Article - Operations

Healthy Data Exchange and Interoperability

By Tim Cassidy|20th January 2023

Delivering data insights that derive action and improve health outcomes is a key goal for payers and providers. For those working within senior care, interoperability progress is being made but getting an advance care plan or following a patient’s journey throughout the system remains challenging. At our most recent Next Generation Healthcare Summit payers and providers shared what’s working and what’s not. 

Connectivity Pain Points in Post-Acute Care

Interoperability within the healthcare system is critical for a healthy exchange of data between payers and providers but as the SVP of Medical Affairs at BrightSpring Dr. William Mills told us there is still a long way to go. “It’s frustrating when you’re a healthcare provider to try and provide services for one segment of that patients care journey and you don’t have visibility into what happened before, there has been progress made for sure with health information exchanges, interoperability, but I think we’re still so far behind.” 

The biggest challenges facing our audience when it comes to post-acute care were managing projects across stakeholders and staffing shortages. Our expert payer and provider panelists say they must extend medical treatments and care plans into the home. Sara Wilson, CEO and President at Home Assist Health offered, “Most of what happens with an individual’s health happens at home, you have to address social determinants of health, healthy habits, healthy behaviors, we need that two-way communication in between your homecare providers and the medical communities so that we can have effective treatment plans so that we have accurate data versus fragmented data.”  

Adrian Schauer, Founder and CEO of AlayaCare is optimistic, “I see a ray of hope that we can address both the labor shortages and connectivity across the care continuum together, for better or worse, home based care is generally not at the center of the health system, particularly on the personal care side, it’s not necessarily the highest status job within the health system and I think if we do a better job of connecting home based care into the continuum of care, you’ll have a more empowered healthcare worker and you actually have a chance of solving the labor shortages at the same time.” 

Interoperability Transformation

Humana created a cloud-based data platform that helps find, cleanse, and standardize the data. However as Dalia Power, the SVP & CIO at Humana told us at first they struggled to identify the same patient across their system, “I think we have broken some ground, we created internally the longitudinal human record that is helping us gather the information about a person and making sure we cleanse the data and standardize it, using that we are able to apply machine learning and AI models so we can get that information and explore that patients journey towards better health outcomes.” 

For Adrian at AlayaCare, they needed to find a way to get the data at the point of care, “Within our software platform there are a ton of notes that are collected at the point of care and often you have an organizational structure with a clinical supervisor, but we know all those notes are not getting read so we developed a natural language processing system that will comb through all the narrative notes collected the point of care and flag some notes that require some oversight which might trigger an action.” 

Metrics & Incentives Matter

Our expert panelists say finding out which metrics matter most to your organization will help drive progress between payers, providers, and patients. Dr. Mills at Bright Spring says incentives tied to those metrics are important, “One of our enterprise outcome measurements is days spent at home, so that the number of days that a given individual can spend at their home in their community and outside of hospitals is really the unifying outcome measure that we have all agreed on across our 12 different business lines, a metric like that gets the technologists, the clinicians and the data scientists a target to harvest disparate data from the various systems and then place them in a data lake where it can be analyzed and used to express value proposition externally, it can be used for initiatives internally, when you have very diversified businesses like we do, it really creates that impetus or a language alignment to really figure out what metrics matter most.” For many healthcare organizations the struggle to align incentives remains challenging.  

Data Security, Privacy & Governance

Patients, especially in the elder care space, have concerns with technology advancement and invasion of their privacy. These healthcare leaders are tasked with ensuring information is safe and inform each patient as to how their information is going to be used.  As Dalia Powers from Humana pointed out, “With HIPA data and PII data it’s really very important that we are very careful about how we use it. In the dark web the estimates indicate that a medical record is worth ten times the value of a credit card, so health related data is important for us to secure and govern.” 

Conclusion

Progress is being made in the post-acute space, some states have started to adopt registries for advance care plans and solution providers are digitizing those plans for better data visibility. Sara Wilson from Home Asist Health concluded, “If we can use technology, collaboration between medical communities and home care partners to actually intervene, help improve self-help management, address social determinants of health and have more targeted personal treatment plans, I do believe that we will see a relief on the healthcare system, reduce ER visits, reduce avoidable admission’s and improve self-help management and hopefully mitigate the rise of early onset disability.” 

GDS Summits are tailored 3-day virtual event conferences that bring together business leaders and solution providers to accelerate sales cycles, industry conversations and outcomes. Regarding the Healthcare Summit 75% of Delegates said their overall experience was either ​Above Average or Excellent and 100% of Delegates said the Digital Summit provided them with actionable outcomes to support their current initiatives. 

For more, click here to hear from attendees on how GDS has helped them to achieve their business outcomes. 

Continue the debate at GDS’ Healthcare Summits where we bring together senior medical executives who are actively seeking to share, learn, engage, and find the best solutions. 

Apply to Attend 

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