The following is a guest article by Vince Kuraitis, co-chair of Health Data Unbound: Innovations in Health Data Sharing for the COVID-19 Era and Beyond.
Day-by-day, the business case for data sharing is growing stronger. In this essay, I’ll describe how COVID-19 is accelerating existing healthcare trends, how data sharing is becoming a key business strategy, and how you can learn more about these developments.
COVID-19 Accelerates Existing Trends
This might surprise you — one result of COVID-19 isn’t so much a new normal as it is the acceleration of pre-existing trends. Andreasen Horowitz venture capitalist Julie Yoo wrote about this in her masterful article: Healthcare: The Great Unlock.
She lists and describes six healthcare trends that are accelerating:
- Unbundling of the hospital
- Value (or outcome) based care and payments
- Consumer or patient directly at the center
- Re-contouring of provider networks as the boundaries of clinical capacity extend beyond traditional geographic lines
- Greater interoperability of data
“We hypothesized that these strong tailwinds were going to change the landscape of healthcare entirely… but that, realistically, they might take on the order of 10 years to play out. Now, because of the forcing function of COVID and its incredible ripple effects across the system, it is more likely that they will play out in the next 2-3 years.”
Accelerating Trends Strengthen the Business Case for Data Sharing
Each of these trends strengthens the business case for data sharing. Let’s take a look at them one-by-one. (The discussion in this short essay is illustrative, not exhaustive.)
Unbundling of the hospital. I worked at an integrated delivery system for 10 years. Even two decades ago, hospitals were subject to “death by a thousand cuts” — physical cuts from competitors. They often joined with “our“ physicians to open dialysis centers, ambulatory surgery centers, imaging centers, even new hospitals.
Today it’s even worse. Hospitals are subjected to “death by ten thousand cuts” — physical and virtual cuts. The new competition isn’t necessarily across town — they can be anywhere. They can be startups, or huge tech or retail Goliaths with little healthcare experience.
This new generation of competitors are digital-first. They are focused, not one size fits all. Yoo notes that “the data generated by these digital health companies is already far higher in resolution, continuous, and comprehensive—leagues above that in traditional EHRs.”
Many have not yet realized it, but the irony becomes that hospitals and doctors are now dependent on gaining information FROM these new competitors.
Value (or outcome) based care and payments. Patients have less and less loyalty to specific delivery systems. The Advisory Board calculated that 80% of patients have data at two or more health systems.
As measured by referrals, physicians also have weak loyalties. A 2018 analysis in the American Journal of Managed Care examined specialty referral leakage in Medicare accountable care organizations (ACOs). The researchers found leakage rates of 61-72% among the most specialty-oriented ACOs.
Providers need to avoid flying blind. They must recognize that “their” patients will be cared for by others outside of their network.
This recognition is critical for success with value based payments. Once you realize that others WILL be caring for your patients, the next recognition is that they will need the best data (i.e., your data) to care for patients properly. And if they don’t — your patients and your payments will suffer.
Consumer or patient directly at the center. Provider data is no longer the center of the data universe. Local providers increasingly only have a sliver of patients’ data. A McKinsey analysis found that “…the average patient will generate 2,750 times more data related to social and environmental influences than to clinical factors.”
No one has a complete, longitudinal view of patients. Data must be shared if providers — local or virtual — are to get anything broader than the narrow view within their own data silos.
Re-contouring of provider networks. COVID-19 showed how rapidly patients and providers can shift to virtual care and telehealth visits when in-person visits aren’t practical or safe.
Some telehealth platform providers such as Amwell or Teladoc/Livongo already have built bi-directional interfaces with EHRs. They are expanding to provide new capabilities, e.g., ongoing chronic care management, specialty referrals, second opinions. They are able to access and optimize data from local delivery systems. Will local delivery systems be prepared to access and optimize from virtual competitors?
Greater interoperability of data. In 2016 Congress passed the 21st Century Cures Act. One of its provisions requires a universal API for exchanging electronic health record data. Another provision supports patient access and control of their electronic health record. Yet other provisions restrict information blocking. Detailed rules implementing this legislation were issued earlier this year.
There’s not a lot of room for debate left here. The law is requiring providers freely to share health record data.
Automation. I’m old enough to remember aggravating patient experiences across departments of hospitals. For decades, every department handed you a clipboard, a pen, and a paper form asking for name, address, allergies, medications, and 19 other pieces of information. The experience generally is better today, but memories linger.
Julie Yoo again provides insight on future automation: “The next generation healthcare system will need a fundamentally new infrastructure layer that treats the patient as a primary end user… this new operating system will automate the majority of rote administrative tasks and clinical interactions…”
We’re not there yet in most health systems, but the vision for data sharing is clear.
Further Exploring the Business Case for Data Sharing
…but wait, there’s more!
There are MANY strategies, value propositions and use cases that support the business case for data sharing.
These will be discussed in an upcoming virtual conference: Health Data Unbound: Innovations in Health Data Sharing for the COVID-19 Era and Beyond
My colleague Leslie Kelly-Hall and I are co-chairs for this event. In 2018 we wrote Hoarding Patient Data is a Lousy Business Strategy: 7 Reasons Why. At this year’s event, we’ll update and extend our rationale.
Please click on the banner below for more details. We hope you will attend!