In February of this year, the ONC and CMS proposed a new interoperability rule that promises to be a game-changer for patients, providers, and software developers like us. Given that the federal government has spent tens of billions of dollars trying to get clinical providers on the electronic health record (EHR) bandwagon with, questionable results at best, it’s a case of better late than never. Here is my perspective as CEO of a clinical decision support startup that stands to benefit from the rule, once it is implemented.
When I started Inferscience, my vision was to integrate with EHRs, analyze the patient data contained within the record, and provide the clinician with solid evidence-based guidelines or recommendations for the care of the patient. It’s been well documented that providers spend a significant amount of time entering data into EHRs. Some of my fellow physicians spend more time doing data entry than they spend doing actual patient care. So, one would hope that patient data is good for something other than saving them from lawsuits and helping their employer bill to the highest level. Unfortunately that’s not the case. EHRs have spent little effort analyzing patient data with the intent of helping providers improve the quality of medical care. They have compounded the problem by holding patients’ data hostage and refusing to interface with outside apps. As a result, providers are stuck clicking, dictating, and typing into EHRs all day, without any assistance in caring for the patient. The losers in this situation are the patients and their providers.
We know that up to 60% of the time, patients do not get optimal care. One of the main reasons is that many medical providers lack the time, and even the knowledge, to give patients the care they deserve. In my opinion, that is a travesty in this age of ubiquitous knowledge availability. The interoperability rule promises to change that by forcing EHRs to share their data via APIs with outside applications of the patient’s or provider’s choosing. APIs, or Application Programming Interfaces, allow disparate applications to share data with each other, which, as you can imagine, should help remove many of the limitations of today’s EHR products. It’s like being able to choose from hundreds of applications within an app store. But, unlike apps that have been built for a specific mobile or desktop operating system, the EHR will be required to exchange data with a myriad of systems, even those belonging to a potential competitor. That’s because the data will belong to, and be under the ultimate control of, the patient and his or her provider.
Once implemented, the rule should encourage developers to come up with applications that enable providers to up their clinical game — as well as facilitate the free exchange of data between healthcare entities. It should also lead to better provider satisfaction because the apps will help them deliver better medical care, more efficiently. Additional benefits that come to mind: ability to access patient data from other EHRs, specialty-specific advanced clinical decision support, automated risk capturing tools, notifications when a patient is hospitalized, easy access to clinical registries, and true medication reconciliation, to name a few. And this list does not even include the revolution in consumer access to data and insights into their health that the rule promises. The new patient and provider-centric ecosystems enabled by the interoperability rule should lead to more efficient and cost-effective medical care because physicians will be able to focus on what’s ultimately important: making a difference in patients’ lives.