Health data standards are finally coming home to roost—and not a moment too soon

Michael Rose

A few co-workers and I had a laugh in the office the other day after someone found an old cellphone tucked away in storage. We weren’t able to charge the 2G device and watch it come back to life, but we were pretty sure of two things… One, it was state-of-the-art technology in its day. And two, all it could do was fill in for a landline phone. No texts. No apps. No web, photos or videos.

Less funny was the realization that while everything has changed about cellphones over the past quarter-century, very little has changed about data transaction standards used in healthcare.

Broadly defined, heath data standards are the main computing component needed to let information flow through the health information infrastructure.

The good news is that initiatives are in the works to bring these standards up-to-date. Along the way, healthcare is being transformed. Where patients’ health-related data once resided in computer “siloes” that could only be accessed in a particular office at particular times, now much of that info can be safely and securely accessed by the appropriate healthcare professionals anytime and anywhere.

As I’m sure you already know, your doctor can access your clinical records, his or her billing staff can access your insurance and payment info—and you may be able to access much if not all of that—right from most any mobile device.

But we’re not fully there yet, and the lag in developing data standards is one of the main gum ups. Once we have a set of common standards across the U.S. healthcare system, the pieces will be in place to get everyone working together to take better care of patients while reducing the cost of care.

A lot of smart people are working hard to make this vision a reality. From my vantage point in the field of electronic data interchange (EDI), I get to interact with many of the best and brightest. One thing I hear a lot from the standards specialists is: “Anybody can deliver data.”

What they mean is that it’s one thing to be able to see that a provider is doing poorly with, for example, verifying the coverage eligibility of patients. It’s another thing altogether to get the data back into the right place in that provider’s practice-management system, or even more finely, into the right place in a provider’s workflow.

Facilitating that second step would allow the provider to make fully informed, data-driven decisions. The result is that care quality improves—and the provider gets paid in full and in a timely fashion.

Providers who fall behind, failing to benefit from the advances now giving health data standards a much-needed makeover, will miss out on opportunities to improve efficiencies along with care quality. They’ll also be leaving money on the table.

Up to now, many of these discussions on data standards have been led by the payer community.

The provider community needs to have its voice heard as well; making sure the industry knows its needs. Together we can work to build consensus and get the standards right.

If you’re not sure where to start getting up to speed on the particulars, I encourage you to take four steps:

  1. Get educated on EDI. Attend informational sessions, join workgroups and otherwise look for input opportunities around HL7, FHIR and other standards-related issues in play. A great place to start is with WEDI – The Workgroup for Electronic Data Interchange                             ( www.wedi.org ), of which GE Healthcare is a premier sponsor and collaborator.
  1. Think about how your clinical and business workflows could be more streamlined and successful. Take a close look at what’s happening around EDI in your practice. Think about where additional data that’s increasingly available today—the data that could and should be flowing into your practice-management system—might play a role in optimizing your business as well as clinical workflows.
  1. Embrace EDI change. It’s human to want to keep doing things the way you’ve always done them. I imagine the user of that ancient cellphone, for example, not upgrading until he or she absolutely had to. After all, why would anyone stash something they know they won’t be needing anymore? Don’t be that person in your office!
  1. Visit the AHIP website. The America’ s Health Insurance Plans (AHIP) is a great way for you to find common ground with payers and begin thinking of innovative ways to improve the patient’s experience of care, improve the health of populations and reduce the per capita cost of health care. GE Healthcare is an AHIP Select Member and we are working with payers and providers to solve these problems. Payers, providers and vendors all have a role to play. To learn more about AHIP visit www.ahip.org.

By committing to these steps, you’re helping ensure that you and your providers can make fully informed, data-driven decisions, improve care quality and receive accurate payment in a timely fashion.


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