By Drew Ivan
Prior to the coronavirus pandemic, it had become increasingly common for healthcare organizations to gradually shift care out of the hospital and into the community and the home with tools like telemedicine, patient portals, apps, and other digital means. Driven by the pandemic, implementation of remote care technologies has accelerated to an astonishing degree, and there is an increasing number of health systems that are shifting care delivery to alternative care settings including pop-up testing tents and temporary clinics. These dynamics have caused significant growing pains for providers and vendors alike, exposing the critical need for high-quality, high-bandwidth, robust, bidirectional data exchange.
Rapid Scaling Exposes Need for Bidirectional Data Exchange
The rapid scaling of alternative care technology and settings during the pandemic has been essential to the continuation of healthcare delivery while also limiting community transmission. However, it has also presented healthcare organizations industry-wide with significant interoperability challenges. The drastic push to deploy virtual care tools and alternative care settings has occurred nearly overnight, meaning organizations have had limited time to properly implement infrastructures robust enough to support these emerging technologies and venues of care. By taking shortcuts to get up to speed quickly, organizations have run into significant challenges around data exchange. Though sharing data among disparate systems is nothing new, it has been a perennial weak spot for many health systems, hospitals, practices, and the technology vendors that serve them. The current circumstances have only further emphasized the need for strong IT infrastructures to support high-quality, bidirectional data exchange.
Provider Organizations Unprepared for COVID-19 Interoperability Challenges
Many organizations were still in the pilot stage of using alternative care tools and technologies when the pandemic began. Telehealth platforms in particular had only been used in a limited capacity, with the intention of scaling gradually over time. Few organizations were prepared to rapidly accelerate their implementations in response to the crisis, and this caused many to make compromises allowing them to get the programs up and running quickly, but also putting them at risk for problems like security and privacy issues, highly manual and error-prone workarounds, and inaccuracy and inefficiency of data sharing.
These shortcuts have resulted in major problems in many areas, include coding and billing, clinician workflow, and bidirectional data exchange.
Coding and Billing
Coding and billing in a pandemic situation with shifting rules from the government and payers is difficult enough. Combine these factors with clinicians who are being pushed to operate outside of their typical parameters and deal with high case volumes—often using new or no software to document care—and it is a recipe for revenue loss and compliance risk. Organizations with more robust IT infrastructures and good interoperability capabilities are in a much better position to adapt to these dynamic environments and integrate new data sources and formats. This makes life much easier and reduces the likelihood of leaving money on the table or getting penalized for inappropriate billing or documentation.
Many payers have allowed providers to temporarily employ consumer video conferencing platforms for telehealth visits, but provider organizations expect to be required to implement HIPAA-compliant dedicated telehealth platforms sooner rather than later. While this has been an extremely convenient stopgap, it can create significant workflow challenges that may carry over when more sophisticated platforms are in use. These challenges include lack of integration with scheduling, records, and billing systems, as well as security and privacy issues. Having to toggle back and forth between, and carry information over among multiple systems, creates many opportunities for inefficiency and errors.
Bidirectional Data Exchange
One of the issues underlying workflow, billing, and coding challenges (as well as a whole host of other problems), is the need to establish robust bidirectional and accurate data exchange to navigate information sharing among multiple software systems and physical locations. The more sophisticated the infrastructure is and its ability to accurately translate across systems, the less room for error and the less human overhead required to ensure operations are running appropriately. Accurate and automated bidirectional data exchange reduces the risk of error and frees up staff for more critical projects. This cannot be overlooked, and when it is prioritized appropriately, the better it is for everyone.
Vendors and Providers Alike Must Prioritize Bidirectional Data Exchange
From telemedicine platforms to pop-up alternative care and testing locations, hospitals and health systems are finding ways to continue providing care under the challenging circumstances that COVID-19 has presented. It’s critical that telemedicine tools are well-integrated and allow clinicians to operate safely and efficiently. In order to meet that need, providers and vendors alike must embrace industry-wide efforts that make interoperability a priority. Telemedicine and electronic health record (EHR) vendors, along with hospitals and health systems, must focus their efforts on the interoperability of data at every level.
What many healthcare organizations and companies do not often fully understand is that the robust infrastructure needed to address all of these interoperability challenges already exists and is readily accessible and available to them. Implementing data integration tools can solve many of the challenges exacerbated by the pandemic, and ensure that providers can support and treat patients, while effectively sharing healthcare data from organization to organization. In the same vein, vendors who wish to meaningfully support their provider-organization customers need to consider leveraging integration capabilities to make data sharing easier, safer, and more robust between their product and those of their fellow vendors.
The Road Forward
Long before the pandemic was ever a concern, flexible information sharing has been an ongoing industry-wide issue. The pandemic has only emphasized this need, exposing the persistent gaps in interoperability and forcing organizations and entities across the continuum of care to examine their role in solving this issue. As healthcare providers work to deliver adequate patient care, telehealth tools have clearly played a critical role in meaningfully caring for patients, while mitigating the spread of the virus.
It’s time for healthcare leaders from vendor and provider organizations to examine their organizational and product infrastructures and find ways to implement more robust bidirectional data exchange capabilities. Healthcare providers must do this to ensure patients are well cared for, and vendors must do what they can to support their provider customers. Interoperability is good for everyone; it resolves data barriers, improves workflow efficiencies, and increases patient and provider satisfaction—among other benefits. When interoperability is prioritized, everyone can be better prepared to take on the challenges of today and the inevitable challenges of tomorrow.
Drew Ivan (Drew.Ivan@lyniate.com) is chief product and strategy officer at Lyniate.Leave a comment