The disconnectedness of data can be a major drag on health care systems, and it can make effective collaboration much harder. But organizations in both the public and private sectors are finding ways to connect the dots.
Speaking at the MIT Sloan Designing for Health Conference on Dec. 6, here’s what three experts from the health care field had to say about how to make health data work more efficiently.
Look upstream and down
Andrew Bertagnolli, a vice president at managed health care provider Optum, said his organization has been leveraging data analytics to get a better view of hospital admission, discharge, and readmission rates to better determine if patients require additional care.
The end goal is to use data to anticipate which patients have mental or behavioral health problems that would make them more likely to be readmitted to the hospital and work to prevent that event ahead of time, he said.
“We’re beginning to look at how we can really use data to identify the early warning signs when someone is maybe starting to have some difficulty, to go off the path, and how can we intervene with them earlier,” Bertagnolli said. “Using data analytics, we’ve begun being able to stratify the population into opportunities.”
Valerie Pietry, chief medical officer at the Family Health Center of Worcester (Massachusetts), recommended that health systems search for data from national and regional associations and use that to benchmark their own performance. “We can be looking across the entire nation while we’re still doing local care,” she said.
Identify discontinuities in the data
The panelists said a major hurdle to interoperable health care data is its often-disjointed nature and the barriers to sharing it among organizations.
Ethical considerations loom large when attempting to connect data in useful ways, especially in the behavioral health sector, Bertagnolli said. Federal regulations designed to protect patient privacy exist for good reason, he acknowledged, but may also be reinforcing stigmas and making certain conditions like substance abuse disorder more difficult to treat effectively.
“As you connect certain types of data, especially as we move into some of the social determinant and consumer data, I think [adhering to privacy regulations] is a challenge,” he said. Pietry said her organization often runs into that problem when working with school systems, which have additional rules governing student privacy.
The lack of interoperability between the various electronic medical record systems used by virtually all health care providers today is a roadblock for providers that work across organizations, said Chris Goldsmith, president of Landmark Health, which sends clinicians into the homes of patients with chronic illnesses in 14 states.
“Even though billions of dollars have been invested in EMR interoperability, it’s still not there today,” he said. “If everyone’s not on the same EMR, then going outside your four walls, on the provider side, is really an immense challenge.”
Still, Goldsmith said, there’s been progress in that area, with regional health information exchanges being set up that facilitate the exchange of health care data and information across organizations in a particular system or region. “I’d love to see them in every single market,” he said.
Do it yourself
As it sought to work with and across numerous organizations, Landmark’s frustration with existing EMR systems led the company to develop its own, Goldsmith said.
“Whether it was the psych [nurse practitioner] who visited the patient, the nurse who made the call, a note that came in from the primary care provider — we put that all in [to the EMR], so when you pull up [that patient], you can see ‘Here’re all the touches,’” he said. “That’s how we use technology to enable that communication.”