September 29, 2022

Healthcare’s “digital transformation” started approximately 30 years ago, and in that time, many functions in healthcare have been fully digitized. Unfortunately, the patient experience is not one of them. Collectively, we offer a fragmented and disjointed experience where cost is disconnected from care, and it takes grit and determination to understand your options as a patient.

The good news is that conditions are right for lasting change and, as an industry, we need to take advantage.

Four dynamics are intersecting to create this opportunity:

  1. By all accounts, we have achieved the goals of Meaningful Use and medical records are built and stored electronically.
  2. Patient out-of-pocket costs continue to rise, driving consumer demand for more information—particularly cost information.
  3. The pandemic has made us more comfortable managing healthcare electronically than ever before.
  4. There are significant legislative tailwinds, primarily driven by the 21st Century Cures Act and the ONC action planned this year around information blocking, FHIR APIs and TEFCA.

As an executive who has spent the last decade helping to shape technology adoption strategies, it is important that we do not rely on legislation alone to chart the course for digital transformation. The onus is on healthcare providers, payers and their technology partners to use the new laws and market dynamics as a catalyst to evolve.

Legislation will get us to information sharing

Nearly six years after Congress passed the 21st Century Cures Act with bipartisan support, we still do not have a fully modernized healthcare system with interoperable data platforms. This year, the ONC is focused on three areas with the intent to make meaningful data sharing a reality. The National Coordinator for Health Information Technology, Micky Tripathi, outlined the priorities in a recent editorial in Health Affairs:

  1. Expand information blocking regulations to all electronic health information (EHI).
  2. Require FHIR APIs for health IT certification.
  3. Create the Trusted Exchange Framework and Common Agreement (TEFCA) to establish a forum for trusted data exchange.

Robust data sharing is the clear first step in bringing those initiatives into practice.

We must move from information sharing to shared decision-making

While the Cures Act promotes the free flow of EHI and its continued enforcement is critical, there is a need to move beyond information sharing and into shared decision-making with real-time, personalized data availability. When healthcare achieves shared decision-making, patients will not only be able to understand their diagnosis, they will have access to their care plans, the cost of that care and available care options, while having the power to make an informed decision for their total health.

Consumers use freely available information to make decisions far less important than their health every day. They can find the best pizza restaurants within a 10-mile radius in seconds. When they’re making a major financial commitment such as building a home or buying a car, they can easily access all of the information needed to make informed decisions that work for their budget. Healthcare has predominantly left patients in the dark when it comes to planning and paying for their care.

By gaining the same transparency in healthcare, patients can finally approach their care from a position of strength. The No Surprises Act is built to protect patients from unexpected medical charges, but budgeting for medical care remains opaque.

Transformation hinges on collaboration 

Over 90% of hospitals have had electronic health record (EHR) systems since 2013—meaning the digitized healthcare system must shift its thinking from strictly implementing new technology to examining how the technology is used. To that end, we’re making meaningful progress toward a static data exchange, which requires EHR data to meet high standards for quality, readability and its impact on patient care.

However, static data exchange alone will not improve healthcare. We must continue to look ahead and create a more cohesive environment for shared decision-making, which requires every stakeholder in healthcare—provider organizations, insurers and technology partners—to come to the table to improve patient outcomes. While those cohorts collectively share a vision for improved care, increased collaboration is critical to continued progress.

With a commitment to stronger collaboration between stakeholders and the innovative spirit that has advanced healthcare technology by leaps and bounds in recent years, our healthcare system is positioned to realize the power of shared decision-making and its impact on patient outcomes.

Photo: elenabs, Getty Images