Tag: interoperability

Interoperability Standards Are Essential, and Someone Has To Create Them

Irv Lichtenwald, president and CEO, Medsphere Systems Corporation.

Irv Lichtenwald
Irv Lichtenwald

It’s not exactly a sweater or tie that gets worn once and then relegated to the top of the closet, but it turns out that patient data may have something in common with unloved holiday gifts. Both, it appears, are shared and then seldom used.

At least that’s one takeaway from a recent Health Affairs study on interoperability and how far forward we’ve actually moved the ball. The authors used the most recent available data (2015) and the four interoperability standards established by the Office of the National Coordinator (ONC)—finding, sending, receiving, integrating—to conclude that progress on this measure is lagging, at best.

“… Progress toward interoperability has been slow, with fewer than 30 percent of hospitals engaging in all four domains of interoperability in 2015 and with an increase of only 5 percentage points from 2014,” the authors write.

The low percentage of hospitals using all four standards is particularly significant in that simply sending or receiving data does not guarantee its use. Of those hospitals that said they sometimes, rarely or never use outside patient data in care (55.8 percent), or didn’t know (11.2 percent) how often they used it, the most oft cited explanation was that “clinicians could not view the information in the EHR as part of their workflow.”

“Issues with integrating information into existing EHR systems and clinical workflows were the most commonly cited barriers for hospitals that were not routinely using external information for patient care, which further underscores the need to shift the policy focus from transmitting information to information usability.”

Ah, yes, usability … yet another technological imperative that ends in ‘ability.’ Health Affairs suggests that data usability has a lot to do with EHR sophistication.

But is it having an advanced EHR that improves data usability? Or is it perhaps having the same EHR as the facility you share data with? As Health Affairs points out, those hospitals that most frequently share patient data via HIE are those working with an EHR and HIE from the same source.

“Without strong incentives that would have created market demand for robust interoperability from the start, we now must retrofit interoperability, rather than having it be a core attribute of our health IT ecosystem,” writes Julia Adler-Milstein, also an author of the Health Affairs study, in a recent NEJM Catalyst article. “And, if there had been stronger incentives from the start, we would not now need to address information blocking: the knowing and intentional interference with interoperability by vendors or providers.”

Adler-Milstein argues that policymakers dropped the ball more than any stakeholder group. The EHR vendors and providers, she says, are just working within the boundaries to retain or improve their respective positions.

“Of the stakeholders, only policymakers have a clear, strong interest in promoting interoperability,” she says. “Therefore, it is up to them to ensure that robust, cross-vendor interoperability is a stay-in-business issue for EHR vendors and providers.”

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The Future of Healthcare with 100 Percent Interoperability

Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.

Abhinav Shashank
Abhinav Shashank

A personal health record of any patient, whether it is an aging parent, a spouse or a child with a chronic illness, contains a summary of medications, lab results, visit notes, billing information and more, and interoperability makes it easy to manage all these files and documents with just a few clicks.

Every form of health data makes an entry in an EHR today thanks to the shift towards a digitized healthcare in U.S. Although this has made data entry, storage, retrieval and exchange easier, it has brought with it certain challenges. Integrating and utilizing EHRs is the first baby step; however, if we are to overcome all the hurdles then achieving 100 percent EHR interoperability is the summit where we are yet to reach.

Physicians want to optimize the full potential and promise of EHRs for the simple reason that improved communication between systems will lead to a better and enhanced care. Once all the systems in use nationwide are connected and interacting with each other, patients will find it easier to seek a second opinion as their health information will reach the physician in a matter of seconds.

How interoperability exists today

Today, various interoperability standards have developed for the sake of continuous improvement in this realm. Health Level Seven (HL7) has produced the likes of HL7v2, HL7v3, and the latest FHIR as competent standards that exist in the industry for better streamlining of documentation and care coordination. With the help of FHIR, physicians can access health data on their mobile phones through various API (Application Programming Interface) functions that FHIR supports. This ease of access to complete and accurate patient data, in due course, helps in many ways. As providers and health coaches work together on improving the health of people, it also significant for them to be able to access accurate data from sources other than EHRs. Apart from EHRs, HIEs have popped up in various places that allow for the smooth flow of data across the health care network.

Ways in which interoperability facilitates healthcare

Physicians can easily access and share medical information with their patients and perform their tasks with greater efficiency. This could be done by increasing the efficiency of monitoring chronic diseases. Besides saving time and labor cost, physicians and patients with access to interoperable health information can benefit from higher-quality patient outcomes. Interoperable EHRs carry the potential of giving easy and ongoing access to patient’s health records to the physician. For a doctor to have an updated and detailed medical history of his patient cannot just be live-saving, it will mainly help those people who are always on the move. This will empower an individual to move across the continuum of care seamlessly with their clinical record.

