If we want to create better mobile health applications and get patients more involved in the important decisions around their care, there's a deep, systemic flaw we need to address.
That flaw is the inability for various healthcare systems, devices, and processes to work properly together. This creates inefficiencies, greater costs, and a more frustrating experience for patients, healthcare providers, and vendors.
We're talking about the interoperability (or lack of it) in healthcare systems.
The Problems and Flaws with Interoperability
Interoperability is vital to getting the right medical information to the right people in the right way at the right time. Unfortunately, a lack of standards and processes means we have a disparate set of systems that aren't very good at exchanging data and medical information. This causes a number of problems.
1. Lack of Universal Standards in Healthcare Information System Technology
A majority of healthcare providers need to install standardized, modern technology that uses established common communication protocols and similar functionality. Policymakers can drive these changes.
2. Lack of Common Workflow and Business Processes
Providers need to innovate their processes, both internally and when working with external systems, organizations, and people. A standardized set of best practices would help solve this issue.
3. Difficult Security and Privacy Challenges
With the danger of hacking always in the background, it's vital for providers and vendors to invest in secure, encrypted ways to store and transmit data.
4. Lack of Coordination and Direction between Influencers and Stakeholders
Everyone involved in getting systems to be interoperable — from policymakers to manufacturers to users and other stakeholders — needs to agree on a common approach. "Standards and rules for patient access must be uniform to bridge existing and future networks," writes Healthcare IT News.
5. Weak Incentives to Change
There simply aren't many economic incentives for providers or vendors to change. If the need for a common system is supported by clear cost / benefit analyses and there's a positive impact on the bottom line, it's likely more providers will make an investment.
How These Flaws are Playing Out in the Real World
In 2014, a collection of professional groups including the American Academy of Family Physicians, the National Rural Health Association, and the American Medical Association among others, drafted a letter to the U.S. Department of Health & Human Services expressing concerns about the Meaningful Use program, which they argued hindered rather than encouraged interoperability.
"Currently, health information stored in most EHRs/EMRs and other HIT systems and devices does not facilitate data exchange but 'locks-in' important patient data and other information that is needed to improve care," they argued.
A report from the RAND Corporation concluded that current regulations discourage innovation and data sharing. "The lack of interoperability is one of the biggest hurdles to clear for widespread data sharing, the key to improving quality and efficiency of health-care delivery," Bloomberg's Kendra Casey Plank wrote of the RAND report.
The Importance of Agreeing on Technological and Health System Standards
For mobile health tools to become more engaging, a couple of things need to happen. First, there needs to be an industry-wide infrastructure that lets the constellation of digital health records and mobile applications communicate — which is exactly what our API platform aims to achieve.
Second, every stakeholder in the healthcare industry needs to agree on standards for data sharing that make everyone comfortable. A lot of work is already going into this, as Medullan's Mark Burrell told mHealth Intelligence's Vera Gruessner last year.
"We did some work recently on a health and wellness application in which patients could share their data," Burrell said. "We discovered a high level of comfort with sharing data with a coach. We found that actually providing transparency and control over who sees the data and what they see helps on the consumer side of things. On the doctor side, we need systematic assurance that mobile health technologies are HIPAA-compliant and provide a secure system for communicating with patients."
How Can We Improve Interoperability?
There are initiatives taking place around the world and across many different vendors, sectors and providers:
- Ahima is on a mission to standardize healthcare interoperability. They believe everyone "must come together to develop and implement technical standards to keep data in a unified format."
- Estonia is working on a plan to secure citizens' health records with cutting-edge technology being driven by Estonian software security company Guardtime.
- The Center For Medical Interoperability believes that procurement should be leading the charge in demanding standards.
There are many approaches to getting better interoperability in place. What's certain is that we need to start now, and we need to do it quickly if we want to engage patients more effectively.
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Tags: Dev, Security