Automation and Closed-Loop Health IT
The need for more complete, timely, and shared patient healthcare data with real-time updates and interoperability has never been more clearly and powerfully illustrated as it has through the lens of the COVID-19 pandemic. Particularly at the outset of the current public health crisis, the lack of robust and timely data sharing and standardization came sharply into focus.
Clinicians and public health officials had an urgent need to rapidly develop clinical guidelines, related decision supports, and quality measures to assess their implementation; the existing healthcare ecosystem lacked the data sharing and interoperability needed to effectively accomplish this. State health departments scrambled to provide the ability to share data for testing, infection rates, and other measures surrounding the pandemic to provide support for critical decision-making.
The deficiencies in data sharing and interoperability remain obstacles the industry must continue to solve to provide transparency across systems to improve patient outcomes and support public health. The CMS Final Rule for Interoperability and Patient Access moved the needle toward the long-term goal of widespread data standardization and sharing, with its mandates on patient access, FHIR APIs, and the associated data standardization. Although the first release of the HL7 Clinical Quality Language (CQL) specifications provides additional support for further FHIR 4.0-based implementation using standardized data, the lack of widespread adoption of standards for data formatting is just one of the multitude of stumbling blocks providers and other healthcare professionals encounter when seeking a more holistic view of patient data.
The crux of the many challenges and their requisite solutions lies with the data: access to the data, standardization of the data formats, accurate and timely data, and data sharing and interoperability. From point of care for patients, to informed decision-making for both patients and healthcare providers, to public health policy and research, data continues to be “noisy,” fragmented, and lacking in standardization. Perhaps COVID will be the catalyst the industry and policymakers need to address these fundamental challenges—and if so, it will still be a generational undertaking.
To prepare for the next public health emergency, and to improve the way healthcare is delivered in normal times, a new generation of healthcare IT systems must incorporate data automation to ensure virtually real-time entry, exchange, and intelligence. This will not only reduce the burden on providers to manually update patient records, allowing them to focus on higher-value work, it will also allow more timely examination of quality measures and other key metrics that inform the development of public health policy and responses. Perhaps most importantly, it must create a closed-loop data ecosystem, where the key insights derived from real-time data can be delivered back to the front lines so that providers and other healthcare workers can continually improve the delivery of care.
The Office of the National Coordinator for Health Information Technology (ONC), which oversees the coordination of national initiatives for implementation and use of cutting-edge health information technology and electronic exchange, has focused its efforts on two primary objectives: advancing the development and use of these capabilities and establishing standards for data sharing. ONC is not only at the forefront of initiatives supporting these goals, it continues to champion progress by promoting and fostering discussion and idea sharing around these key topics. This year, the organization once again hosted its ONC Tech Forum; the forum focused on perspectives from the industry around health IT progress over the preceding year, and approaches for continuation of the advancement of health technology to improve patient care, health equity, data exchange, and interoperability, presented in a virtual setting. Leap Orbit partner Mrinal Bhasker recently participated in the 2021 ONC Virtual Tech Forum. Mrinal and other distinguished experts from across the spectrum of the healthcare industry delved into the challenges ahead during the breakout session Automation & the Future State of Quality Measures: New Initiatives to Transform Health Care.