Doing more with less

As value-based care and reimbursements stepped into healthcare, the US managed to turn the tide towards a more qualitative and equitable delivery of care. This has made physicians more responsible for better patient health outcomes than ever before. To manage hospital readmission and managed care plans, physicians need to have as much patient information as possible at hand at all times. This is where interoperability comes into play by aggregating and relaying data from disparate regions and bringing it onto a single platform.

For a secure data exchange to take place amongst healthcare organizations and patients, it’s important that both parties are willing and equally involved in the sharing process. This will inevitably lead to shared decision making apart from the fact that the physician will be able to make quick and informed decisions. The ultimate aim is to have a complete understanding of the health status of patients and helping them navigate effectively in their health journey for a better patient experience.

Patient-centric interoperability is the direction in which healthcare is slowly moving. There’s so much that we can do with the availability of data. Ongoing monitoring of patient data can better facilitate the ongoing management of that patient’s health and the physician can intervene where necessary. With this, patients too can track their progress and work towards improving their health hand-in-hand with the physicians.

 Challenges that interoperability is yet to solve

 One of the issues that interoperability is dealing with today is the vast and disjointed patient data that exists in regional HIEs and independent, transactional databases like EHRs. Along with this, patient privacy concerns and consent are other risk factors that need to be considered when diving through protected health information data. Lack of a common standard, state policy rules, workflow and policy difference and the need for incentives are some barriers in the way of achieving 100 percent interoperability.

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Three Steps to Creating a Secure and Scalable Healthcare Ecosystem

Guest post by Joanna Gorovoy, senior director product and solutions marketing, Axway.

Joanna Gorovoy, MBA
Joanna Gorovoy, MBA

The healthcare industry is in the midst of digital transformation. At the same time, heightened government regulation, evolving healthcare policies and a rise in healthcare consumerism are driving a shift toward value-based, outcome-driven care models.

The focus on maximizing value and outcomes requires organizations across the healthcare ecosystem to work together, especially across a variety of different, and often unaffiliated organizations, including hospitals, health insurance companies, pharmacies and wearable health tech companies. Additionally, data silos and interoperability issues make it difficult to derive value from health data across ecosystems, provide quality patient care and optimize health outcomes.

Healthcare IT leaders in today’s digital era face a great opportunity and a daunting challenge: deriving value from massive volumes of healthcare data while meeting heightened demands for data privacy and security. In 2016 alone there were 106 major healthcare data breaches, exposing 13.5 million individuals’ records. As healthcare data breaches continue to rise in numbers, healthcare IT leaders must reevaluate how they approach key initiatives across patient engagement, population health management and care coordination.

They need to provide secure and innovative digital experiences by implementing application program interfaces (APIs), which are a set of routines, protocols and tools for building software applications, and increase awareness of industry standards, such as Health Level Seven International’s (HL7) Fast Healthcare Interoperability Resources (FHIR). Doing these two things will provide assistance in addressing interoperability issues and simplify the exchange of health information across the ecosystem.

But it doesn’t stop there. Moving toward a future where healthcare data is more widely accessible will require greater security management across all organizations that have access to patient data. To create a more secure and scalable foundation for digital innovation in healthcare you must follow these three steps:

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The Healthcare IT Data Revolution: Maintaining Independence With Innovative HCIT Systems

Guest post by Scott Ciccarelli, CEO, SRS Health.

Scott Ciccarelli
Scott Ciccarelli

At the beginning of their existence, electronic health records (EHRs) were primarily used as a document management system. Now, they have realigned their objectives and value to the physicians and practices they serve, to focus on data intelligence. If specialty practices want to stay independent they need to continue to evolve, prioritize value-based care and stay profitable. Moreover, they need the right partners to help enhance operational efficiency, increase patient engagement and achieve better clinical outcomes. As such, the scope of the EHRs responsibility for the practice’s health, growth, and sustainability has increased exponentially.

How will specialty practices ensure their future? By leveraging the power of clinical and operational data in their EHR and supplemental business applications, working together within the healthcare IT (HCIT) ecosystem. Businesses across all industries analyze data to measure overall industry performance. Metrics are the foundation for any successful business and physician groups are not excluded. Metrics should be the driving force behind every major decision that will boost productivity. However, physicians are not data scientists, but by utilizing the next generation HCIT systems, they can employ technology that will streamline the decision making process.

