In a recent article in Medical Economics, Edward Gold, MD, makes a compelling argument and call-to-action on one of the most complex demands of the Affordable Care Act: Interoperability. A topic with enormous impact, but little discussed.
Simply put it means every Electronic Health Record, every doctor’s office, every surgery center, every patient App, all have to be sharing data and centralizing it for the better care and healthier outcomes for patients. Cost control is a big part of this, too. But the bottom line is cost control comes from coordinated, proactive care and an engaged patient. What is difficult is that so much venture money and rush to install non-compatible systems have been done over the past 5 years and wasted billions of dollars. As Dr. gold puts it: “I don’t think we’re more interoperable than we were three or four years ago,” he says. He still can’t exchange secure messages with most other doctors, he notes, and a local health information exchange (HIE) initiative has come to naught so far.
A 2014 study published in Health Affairs found that health information exchange was still quite low, despite the rapid increase in the percentages of providers who had adopted EHRs. Only 14% of physicians, for example, shared information with providers outside their organizations in 2014. There are more reasons for this problem than can be counted — half are just sheer human stupidity, poor User Experience and resistance to change, half are that the government was slow to set standards.
Why is this hot? First, because the ACA demands it and the health economics will not show efficiencies and savings without it. Next, comes the patient/doctor relationship; within a year, doctors will be paid for emailing not seeing patients; but if you had a surgery at one hospital, are at home being monitored, and your doctor is in a private practice, as of now, you are afloat in the world of disconnected data. No one is really watching out for you. Email or visit, no one professional is seeing your entire picture.
Many experts say this will work its way out. But will it? Some systems are light years ahead of others; it is almost as if a digital caste system of have and have-nots is being created due to lack of interoperability. We all need to be our advocates for ourselves, parents, children and ask ALL your healthcare providers: how connected are you?