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The Road to Interoperability: More Than Technology

Published on 5/5/2017

Zane Burke recently spoke with Modern Healthcare about the standards and technologies driving interoperability. To read the full article, click here.

Interoperability remains a hot-button issue at the forefront of health care reform as the industry shifts to value-based care to enhance the consumer experience, improve the health of populations and reduce costs. But when people talk about interoperability, they often focus on the technology. The reality is that interoperability is much more complex than that. It's going to take suppliers, health care organizations and clinicians, all working side by side, to ultimately connect patients to their data.

While it's easy to talk interoperability, it's much harder to do it, and the challenges transcend technology. I like to explain it this way: Think of interoperability as the plumbing in your home. Health IT suppliers, like Cerner, can manufacture the pipes, but health systems have to install them, and clinicians and health care consumers supply the "water," or data, that flows freely through the system. It takes all of us to be successful, and those organizations that have been on the sidelines need to understand interoperability is no longer the leading edge — it's table stakes. In fact, I'm personally reaching out to CEOs at health systems throughout the United States to get them engaged.

Cerner has been a trailblazer in leading and supporting efforts that advocate for the adoption and use of common standards and practices that advance interoperability for nearly three decades. Our vision for true interoperability is that you, as a consumer, will be able to engage a clinician you've never seen before, provide your consent and then the doctor can click a button in the electronic health record (EHR) to compile the most relevant information from your lifetime of experiences with health care providers around the world. This is significant when you consider the average person in the United States has seen 18 different doctors in their lifetime. For people over 65, that number is 28.

National Patient Identifier

Accurate patient identification is also essential for true interoperability to become a reality. This country needs a national patient identifier to maximize the ability for health IT to ensure the best possible outcome for the patient. And here's why high fidelity records matching is an absolute necessity: I have a client in Houston that has 90,000 different Maria Torres records in its database. It's difficult, at best, for that provider to locate accurate and complete electronic medical records at any given time for the right Maria Torres, especially if the patient's condition limits their ability to communicate. A unique patient identifier is the solution, and it's up to those in our industry, like Cerner, that are willing to collaborate for the better good to innovate and clear this hurdle for the benefit of all.

The CommonWell Health Alliance has a reliable national patient identifier that provides the capability for a Cerner record to easily be linked to another supplier's record through proper matching. It's the only approach happening today where a match is taking place, and we encourage others to adopt this method. Not only do we need to make sure systems can receive data and effectively connect records across multiple provider sites and IT systems, the data needs to be presented directly and conveniently in the physician's workflow.

Interoperability is a national struggle, and it affects everyone. No one is immune. This is why former Vice President Joe Biden developed the Cancer Moonshot Initiative, frustrated with his son's fight against cancer and trying to get different health care providers to share information. If the vice president has trouble getting records, how is the average person going to easily get access?

Outside of health care, there are plenty of examples where competing business interests have come together to solve interoperability problems. It's happening in retail, entertainment, banking, manufacturing and distribution, and it needs to happen in health care. You can go to any ATM in the world to access your money, and your Apple and Android mobile phones can talk to one another. It is clear change is necessary.

Open and Interoperable

I have said either you're going to be open and interoperable, or you'll be obsolete. And while we view open and interoperable as two different concepts, they are related. Interoperable is the ability to go and retrieve information from any disparate system, while adopting an open mindset to innovation is how we as an industry will use the plumbing of digitized records to create additional insights and value out of the EHR.

We've made a heavy investment in helping developers create SMART apps using FHIR standards and otherwise opening up our ecosystem and platforms to create a culture of collaboration. Much of the industry-leading $700 million we spend on research and development goes toward advancing open approaches to HIT by working with partners and enabling them to develop on top of Cerner software via our APIs. It's this collaboration that will help the industry advance the way care is delivered through improved information exchange.

For us, open development is not just conceptual or theoretical, it is real and road-tested by our clients, with 1,500 unique users accessing apps and innovations on our open platforms each month. We're focused on being a catalyst for innovation by engaging at scale, not only with our clients, but also with third-party companies to provide incremental value that the industry wants and needs.

Person-Centered Care

Person-centered care is the future, and Cerner supports any ideas from all corners of the industry that help us all move forward to improve provider and consumer access to data. Interoperability isn't just about what's good for Cerner's business — it's about doing the right thing by consumers and clinicians. It's our moral obligation.

Sharing data is foundational to Cerner's patient-centric interoperability. Learn more about our commitment.