Challenges turn into opportunities

According to the Centers for Medicare and Medicaid Services (CMS), 171,000 physicians who did not collect and use data to comply with government regulations are looking at a three percent Meaningful Use penalty in 2017. Coupled with a new focus on value-based care requirements playing a critical role in care and outcomes, upgrading their data platform and capabilities should be the number one priority to comply with new industry standards. Data driven HCIT solution providers can prepare specialty practices for these coming changes. They help collect and analyze data to ensure effective treatment plans at lower costs.

Bottom line: This helps improve patient health and satisfaction.

Today’s HCIT systems are considered business tools that help physicians analyze data and reveal insights to use for enhanced decision making. Popular “big-box” HCIT systems try to be all things to all providers, yet they are tailored to hospitals and primary care physicians—many who typically see far fewer patients in a day than specialists. This puts a major burden on specialists, who rely on different clinical and operational data to help maximize outcomes.

Specialists potentially see up to 60 patients a day – and cover surgeries, follow-ups and everything in between. Generic HCIT systems fall short in relation to appointment volume. Combined with the fact those systems make data entry inefficient, impede clinical workflows, and lack business metrics, this is the major argument for specialty-focused HCIT solutions. Some groups acquired by hospitals or health systems have not adopted the integrated systems of their new parent companies. Instead, they stay with their specialty HCIT systems—interoperable with their parent companies’ technology—because of their ability to serve existing, proven workflows.

Data insights and a workflow makeover

Specialty HCIT systems that analyze a variety of data and provide practices with the knowledge to improve their performance will deliver the best outcomes for patients and practices. Analyzing operational data provides an understanding of how to deliver the best patient care at the lowest cost, thereby delivering optimal outcomes and increasing patient satisfaction levels.

Specialists should take the opportunity to re-evaluate their EHR and determine if their goals are helped or hindered by their current HCIT ecosystem. A productivity-boosting HCIT system can harness the power of data to deliver clinical and business applications, workflows, and insight through one user interface and make compliance with reporting requirements simple and straightforward.

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Healthcare “Digitization”: Integrating Health Tracker Device Data in the Healthcare Enterprise

Guest post by Joel Rydbeck, director, healthcare technology and strategy, Infor.

Joel Rydbeck

Healthcare is undergoing rapid “digitization” – a move toward an integrated ecosystem of mobile applications and data exchange that integrate consumer data into the enterprise. For healthcare, this could enhance patient engagement and enable care to become more efficient and “real time”.

Nonetheless, moving to a more digital healthcare enterprise presents a series of challenges:

We’ve all visited a doctor and been asked “How are you sleeping?” and “Are you getting exercise?”. If you are among the growing number of people with a fitness tracker, you may think, “Hold on, I have that recorded”. So, you pull out your mobile phone and respond “I am getting six to seven hours of sleep a night and about 11,000 steps a day. Is that good?” While your doctor may understand your quick synopsis of the data, imagine if they were getting the data real-time. Would they know what to do with it? What if it contains disturbing trends? It would be unfortunate if crucial information wasn’t put to good use. But how?

Interactions like these prompted Washington University’s Olin School of Business and Infor Healthcare to collaborate on improving the usability of personal tracker data. This collaboration included conducting a small survey of 39 physicians from a broad spectrum of specialties asking their thoughts about the use of tracker data for clinical care.

The survey uncovered differing views on what information would actually be useful, showing:

The survey also asked providers what factors would enhance their likelihood of using tracker data for patient care. Majority would like to see better integration with their electronic health record (EHR), more patients using the devices, and additional data, such as blood sugar, being collected.

Physicians reported lack of education as a barrier to effectively using the data. About 50 percent believed that education, in the form of a short presentation or discussion, would be useful while 31 percent thought that a short guide would suffice.

While two-thirds of providers were open to discussing personal trackers with their patients, they did express concerns in using the data for care. The data must be proven accurate before physicians will place trust in it. Inconsistent or inaccurate data could lead to unnecessary anxiety and possibly harm. Also noted is that extraneous data can clutter the EHR and complicate patient care. Many of the providers mentioning drawbacks to using device data stated that the devices might work best as motivational tools for patients. More study towards interpreting tracker data for clinical use is needed.

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Why Don’t We Have Coordinated Healthcare Networks?

Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.

