The response to my article asking the question “Are we at the end of the healthcare interoperability tunnel?” was quite interesting. I think some people thought that I was hammering on all the work that’s being done on healthcare interoperability. Others understood that I was saying we can recognize the progress we’ve made on healthcare interoperability and also recognize that there will always be more work to be done.
A great example of this progress was the announcement from DirectTrust that the community has exchanged over 2 Billion messages (2.12 Billion at the end of 2020 to be exact). Yes, that’s Billion with a B with the 4th quarter of 2020 seeing $265+ million direct transactions between trusted endpoints. Here’s a look at a chart showing their growth by quarter since 2014:
What might be even more interesting is that they’re now up to 2,498,542 trusted endpoint addresses across 259,173 organizations that are served by DirectTrust HISPs. One of the big issues with Direct Messaging when it started was getting everyone a Direct address. It’s great to see this progressing so that direct addresses will be as common as fax machines.
In fact, one of the really interesting pieces of DirectTrust’s end of year metrics report is the growth in the number of patient/consumers with direct addresses. The growth of patients using direct could mean direct addresses will become more common than fax machines. Take a look at the huge growth in patient addresses they saw in 2020:
One other really interesting thing to note is that DirectTrust saw a pretty big dip in transactions at the start of 2020. You can see the dip in this chart that shows DirectTrust enabled transactions by quarter from 2014-2020:
Obviously, COVID shut down a lot of healthcare organizations and so they weren’t sharing messages at the same rate. However, it’s still pretty amazing that amidst COVID healthcare organizations were still sending what looks like about 140 million messages per quarter. Plus, the 4th quarter of 2020 illustrated how messaging came back as healthcare organizations came back. In fact, transactions continued to grow. Scott Stuewe, DirectTrust president and CEO, noted that it took 5.5 years to reach the first billion and they passed the 2nd billion in just 18 months.
Looking at interoperability beyond DirectTrust, a report from HEALTHeLINK, an HIE in Western New York, highlighted that they’d sent over 5.4 million COVID-19 related alert notifications since March, are sending 869,013 clinical results (lab test results, radiology reports, etc) monthly, and they delivered over 10 million alerts in 2020. Plus, they had almost 1 million patient record lookups and now have over 10.4+ million patient encounter records uploaded through HEALTHeLINK in 2020 and that’s just one HIE in New York.
What all this data really shows is that healthcare interoperability is happening. Although, as the KLAS report shows, there’s still more work to be done. Of course, if you’re a patient in the 33% of healthcare organizations that doesn’t have electronic access to your data, the billions of transactions might feel like a cognitive dissonance. In fact, as a patient that doesn’t experience interoperable health data or access to health data, seeing these numbers is likely painful.
This is why the work of healthcare interoperability is so important and hopefully we’re are the start of hockey stick growth when it comes to data sharing. It’s taken time to get where we are and in some ways that’s not a bad thing. We don’t want to start sharing health data willy nilly. Doing so can often hurt patients and has all sorts of privacy challenges. However, done in a thoughtful way, patients privacy can be protected and patient care can be improved by having the right information at the right place and the right time.