Today's health data are fragmented and coveted. Patient medical information and assets (medical images, medications, etc.) are not patient-centric, but more often health system-centric. That can change thanks to vendor-neutral archives, according to Ifetayo Freeman of Ascendian Healthcare Consulting.
Most remember in the '80s to early '90s the experience of calling your favorite large corporation and, depending on your issue, being transferred between customer service, finance, collections, shipping, and other departments because no one had your complete information. It was fragmented, and each only had a specialized view of you (the customer), making any customer-care issue a labyrinth of frustration. This was largely fixed through customer-care and loyalty solutions, and now you can typically call one department and they can access your history across multiple departments and activities.
Healthcare modernization and reform is starting to break down data silos, and the opportunity and efficiency of true patient care and data interconnectivity are emerging. Health information exchanges (HIEs) are piloting the new era of data exchange, but data flow is limited. No matter what governance and operational characteristics are selected within various regions -- either full electronic health record (EHR) or a secure direct messaging system for disaster recovery -- the value of HIE to patients, physicians, and payors must be quantifiably demonstrated. In other words, HIE will need to develop a business model where sustainability is paramount and which moves beyond generating revenue for the vendors who today control the allocation of resources.
Leaders are needed who are interested in working collaboratively to create a common vision and one care team across multiple facilities for patients. To attract funding for innovative initiatives where the mission is to improve the quality of patient care, healthcare leaders need to communicate proactively about plans to ensure quality care for patients that truly support the sharing of operating costs and governance across health plans, community stakeholders, and providers for continued growth at the local level.
One of the most undervalued concepts in healthcare data management is the importance of providing a clinical view of medical images through the HIE. While an imaging report is valuable, a picture is much more useful for the clinician and patient as care options are discussed. Vendor-neutral archives (VNAs) are smart tools for managing imaging data locally and regionally, and they should be at the top of the list of priorities for collaboration tools.
It is widely understood that VNAs improve the way healthcare providers access patient data, and when they are implemented correctly, they can provide clinicians with a more complete patient record that could lead to better care. Perhaps lesser known is the potential of VNAs to serve as a pathway for all care providers to access patient imaging data or all data if configured as an XDS repository when and where it is needed. Information in this article will help local and regional healthcare leaders focus on procuring the infrastructure necessary to build and maintain federated architecture while building a case for VNA in their region.
Bypassing data ownership
One of the Healthcare Information and Management Systems Society (HIMSS) 2013-2014 Public Policy Principles is "data control governance and stewardship rather than data ownership." Granted, accreditation, contracts, and interoperability standards are important. Collaboration and planning between healthcare executives to lay out shared goals at the local and regional levels to enable data sharing would change the dynamics of power for the better. The work of vendors is essential to create universal patient record searches. How content will be managed in data repositories for maximum flow of data across healthcare communities will not be solved in the current environment.
A true VNA has the capacity to store all of a patient's images and data, yet a mere one-third of the U.S. hospital market as of last year had adopted one. VNAs create possibilities for a neutral third party that can work in concert with accountable care organizations (ACOs) and HIEs to clean the data. VNAs are a viable platform for accessing data at rest featuring a single control point for stored data if configured correctly -- a much-needed tool for interoperability beyond individual hospital systems.
"A true VNA offers a singular integration point to an HIE as opposed to multiple integration points throughout healthcare enterprise systems with different levels and abilities," according to Ascendian Healthcare Consulting VNA expert Jon Shoemaker. "A VNA has the capability to publish the data into the registry utilizing standards and act as a singular enterprise repository."
Patients want online access to medical images. A common registry of scanned documents -- specifically medical images -- operated jointly between ACOs using a neutral third party is arguably pre-eminent to patients and providers alike for EHR transactions to have the kind of value that can drive the long-term sustainability of HIE as a business model.
Assessing a healthcare community's strengths and weaknesses for providing patient care and including VNA in the planning discussions contributes a strong case for funding HIE.
Ifetayo Freeman is an analyst at Ascendian Healthcare Consulting and a frequent writer and thought leader regarding health information exchanges. If you have questions, you can contact Ifetayo at [email protected].
The comments and observations expressed herein are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.