Abhinav Shashank

The story of Geraldine Alshamy explains how a minor complication in healthcare network can be catastrophic! The patient started experiencing severe headaches, and she was rushed to an emergency room. Since she didn’t have a primary care physician, she had a previous condition of hypothyroidism. But because of a lack of proper communication channel, her care process wasn’t the best that she could have gotten and, unfortunately, she had a heart attack!

This story might seem unusual but enough to understand that the consequences of uncoordinated health care could be grave. Health care is too critical and margin of error doesn’t exist here, it is imperative that we realize the importance of coordinating the healthcare sector and bridge the gaps in care.

Why Coordinated Healthcare?

When patients are brought in to be treated, the thing that physicians, nurses, assistants and other professionals require are the relevant medical information about them. For such a scenario, healthcare providers need to be well connected to provide coordinated care through smooth information flow.

According to a survey, some 40 percent of physicians believe that their patients undergo problems because of lack of coordination and information exchange between providers. The possibility of repetitive tests, unnecessary visits to the emergency rooms and preventable readmissions increases, giving way to poor health outcomes. Inadequate care coordination is estimated to cost as much as $45 billion to the healthcare industry, tagged as wasteful spending — $8.3 billion are lost every year because of inefficient technology.

What is the aim?

With everything around us changing and healthcare picking up pace, it’s high time we start thinking accordingly. The future of healthcare is smart teams aiding the one-on-one patient-physician interaction for better outcomes. These teams have physicians, nurses, financial advisors, health coaches and even family members and watch over patient’s health, follow-ups, and the insurance matters as well.

We have to move beyond the paradigm of isolated partial care towards integrated teams performing comprehensive patient care by encouraging the development of technology and providing care at hand with the center of our focus being:

1.) Accessible Care Anywhere

There used to be a time where people were not as well-connected to each other, and the only way of staying informed was telephones, letters, and postcards. With the evolution of information technology, we can safely share every ounce of information.

We need to put the rapid evolution of information technology to use and have patients connected with their physicians. Real-time alerts, genome sequencing, and data analytics will help us establish a world where patients won’t necessarily have to travel to a particular building and wait for hours to get treated.

2.) Connected Care Networks

Coordinated healthcare will hardly be possible without interoperable technology: teams connecting providers and specialists everywhere with the aim to deliver quality care. And the primary requirement for creating this team would be health information exchange, followed by notifying the PCPs.

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Predictions for Health IT in 2017

Guest post by John Squire, president and COO, Amazing Charts.

John Squire

As developers of electronic health record (EHR) software, my company gets into a lot of conversations with providers about their expectations for the future. This information helps us make decisions about what to build next. Here are three trends we’re hearing from our customers right now:

Low-tech beats high-tech in telemedicine

Unlike the way it was imagined decades ago by science fiction writers, telemedicine does not necessarily mean holographic images or live video conferencing with a physician half a continent away. Patients would rather receive “low tech” remote care from their primary care physician who has a full picture of their health status.

This form of telemedicine happens whenever an EHR system adds to a patient’s clinical chart the messages, pictures, or videos sent securely via smartphone. It happens whenever a smartphone connects to a remote health monitoring device for collection of real-time data such as blood pressure, oxygen levels, and heart rate.

The new rules allowing reimbursement of telemedicine and other non-face-to-face services will encourage physicians to bill for these remote care activities. Medicare’s recently expanded set of billing codes for Chronic Care Management (CCM) is a good example of how the future of value-based care goes beyond the office visit to keep patients out of hospitals and emergency rooms. The ability to securely and rapidly receive and answer a patient’s questions via text, and then capture those activities in the patient’s permanent clinical record is a critical step in that direction.

Primary care providers are trying new types of practices

Primary care physicians are frustrated with the hassle and expense of dealing with insurance companies. The new Medicare fee-for-value quality payment program is creating uncertainty about future reimbursement levels and requires additional reporting. Also, there is an acute level of burnout with “corporate medicine,” which has providers booked for dozens of daily appointments, only to spend less than 15 minutes with each patient.

In order to remain independent, a small but growing group of primary care practitioners are becoming more financially creative and experimenting with new models of practice. One example is direct care, in which a financial relationship is established directly between patient and provider, cutting out insurance altogether. This model includes concierge and direct primary care (DPC), where patients become “members” of a practice and pay a fixed monthly fee for unlimited primary care – similar to a gym membership, but for healthcare. Another example of direct care is the cash-only practice that sees walk-in patients for urgent care.

