Anmol: Welcome back to another exciting episode of the Unthinkable Tech Podcast, the go-to source for the pulse on technology that is shaping our future. I am your host Anmol Satija and today we’re discussing a subject that’s not only crucial but transformative for healthcare organizations across the globe.

Data paradox in Healthcare

You know the healthcare sector currently accounts for 30% of the entire global database stream and is expected to rise to 36% by 2025. No doubt the data is growing at a mind-blowing rate but are we really managing and utilizing this data effectively?

I am afraid not as a recent study suggested that on average, doctors spend 18.5 million hours every year doing the most basic data collection administration stuff. This is clearly a paradox! This highlights the necessity of attaining interoperability in healthcare.

And that’s where our story begins today. To navigate this complex yet fascinating landscape, we have a very special guest joining us today. the Healthcare COE Lead at Unthinkable Solutions, Anirban Kundu, who has been a clinician himself and also got his fair experience on the other side of the table!

Anirban, welcome to “The Unthinkable Tech Podcast.” We’re thrilled to have you with us.

Anirban: Thank you, Anmol.

This is a topic which I have been dealing with very closely for the past few years and love to talk about based on my experience with the subject.

What is data interoperability and why it’s crucial?

Anmol: Fantastic! Let’s dive deep into Data Interoperability, Can you help us understand the nitty-gritty of data interoperability in healthcare, and why it’s particularly significant for the industry today?

Anirban: Absolutely, Anmol. Data interoperability in healthcare is all about the seamless exchange and utilization of health information across various systems, platforms, and organizations. Now, merely aggregating the data ingested from all the sources is no longer going to suffice.

Healthcare digital platforms and other software applications today need to communicate, exchange data, and use the information that has been exchanged effectively from an analytics perspective as well.

Also, in order to cut down the competition, like what we say #DoTheUnthinkable, solutions of today need to have additional intuitive nuances baked into the same solution to provide the competitive edge – like our relatively simpler platform implementations like Telehealth solutions provide additional value propositions like Provider transcripts and Sentiment Analysis using AI.

Not to forget the ML algorithms for symptom checker and ease of appointment booking via Smart Search capabilities using geo-fencing to improve the adoption and utilization of the solution, thereby improving the overall patient engagement aspect.

Anmol: Thanks for the insight. No doubt the CSAT score for this customer came up to be 4.8 which is pretty impressive.

I was reading through a couple of recent articles which highlighted the volume of data, and if my memory serves me right, I read the lack of proper interoperability in 2024 would cost US Healthcare systems more than 30 billion USD, which is a humongous number I believe.

Could you tell us what is the average volume of data that is generated by an average hospital system in the US and how so?

Custom EHR for integrated delivery networks (IDNs)

Anirban: Well, to discuss this I’d like to use another example of a bit more complex deployment that we went live with, last month which was of a customized EHR solution for an Integrated Delivery Networks or an (IDN).

Now these Integrated Delivery Networks bring health data together from different source systems like the systems used across their departments, clinics, and other healthcare services under one umbrella to offer a more comprehensive and coordinated care.

Interoperability becomes utmost important here, as it ensures that protected patient information traverses seamlessly within these networks, thereby aiding in the delivery of comprehensive care in a more streamlined and timely fashion.

Anmol: Could you please explain in more simpler terms for our audience to comprehend this better?

Anirban: Okay, so consider a patient who visits multiple specialists within an IDN or a hospital facility, undergoes various treatments, and receives care at different facilities. Without interoperability, each provider might only have a fragment of the patient’s health history, leading to potential care gaps, redundant investigations, and even errors in clinical treatment modalities.

So, interoperable systems ensure that every healthcare provider has access to the same comprehensive health record, leading to more informed decision-making, streamlined care and improve overall provider productivity.

It allows healthcare organizations to break down the knowledge residing in silos within different hospital units/departments, enabling a more comprehensive view of a patient’s entire medical history in real or near real-time.

Value-based care demands intelligent interoperability

Anmol: So, per my understanding IDNs are only a piece of the entire pie when it comes to the US Healthcare landscape today, especially when everyone is talking about Value Based Care models and its transition from the traditional FFS model which these systems have been treading with, for a pretty long period of time.

Well then let me take another example of our recent encounter with one of the largest ACOs in the US….when it comes to the ACO side of US Healthcare….our Unthinkable Healthcare solutions not just enables data sharing amongst all the providers involved in patient care or maintain the care continuum post encounter, we cater to more advanced requirements of leveraging ML models to provide real-time clinical recommendations to identify and address care gaps in order to reduce the overall risk score for the patient and improve the end-of-the-year reporting for the providers leading to better incentivization and improved patient quality care outcomes.

Long story short, It’s crucial for accurately tracking patient outcomes, facilitating preventative care, and managing chronic conditions, which are all vital….extremely significant for value-based care approaches.

