MedCity Influencers, Health IT

Interoperability falls short of turning innovation into transformation. Here’s why.

In healthcare, we tend to mistake “virtual” or “innovative” for “transformative” when, in fact, building shiny new digital tools often forces us to deprioritize strengthening healthcare’s biggest building blocks.

Later this month, my daughter will have her first virtual dentist appointment.

Let that sink in.

The days of sitting in an orthodontist chair for hours bonding metal braces with cement, tooth by tooth, are largely over. They are instead replaced by an impossibly simple process of receiving Invisalign retainers in the mail, sending pictures to the dentist to monitor progress, and asking questions via text every step of the way — all from the comfort of a living room couch.

While virtual care is changing the way that clinicians deliver and patients receive care in ways that we previously never thought were possible, it is, unfortunately, just another example of where digital disruptors have innovated in pockets without accelerating true industry-wide transformation. My daughter’s dental care details — like any patient’s care details — are bound to sit in their current silo; other clinical providers will remain unaware unless the information is manually input, faxed over, or verbally relayed from patient to clinician.

In healthcare, we tend to mistake “virtual” or “innovative” for “transformative” when, in fact, building shiny new digital tools often forces us to deprioritize strengthening healthcare’s biggest building blocks. As an industry, our greatest downfall is assuming that interoperability will inherently make data actionable, empower on-the-ground collaboration, and enable new business models to transform the space. The past decade of trying — and struggling — to make point solutions and siloed platforms play nice with each other has proven out this fallacy. In actuality, digital health innovators must build — and health organizations must adopt — foundational operating systems that unite new solutions with legacy systems, so that clinicians aren’t left to connect all of these dots themselves.

There are three key areas where interoperability often stops short — but where fundamentally collaborative innovation, started from the inside out, may open new doors.

1. Traditional workflows lack actionable insights

When it comes to the patient data needed to improve the healthcare experience, in place today are the bare-minimum foundations of interoperability — piecemeal tools that lack the fundamental ability to securely share and structure this data at scale across hospital systems and EHRs to patients, providers, and payers alike. The data as it exists isn’t readily available or actionable; in fact, despite having one of the fastest-growing datasets across industries, a staggering 97% of healthcare data goes unused.

In a healthcare ecosystem where data-sharing is becoming table stakes, the clarity that will cut through the data noise — and what will push our industry forward — is meaningful data activation through open collaboration. Insights surfaced in the moment of care and trend lines woven together over time have the power to enhance the caregiving experience for clinicians and, as a result, lead to increased operational efficiency (the right care at the right time) and financial fortitude (closing care gaps across the care continuum). And for the patient, this will create a more tailored and seamless care experience and enable individualized and improved outcomes.

2. Clinical systems don’t account for broader data input

The conversation around interoperability often starts with building data pipelines between disparate EHRs — and that’s also where it often ends. Yet clinicians and care providers know firsthand that when patients take the time to engage directly with their health aside from their annual physical, it often occurs outside of the EHR in places like diagnostic labs, insurance systems, or their own Fitbit or Apple Watch.

When people identify themselves to friends, to coworkers, to loved ones, very rarely do they say, I’m a patient or I’m a consumer. More often, they think, I’m a parent. I’m a partner. I’m a person. If health organizations only gather information about patients in instances when they view themselves as patients, care delivery and outcomes will always be inherently limited.

Interoperability is not a technology problem; if it were, healthcare would have solved it by now. It is ultimately a boundary problem, with each entity across the care continuum having in place its own parameters of technology engagement with doors that only open to a select few partner platforms — or to none at all. The four walls of the clinic must be broken open in order to deliver truly people-first care. Value-based care, social determinants of health, and other personalized care models and settings will be a core component of building a comprehensive whole-person view.

3. Innovation is too often technology-first, clinician-second

Our industry’s valiant efforts to improve care quality and the patient experience through digital innovation have inadvertently created an environment where people serve the technology — not the other way around. Too often, clinicians are put into positions where they have to compromise the care they provide: input into clinical technology or interface with patients; prioritize quality of outcomes or quantity of visits; document in the EHR after hours or focus on work-life balance at the risk of missing valuable information.

Just as health organizations are collectively beginning to embrace patients as consumers of healthcare outcomes, digital health innovators should begin to consider clinicians as consumers of healthcare technology. Clinicians know best what they need, so — as U.S. Surgeon General Vivek Murthy recently highlighted in an advisory on burnout in healthcare — health tech companies must design solutions that serve their needs.

A good starting place is enabling clinicians with intelligent technology, such as workflow creation tools, that can be customized to meet individual clinical needs while standardized enough to adhere to operational requirements. Additionally, startups and digital innovators should be cognizant to prioritize clinician leadership and a robust feedback loop from early adopters to ensure the challenges we’re facing in the industry are fixed from the inside out.

Gone are the days of attempted silver-bullet solutions. Radical collaboration — rather than disruptive innovation — is the key to untangling clinicians from technology and empowering them to deliver care without compromise. By uniting an army of responsible innovators and connected technologies across the healthcare ecosystem, I believe that our collective healthcare industry can finally achieve true interoperability and begin to advance people-first care through meaningful transformation.

Photo: LeoWolfert, Getty Images

Ashwini M. Zenooz, MD, is the chief executive officer of Commure, the first operating system designed for healthcare. A board-certified radiologist, Dr. Zenooz has more than 20 years of clinical experience and has held leadership roles across the public and private sectors.

Before Commure, Dr. Zenooz served as chief medical officer and general manager at Salesforce, where she led the company’s vision and operations for the global healthcare and life sciences business. Prior, Dr. Zenooz oversaw EHR modernization efforts as chief medical officer at the U.S. Department of Veterans Affairs. She has also served as deputy under secretary for Veterans Affairs Health Policy and Services, legislative health policy fellow with U.S. Senator Richard Blumenthal, and committee staff in the U.S. Senate.

Dr. Zenooz received her doctor of medicine in the Medical Honors Program at the University of Florida, completed her radiology residency at Henry Ford Health System, and completed an abdominal imaging fellowship at Massachusetts General Hospital.

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