EHR interoperability will catch FHIR

Physicians and their patients are frustrated with the lack of interoperability in health IT. The concept of having a patient’s medical records accessible to any authorized provider at any time is still a rare occurrence. When a patient switches primary care physicians, the first office typically prints out and faxes their medical records to the second office, which introduces the possibility of errors, HIPAA violations, and others.

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How Does the Future of Health IT Look Under the New Administration?

Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.

Abhinav Shashank
Abhinav Shashank

The picture of healthcare industry is changing rapidly and still continues to evolve, with technology playing a huge role and the other factor being the government. With a new administration in the White House, the Senate and the House of Representatives, there ought to be numerous changes in healthcare, modifying ACA being one of them. Come January, what will be the effect of the new policies of the GOP have on health IT?

Healthcare Today

In his victory speech, President-elect Donald Trump emphasized on restoring and improving infrastructure and calling healthcare and hospitals an integral part of that plan. The Trump administration even after a session is less likely to remove its focus from IT investments and developments in healthcare; the Republicans believe in leveraging technology and healthcare experts are confident that healthcare-related initiatives like Cancer Moonshot and Precision Medicine Initiative will continue to speed up.

According to a recent ONC report, 96 percent of hospitals and 78 percent of physician offices were using certified EHRs to maintain patient data.

With digital initiatives developing, the hassle in prescribing medicines, scheduling appointments and access to vital records have reduced.

Making the consumer the center of the healthcare system and empowering them has been favorable. According to a survey conducted on 13,000 users, it was revealed that 28% changed their providers based on data made available online – implying that patients wish to be a part of the decision making.
A substantial number of digital health startups have emerged, and their revenue in 2015 was over $4.5 billion – and continues to grow.

Health IT developments to look ahead

Although Donald Trump has his healthcare plan for the country under the covers, some significant advancements are coming our way and following is a slice of what’s coming:

Value-Based Care: One of the most important thing Trump has asserted on in his plan is that he wants to ensure that “no one slips through the cracks simply because they cannot afford insurance.” With U.S. healthcare accounting for 17.1% of the entire nation’s GDP, it’s important to back this transition towards value-based care.

Advancements in Interoperability: In ONC’s latest report to Congress, interoperability was tagged as an essential priority. There are still a lot of factors getting in the way of free flow of data between providers, topped with the inability on patients’ part to access their medical information freely. There are many initiatives on the block: the Sequoia Project’s Care Quality programs, the development of FHIR standards that will be backed by Trump and will pan out impressively.

Banking on Digitization: In sustaining the momentum of this transformation, digitization would be the cornerstone. The use of data analytics, machine learning, patient-centered technology developments and the Internet of Things will unleash their forces under Trump administration and fuel further developments and investments.

Changing the Dynamics of the Marketplace: Donald Trump plans to allow insurance companies to sell their plans across the state lines which may result in an increase in competition and making their plans value-focused. Allowing a free market for drug import could also prove critical in reducing the cost of healthcare: he said in one of his speeches that Medicare could save as much as $300 billion every year, if drug prices were negotiated.

Future Implications

Health IT will stay because the need is to continue to work on making healthcare industry interoperable. Major value-focused programs on healthcare by federal government, such as MACRA won’t see significant changes. However, there is a possibility that the Quality Payment Program could be “enhanced.”

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Can EHR’s Survive Cyber Attacks with An Antidote of Machine-Learning, Ambience and Behavioral Analytics?

Guest post by Santosh Varughese, president, Cognetyx.

Santosh Varughese
Santosh Varughese

Since cybersecurity healthcare threats on hospital EHR systems have become a topic of nightly newscasts, no longer is anyone shocked by their scope and veracity. What is shocking is the financial damage the attacks are predicted to cause as they reverberate throughout the economy.

In the 30 days of June 2016, more than 11 million patient EHRs were breached, making it the year’s worst incident according to a study by DataBreaches.net and Prontenus. For comparison, May had less than 700,000 and 2016’s former breach leader (March) topped out at just over 2.5 million.

While traditional security filters like firewalls and reputation lists are good practice, they are no longer enough. Hackers increasingly bypasses perimeter security, enabling cyber thieves to pose as authorized users with access to hospital networks for unlimited periods of time. The problem is not only high-tech, but also low-tech, requiring that providers across the healthcare continuum simply become smarter about data protection and privacy issues.

Healthcare security executives need to pick up where those traditional security tools end and investigate AI cybersecurity digital safety nets. IDC forecasts global spending on cognitive systems will reach nearly $31.3 billion in 2019.

