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Top Focus Areas for Patient-Centered Interoperability


Patients are the catalysts to interoperability changes, according to the Council of Accountable Physician Practices, an affiliate organization of the American Medical Group Foundation.

Putting patients at the center of communications will spur changes to make interoperability more attainable, according to the Council of Accountable Physician Practices (CAPP), an affiliate organization of the American Medical Group Foundation. The organization released its second set of recommendations to policymakers and industry leaders in January 2018, aimed at improving interoperability for healthcare delivery systems.

Listening to patients’ frustrations with multiple portals and other healthcare communications should cause a fragmented system to provide more synchronized technology, says Ira Nash, MD, FACC, FAHA, FACP, a member of the CAPP board of directors, and senior vice president of Northwell Health.

“Patients are going to demand that someone makes it easier for them to access their information in a way that is aggregated, curated and easy for them to understand, and then use to improve their health and quality of life,” Nash says. “They are frustrated by a health system that lets them get some information from a patient portal, but demands that they use different portals to get information from different providers. They are also frustrated by how hard it is for their providers to share information with each other, so they are left to lug paper from one office to another, even if both use electronic systems.”

In order to create patient-centered interoperability, CAPP suggests that stakeholders focus on improved and harmonized quality measurement and reporting, robust and coordinated use of health information technology, and value-based payment. Ultimately, these changes center around patients being in charge of their health records, and their needs being the most important part of data exchanges, Nash says.

Patient narratives as a part of quality measures

Nash says one of the important elements missing from current patient data is the narrative from the patient about their own health.

“As any good clinician will tell you, the most important parts of a patient encounter are the

insights, background and backstory we used to be able to include in the narrative,” Nash says. “That’s one of the challenges with some of the current approaches to EHR, we are so busy

clicking and pointing, we can’t hear the patient story.”

Because metrics around complete, integrated, usable patient data available to both patients and providers aren’t established, measuring the effectiveness of interoperability will continue to be difficult, according to CAPP.

“Our goal is to ensure that we also find ways to communicate more of the patient story and our experiences with that patient that could provide clinical benefit to all providers along the continuum,” Nash says.

Next: Patient ownership of healthcare data



Patient ownership of healthcare data

Shifting the paradigm in healthcare to patients owning their healthcare data also shifts interoperability measures, Nash says. Allowing patients to have better access of their records, and then share that information with companies that are making strides in health IT, such as Google, Apple, and Amazon, allows for more innovation that benefits all of healthcare, according to CAPP.

“We need to make it more accessible and meaningful, without making it frightening or confusing. Second, we need to determine who is the keeper of the record. Who will decide what information is shared and with whom?” Nash says.

He adds that with accessibility and ownership, patient data should also be recorded in a way that is easier to understand by patients.

“We are finally giving patients more access to their data but it still needs an English to English translation. We aren’t yet taking into account that patients, who have various levels of health literacy, will be reading our notes,” Nash says. “It’s time that healthcare providers became much more mindful of what they record about patient encounters, and that we make it more appropriate and accessible for a lay audience. That is going to require a change in mindset. It won’t happen overnight but we need to start making those changes today.”


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