Closing the Last Mile in Healthcare Data Exchange

So much depends on the ability to access meaningful information about patients at the point of referral, admission, and care – from the ease with which clinicians can pinpoint patients’ needs to clinicians’ impact on quality of care, access to care and health outcomes. 

“If you are engaged in the digital ecosystem and you create or generate health data, you also have an obligation to make sure that it is accessible outside of your organizational four walls,” Angie Bass, chief strategy officer, Michigan Health Information Network Shared Services (MiHIN), shared during ViVE.

Yet access to data doesn’t always equal access to information, or the insight needed to improve health. In fact, challenges related to information exchange are common across healthcare’s “digital have-nots”—organizations that weren’t eligible for EHR implementation incentives, like post-acute facilities, skilled nursing, home health, substance use disorder clinics and assisted living facilities. 

These providers need pragmatic solutions that leverage existing technologies to strengthen electronic information exchange. But there is no one-size-fits-all approach. Finding the right solution depends on a careful assessment of an organization’s needs.

Barriers to Health Information Exchange 

Data interoperability is critical to continuity of care and the ability to identify and respond to patients’ whole-person needs. Yet too often, facilities don’t have access to the data they need when it is needed most. When data is available, it is often lower-quality, paper-based (e.g., faxed, scanned, hand-written) and requires significant manual intervention to process – often retype – and get to the right place. Ultimately, these challenges affect access to care, care quality, health outcomes, and health equity.

For instance, among post-acute care facilities, timely responses to care referral decisions often hinge on electronic information exchange. But many post-acute and home health providers simply do not have the resources to implement an EHR. 

And at a time when maternity units across the country are closing, obstacles to information exchange with birthing centers put women and infants at risk. “Maternal health data is not standardized, and data exchange is not interoperable across many settings, which impedes care and research on maternal morbidity, longitudinal maternal care, and associated impacts to infant and infant health,” according to the HealthIT.gov Interoperability Standards Advisory. Breakdowns in information exchange also lead to gaps in understanding a mother’s health during pregnancy and afterward, including the effects of SDOH on pregnancy. 

Even when these facilities do have access to an EHR, many of them lack meaningful connectivity with referral partners—typically hospitals and health systems—or other providers along the continuum of care.

“Our job is not only to build the pipes of connectivity, making sure we can go here, there and everywhere to access data and bring it forward, but also to cleanse and normalize the data and make it actionable,” Bass said. When the data isn’t cleansed and served up into a platform where analytics can be performed, “It is not valuable,” she said. 

Without actionable analysis of unstructured data, patients become lost in the “last mile” of interoperability.

Closing the Data Gap for Digital Have-Nots

There are solutions that leverage existing technologies to strengthen data sharing and turn data into actionable intelligence. But one size does not fit all. Selecting the optimal approach depends on careful examination of an organization’s needs and its resources.

Here are two options to consider.

• Look for a platform that enables your organization to manage all your unstructured documents from a dashboard that doesn’t require an EHR. 

Organizations that can’t afford to implement an EHR can still exchange data across complex systems in a simple send and receive platform leveraging technology they likely already own: digital fax. While fax has been referred to as a legacy technology by some, such a solution gives “digital have-nots” a pathway to share important content from one care setting to the other. This enables them to provide more coordinated care even if the data is unstructured. The impact: better outcomes at reduced cost.

• Invest in intelligent data extraction.

Increasingly, healthcare organizations are combining common tools with natural language processing (NLP) and artificial intelligence (AI) software to manage scanned images, PDFs, faxes, etc.. By utilizing intelligent data extraction, it becomes easier to gather structured and shareable information in a more complete way. These solutions pull needed information from unstructured documents and send it to clinicians and staff directly within their workflows without the need for data entry. This speeds access to critical information that may be needed for care, avoiding delays in treatment that could potentially impact outcomes.

In the move to advance health equity, we can’t forget that technology plays an essential role in ensuring equitable access to care and care expertise. Finding pragmatic solutions for leveraging existing technologies to strengthen electronic information exchange, like the approaches described above, is vital.