In this episode we continue our interoperability conversation with CHESS Vice President of Health Informatics, Mark Dunnagan. Last time, we focused on the importance of shared data in value based care and the need to overcome any barriers. Today we talk about the logistics of interoperability and the modernization of data exchange.
Mark, last time we left off talking about data exchange There always seems to be ongoing conversations in this topic about APIs. Do you feel like more improvement in APIs could be a potential solution?
I do I use the metaphor of a quiver of arrows quite often when describing you know interoperability. I think you know it's my job as you know the head of a team that that must figure out how to get data and get it in a timely fashion and in a way that fulfills our contractual obligations and our obligations to the patient. I think APIs is one more arrow in the quiver. You know it gives us a programmatic way to access you know large volumes of complex data, but it's not necessarily the only way. You know when we sign on a health system let's say to one of our ACOs, you know I can pretty much rest assured that they're using one of a small number of vendors and you know those vendors are fully capable of producing certain constructs that that my team can consume. Same with most payers. Although you know, the outputs may differ certainly. But as I work my way down the chain, particularly in working with ambulatory clinics and what not, you know, I gosh last time I checked there are over 200 EMRs here in my home state of North Carolina. Each one of those with a slightly different interpretation of certain standards. Not all of them have viable API interfaces, you know, not all of them have the same way of communicating with them. So, I have to be open to old school HL 7, which is kind of the equivalent of opening up a channel and typing over it. I have to be open to flat file exchange. I have to be open to various forms of XML, JSON, and it truly depends on what that endpoint can offer. So again, APIs are extremely valuable but they're not the only tool that a team like mine has to has to be able to wield to be interoperable to be successful in the exchange of healthcare data.
Interesting. So as someone who's spent a career in the data and informatics space, can you share how these analytical tools help control the cost of healthcare?
There's many answers to this. I would say again I'll draw back to what we do which is value based services. You know I need to know when something happens and I need to be able to inform our performance improvement teams and so that they can communicate with the providers. I need to inform the care managers when something of interest when someone is checked into a hospital, someone has sought, you know, specialty care outside of network, when someone has been discharged, they need to know that and I need to inform them, you know, not only that it's happened, but give them enough descriptive information that they can intervene appropriately. I would go further to say that I need to glean enough good information, rather my team has to be able to accumulate and collate enough information to get ahead of what might be coming. You know, we're making some very powerful strides, you know, not only in, you know, intelligently stratifying our population to kind of know who to intervene with first, but also in quantifying rising risk and rising cost. Who do we think based on what we're seeing happen now? What do we think's going to happen to them tomorrow? And can we get ahead of that in time to affect that? Can we keep them out of the hospital? Do we know there's a costly intervention or fall coming, and can we intervene or get them some community based services in time? So, you know it's a large part of what we do and and again something that at least on the value side we have to contemplate every day.
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