Everywhere you look, healthcare industry leaders are discussing the importance of interoperability and how it will transform healthcare. However, this notion – despite its hype – can be dangerous and misleading as it pushes interoperability as an excuse and the main reason for inefficiencies in healthcare.
If interoperability was truly a material barrier to efficiency, wouldn’t it mean that healthcare providers with single system platforms are significantly more efficient and effective than those without? This is certainly not the case. We don’t see story after story about massive efficiency gains and patient satisfaction improvements as a result of just having a single contiguous data asset – at least we haven’t to date.
When single systems can’t even “interoperate” with themselves, there is clearly a fragmentation issue that runs deeper. And I believe it comes down to one fundamental problem: a lack of focus on the patient and an inability to deliver the best outcome consistently.
Creating a consistent, patient-centric system
Fundamentally, fragmentation is a result of structural issues in the healthcare system that prevent more efficient delivery of care. This is because healthcare organizations are not designed to be customer-centric, and do not view the patient as the “customer” within the current business model. Rather than streamlining the patient’s journey, so far health organizations’ digital processes have largely been focused on internal billing and data capture.
Instead, the “customer” in most healthcare organizations is the physician. And if physicians are not happy, they may choose to leave and find another hospital or care center at which to work. When they leave, they take their patients and all referrals with them, which breaks up the workflow and further fuels the fragmentation fire.
If the shared aim is to make healthcare more affordable, effective, compliant, and improve system success, is interoperability the right place to start? It shouldn’t be. Instead, healthcare must focus on the patient and excellence in their care delivery. Patients need to be treated in a consistent and predictable way, which is not currently the case. A patient could go to two different provider locations with the same symptoms and she could receive very different treatment and outcomes.
Addressing fragmentation at its core is not about technology
The shift towards value-based care in the U.S. is an important step to addressing the larger fragmentation issue – the fragmentation of people, roles, responsibilities and facilities. An interesting symptom of this is the lack of a person or role who oversees the care of a patient. To solve this, healthcare organizations should now be reimagining how to design IT infrastructure around the patient, enabling care teams to engage with patients across the entire patient journey, upstream and downstream.
Particularly in the U.S., this will require a broad-scale shift in the way we think about care delivery, to ensure that all providers and care team members are focused on the long-term care of the patient. When healthcare delivery is thought of as a product, where there is a fixed amount of money paid for delivering an outcome, then you can hone the “product” and incentive system by thinking about efficiency, standardization, and compliance. This is what will help open up the doors for interoperability.
The long-term solution is not a technological one, but instead a cultural one that must be addressed through a re-education for everyone in the industry – the entire approach to patient care has to change. This should start in medical school, where budding healthcare professionals are trained and educated to truly think about the process of achieving consistently good outcomes end-to-end.
Interoperability itself won’t change this fragmentation problem. We must start to get to grips with holistic care delivery design, where technology alone may not be the answer after all.