Barriers to interoperability in the US healthcare system

Anmol: So let’s double-click on a couple of pointers that you highlighted. I think the world acknowledges the importance and the potential benefits of data interoperability but what’s the ground reality?

The question is – Are we there yet? If not, could you talk about some of the most pressing challenges that you see U.S. healthcare systems currently face in achieving the true potential of data interoperability?

Anirban: You’re right, Anmol.

While we are discussing the significance of data interoperability, the reality of its implementation comes with its own set of challenges from both a business and a technical front.

We’ve come a long way with the adoption of digital systems electronic health records (EHRs) but achieving the full potential of interoperability across the healthcare system is still an ongoing effort. I’d say, with a long way to go, I believe.

As one of the primary challenges that we see is: There’s a variety of digital platforms in today’s market but they most often lack the required standardization, which complicates the ability to share data across different platforms.

This becomes all the more problematic when trying to coordinate care, be it within an Integrated Delivery Network (IDNs) or ACO, we are getting leads where the prospective customers are not looking for an off-the-shelf product delivered in a SaaS model, they are expecting technology to do more.

Navigating ONC compliance & regulatory demands

Remember the other use case we delivered for the specialty-specific Digital Front Door platform? In reality, it was way more than that.

The prospect (now a customer) came to us with the requirements:
• Build a comprehensive custom platform that can easily integrate with their 70 stand-alone specialty clinics
• Manage and integrate workflows as per clinical practice to increase provider productivity
• Meet the ONC compliance requirements as well

Keeping these in mind we delivered a Solution that:
• Fixed the defects of their existing systems
• Introduced new functionalities under every module
• API integration for a smoother performance
• Different modules to simplify workflows – like front scheduler, appointment booking, billing, insurance, reporting, data protection and compliance.

Anmol: So what was the ROI that the customer derived out of this solution?

Anirban: The result was not just a 60% increase in overall productivity but also an 80% reduction in their annual recurring cost for day-to-day operations.

Anmol: Wow! I believe we are truly doing the Unthinkable here. But what about the compliance part? I guess this is one of the major pain points for the US Healthcare giants and it applies to the majority of the healthcare players in the market today. How are we tackling this piece for our existing customers?

Anirban: From a compliance forefront, we ensured that we do not just cater to the Nov 2023 requirement of Establishment of Disincentives for Health Care Providers Who Have Committed Information Blocking including identifying all sources of Electronic Health Information (EHI) held within HIT, which means of being able to respond to requests for access, exchange, and use of HIT, and to support patient access to EHI, but we also Ensured that we make them Future-ready for the June 2024 final rule of Administrative Simplification with the Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures. At the same time make the necessary Modifications to their Referral Certification and Authorization Standards.

Building future-ready, interoperable healthcare platforms

Anmol: Now that we have discussed challenges, compliance regulations,
and standards, what should be the roadmap for organizations to pursue, in terms of being truly up-to-date and having a truly comprehensive digital platform or solution?

Anirban: Well, the solution is pretty dynamic – given we are living in the era of advanced technologies like Gen AI or Predictive analytics on one hand and also dealing with the concepts of digital transformation on the other.

The most crucial aspect should be to make use of the data that is being generated via all the different sources or systems so that the 97% of the healthcare data that is getting unused today, is effectively utilized to provide the required insights which can ultimately help to improve efficiency, enhance the provider’s productivity and also aid in identifying and closing the patient care gaps.

Governance, FHIR & sustainable digital transformation

Anmol: But how do we ensure consistency in deriving these insights smoothly and at the same time keep up with the technology advancements?

Anirban: That’s where governance comes into play. Establishing clear governance structures around data management ensures that data is not only high-quality and interoperable but also secure and used in compliance with all relevant regulations.

In conclusion, focusing on a comprehensive understanding of standards, building a strong technology infrastructure, and leveraging FHIR for simplified data exchange is the starting line, harnessing the power of data analytics, automating resource exhaustive pieces of the workflows, and establishing stringent governance, healthcare organizations can effectively stay up-to-date with regulations and standards.

This approach will not only foster interoperability but also support the Unthinkable goal of delivering superior patient care and achieving operational excellence.

Anmol: Thank you Anirban for that comprehensive breakdown. This was a great discussion where you not only highlighted how important it is to keep up with interoperability but at the same time also made us aware of the lesser-known yet very crucial aspects.

Thank you for joining and enlightening us!

Anmol: Thank you listeners for tuning in. We hope today’s discussion has shed some light on the critical role that interoperability plays in the healthcare industry and has provided valuable insights for healthcare professionals looking to navigate this space.

Stay tuned for more thought-provoking discussions on “The Unthinkable Tech Podcast.” Don’t forget to like, share, and subscribe. Take care and keep listening.