Building a health data utility: Three secrets to a fresh model for interoperability

March 20, 2019
By Claudia Williams

We all know that interoperability is one of the most complex, most intractable issues in the effort to modernize American healthcare. More simply put, healthcare doesn’t like to share. Or at least it hasn’t until recently.

Things are changing now that value-based care has become a reality across much of our sector. The economics have shifted so that every healthcare organization has to have insights from outside their own walls in order to succeed. Data hoarding doesn’t work any longer when you’re taking on risk for patient outcomes and cost.

There’s a quote I love that reflects this transition, from Joseph Badaracco at Harvard Business School: “In today’s environment, hoarding knowledge ultimately erodes your power. If you know something very important, the way to get power is by sharing it.”

Each hospital, medical practice, laboratory, health plan, and nursing home today knows a bit of something very important about a patient. It’s only when they’re able to bring these elements together and to creatively take data-driven action to improve patient care that this new kind of healthcare power emerges. The winners in our healthcare future are the healthcare leaders who are more responsive, more preventive, more smartly attuned to what patients need and want.

The economic challenges to interoperability are being resolved; now we need to create technology solutions to meet healthcare leaders where they are. How do we create an equitable, secure, reliable infrastructure for health data that removes the competition and serves as a foundation for innovation?

As the conversations around interoperability and health data heat up in the nation’s capital and across the country, we know even more organizations will think about how to make these connections work. Here are three secrets to success in building a new model for health data networks:

- Combine the clinical + claims worlds — It’s only with the combination of clinical and claims data that you can get an accurate picture of patient health. Sure, the prescription was issued ... but was it also picked up at the pharmacy? Having this data combined in a single source helps make it more valuable for value-based care, HEDIS pursuit, and other crucial informatics work.

- Build a scalable suite of partners — For the core platform where you store, match, and de-duplicate data, choose partners who will reliably help you scale. Then make your data available through FHIR APIs so you can leverage additional innovative partners to solve specific problems. No one vendor is going to be able to meet all your needs.

- Focus on delivering value — Most importantly, organizations must be committed to helping their participants put this health data to work. The vast network of health data has no value if providers can’t extract signal from the noise. In large systems, that means securely delivering raw feeds of health data to connect directly into existing EHR, notification, and population health management systems. In small practices, that means delivering easy-to-use real-time hospitalization notifications with just the details providers need to act and a suite of free analytics tools to help with simple population health and risk modeling searches.

These three “secrets” are modern, common-sense tactics that will help all of us realize the real potential of health data — to improve care, enhance health, and lower costs. When one of our participants comes to us saying they’ve been able to dramatically reduce the year-over-year health spend for their riskiest patients, that’s what matters.

About the author: Claudia Williams is CEO of Manifest MedEx, California’s nonprofit health data network. Manifest MedEx delivers real-time data from 11 million claims records and 5 million clinical records through a network of 400+ healthcare organizations. Prior to leading this organization, she held health technology leadership roles in the White House, the Department of Health and Human Services, and the Markle Foundation. She can be found on Twitter at @ClaudiaWilliams.

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