CISOs are recognizing that security shields must be placed where the data resides in the EHR systems as opposed to monitoring data traveling across the network. Cloud deployment directly targeting EHR systems data is needed rather than simply protecting the network or the perimeter.

Pre-cursors to AI are also no longer that reliable. Organizational threats manifest themselves through changing and complex signals that are difficult to detect with traditional signature-based and rule-based monitoring solutions. These threats include external attacks that evade perimeter defenses and internal attacks by malicious insiders or negligent employees.

Along with insufficient threat detection, traditional tools can contribute to “alert fatigue” by excessively warning about activities that may not be indicative of a real security incident. This requires skilled security analysts to identify and investigate these alerts when there is already a shortage of these skilled professionals. Hospital CISOs and CIOs already operate under tight budgets without needing to hire additional cybersecurity guards.

Some cybersecurity sleuths deploy a variety of traps, including identifying an offensive file with a threat intelligence platform using signature-based detection and blacklists that scans a computer for known offenders. This identifies whether those types of files exist in the system which are driven by human decisions.

However, millions of patient and other medical data files need to be uploaded to cloud-based threat-intelligent platforms, scanning a computer for all of them would slow the machine down to a crawl or make it inoperable. But the threats develop so fast that those techniques don’t keep up with the bad guys and also; why wait until you are hacked?

The Mix of Forensics and Machine Learning

Instead of signature and reputation-based detection methods, smart healthcare CSOs and CISOs are moving from post-incident to pre-incident threat intelligence. AI innovations that use machine learning algorithms to drive superior forensics results and deploy pre-incident security are just what the IT doctor should be prescribing.

In the past, humans had to look at large sets of data to try to distinguish the good characteristics from the bad ones. With machine learning, the computer is trained to find those differences, but much faster with multidimensional signatures that detect problems and examine patterns to identify anomalies that trigger a mitigation response.

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To Predict Healthcare’s Future: Look to Education

Guest post by Edgar T. Wilson, writer, consultant and analyst.

The current plight of America’s healthcare industry is not wholly unprecedented. In fact, it isn’t even unique.

Edgar T. Wilson
Edgar T. Wilson

American education — higher education in particular — is going through a parallel period of turmoil and scrutiny. It is really uncanny how closely the two industries actually reflect one another. Consider:

In the race to modernize and reconcile many of these conflicts of purpose and identity, it appears that higher education as a whole may be slightly ahead. Because of this relative lead on the healthcare industry, behavior within the American college and university system can act as a rough preview for the health sector. So, what do we see upon gazing into this crystal ball?

All for One?

A helpful place to direct this gaze is the recent ASU GSV Summit. The name alone reveals much about what is happening in higher education, and needs to happen in healthcare: Arizona State University, in the interest of promoting innovation, collaboration, and evolution in the higher education sector, joined forces with Global Silicon Valley’s family of companies to create their joint summit.

The summit began in 2009, seven years into the tenure of ASU president Michael Crow, who has become one of the leading voices and actors in higher education’s 21st century evolution. The summit is just one of the many strategic partnerships Crow has helped organize through ASU. Aligning the school with everything from technology startups supporting the development of ASU’s online degree programs, to the Mayo Clinic Medical School to offer future doctors transdisciplinary education in fields like business or engineering, Crow is expanding the reach of America’s largest public university by strategically sharing its resources.

In American medicine, there is a clear need for a similar attitude toward strategic partnerships and mission alignment, especially with technology companies and developers. This need is most acute in terms of EHR interoperability. Despite all the rhetoric, the old mentality of siloes, competition, and proprietary ownership prevail, and information remains immobile.

This symptom has implications that extend into every other facet of healthcare.

Patrick Soon-Shiong, billionaire, surgeon and incorrigible optimist, has set his sights on curing cancer. Much like the Precision Medicine Initiative, Soon-Shiong’s approach to this challenge is a matter of getting more, better data from as many partner institutions as possible.

“Cancer is really a rare disease,” he explains. “Because of the molecular signature, because of the heterogeneity, no single institution will have enough data about any [single] cancer. So you actually need to create a collaborative overarching global connected system.”

The end result — better medicine, better outcomes — is something common to the mission of every clinical organization, and ever caregiver practicing medicine. But the means — large scale collaboration, facilitated by transparency and a suspension of select elements of competition — are seldom realized in the current environment. Reconciling the ends and the means requires organizations to think bigger than themselves, and prioritize the sort of partnerships that bring new perspectives, larger pools of data, and creative solutions where they are desperately needed.

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