100% of survey responders’ expectations!

 

Results from the Guest Survey:

  • There are more people and efforts working towards interoperability than they were aware existed. 
  • There is a complicated infrastructure to interoperability (e.g. FHIR, CDS Hooks) that needs to be better understood. 
  • A huge range of areas and fields are impacted by data sharing. 

 

100% of survey responders made meaningful connections at this summit.

The majority of survey responders said that their sense of optimism regarding data interoperability and consumer empowerment had improved:

 

Thank you for making our Interoperability Summit a success!

  • Check out the Interoperability presentation slides here
  • Check out the event video here
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