Electronic Health Reporter

Q&A with Life Image president and CEO, Matthew Michela

Seventy-five percent of consumers are willing to share their health data with their preferred local healthcare institution, according to a recent survey. That is a significant increase from the approximately 53% surveyed pre-COVID-19 who were willing to share data to help a doctor provide better care.

The drastic shift to virtual care and a population focused on the dangers of COVID-19 spurred the acceleration and adoption of technology tools bringing healthcare to the Digital Age. And, as consumers become increasingly more active and engaged in managing risks to their health there is a notion that tools to access and manage their health data remain available in a post-COVID healthcare setting.

How can organizations adapt to the COVID-fueled consumer revolution and exceed patient expectations for healthcare?

Consumer-oriented healthcare technology remains significantly behind other types of services. Not because healthcare technology is inferior but because mature technology present everywhere in our lives isn’t applied to healthcare. The tools and patient portals available today fail to help consumers manage the logistics, payment, evaluation, and coordination of their care. Consider the way medical information is actually available to patients, and try not to be frustrated when you realize that getting rid of faxes and CDs in healthcare will be considered a major industry breakthrough.

Starting from this context, the digitization of healthcare, more specifically, putting healthcare data at patients’ fingertips through the app economy, is now understood by consumers as essential and recognition of its importance has been accelerated by COVID-19. Unfortunately, it took a pandemic to fully realize that giving patients control of their medical data improves interoperability and moves clinical information more quickly to where it is useful.

The pandemic also presented to healthcare organizations a direct need to manage patient records longitudinally. With many more consumers surprised and frustrated to learn that something so seemingly simple as medical records is so difficult to access and share. Patients are waiting for their service providers in earnest for a practical and bonafide digital experience to materialize. COVID-19 has been a catalyst to drive adoption of more comprehensive portals to store and share complex medical data and successful organizations will address these needs.

How has the increase in telehealth during the pandemic highlighted the industry’s long-standing issues with interoperability?

The coronavirus is exposing the failures in response caused directly by the lack of data technology solutions whether focused on compiling data for public health or virtualizing care with telehealth. Leaders are now recognizing that technology must be a critical part of the pandemic response. Telehealth has boomed but in many cases is essentially a phone consult. You can see and examine the patient or examine the results of advanced diagnostics such as radiological images. There is limited clinical value to the interaction when more complex or chronic cases require more advanced tools.

In this high-risk rapid-change environment, healthcare workers need as much relevant clinical data as possible to understand a patient’s medical history and make accurate clinical decisions; and they need it immediately. However, complex data, such as diagnostic images are notoriously difficult to access and often transferred by physical formats such as on CD.

Ramping up technology to reduce dependence on physical media controls infection spread by removing high-touch physical records. Expediting the setup of digital methods to exchange patient data has a significant positive impact on effectively managing COVID-19 spread. With digital connections, hospitals can improve care coordination by connecting with community providers to exchange patient data ahead of transfer.

Outside of the traditional hospital setting, technology supports COVID patients through their long recovery. Many patients will require follow-up treatment and monitoring as they heal, which often includes imaging or specialist visits. Patients will accumulate a wealth of data on their road to recovery that needs to be managed across dispersed care teams. Much of this post-acute care will be virtual as hospitals and providers limit in-person visits, and increase digital exchange methods to effectively monitor recovery and adjust treatment plans. Similar to telehealth, the industry is recognizing the benefits of adopting technology to improve access to patient data, it will remain in post-COVID-19 care settings.

What technological advances are you seeing that has helped patients gain access to their own health data?

Patient portals have been around for the better part of a decade but are just now undergoing an evolution to the next generation to address gaps and help patients not only access but control their health data. Patient portals that store simple forms of medical data (such as lab results) have existed for some time now but they are limited in scope. Most portals can’t handle advanced data such as medical imaging, genomics, or pathology.

Most portals only allow patients to view their own information from a single facility. Patients can’t own and share their own data. In fact, 66% of patients in our recent survey have a portal offered by a provider. However, only 13% of those respondents have received records through the portal, indicating low adoption on the provider end to use portals as a data-sharing platform.

It is not enough to have a portal to access simple medical data especially when a patient is experiencing chronic or complex conditions where it is essential to access their longitudinal history for care management or advancing research. The portal must be robust, matching clinically valuable data from different sources (such as EMR data along with diagnostic imaging and lab reports) together in one place to create a complete history of a patient.

Along with the pandemic, the forthcoming ONC interoperability rules are also shifting the industry to a consumer-centric model. What should organizations be focusing on now to ensure they comply with the rules once they are fully implemented?

The coronavirus was a demonstration of why the rules were needed long ago. Under the Cures Act Final Rule finalized by the Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC) giving patients control of their medical data through smartphone apps and modern software will soon be required. The rule supports a patient’s right to securely access and control their electronic medical records and requires healthcare and health IT to advance APIs and technology to make that happen.

While the HIPAA Right to Access rule already allows a patient to access their records in the form or format of their choice (e.g. via an online app), additional federal laws will strengthen this ability even further with big penalties for those who engage in information blocking. The rules break down barriers that lie within institutional practices and refusal to change approaches at a practice level that inhibit the inclusion of unstructured data elements, such as diagnostic imaging or pathology reports, with the rest of the patient history.

You will have to let patients control and own their own data. You will need the tools to be compliant. Providers need to act with urgency to implement interoperable technology. Things change very slowly in healthcare so this industry has to adjust a different pace or risk being obliterated in the market by new competitors from Silicon Valley that have already been solving more mature data problems.

What are your predictions for the coming year in relation to consumerism and patient data access?

For years the technology to make secure sharing of PHI electronically and on-demand with patients has existed, but providers have continued to hold out and use outdated means of sharing information; relying on fax, CD’s and US mail. Interoperability, or more seamless data exchange, has been viewed as an expensive task or a threat that is bad for business risking patient leakage. But the reality is that as the world becomes more interconnected, interoperability in healthcare will catapult healthcare to the 21st century with easy access to clinical data for all stakeholders.

The big incumbents cannot try to continue to slow-walk and resist change. That will be a big challenge to the success of the ONC rules. In the coming year, enforcement will be key because, without enforcement, the industry is going to continue doing what it has always done – resist and stall.