By David A. Watson, chief executive officer of Akiri, and former CTO, Kaiser Permanente.
The American Medical Association (AMA) identifies one of the biggest challenges in healthcare today as the secure sharing and use of trusted health data in real time across the complex U.S. healthcare ecosystem. To hijack a Winston Churchill quote — data liquidity is a riddle wrapped in a mystery inside an enigma. The key to solving this puzzle is not more technology; we’ve had good integration technology for 30 years. What we need is a fundamentally different approach that addresses the adoption issues that have so far prevented success.
Do we face challenges caused by the inability to accurately identify different fragments of patient data coming from different systems producing incompatible data that is exacerbated by incomplete or inadequate data standards? Absolutely. And they are being addressed – albeit slowly – by the technology community. The more intractable problem is adoption. That challenge can be boiled down to three overlapping issues which hinder productive health outcomes:
- Trust – there is insufficient trust among the healthcare data trading partners (e.g., healthcare organizations fear that shared data could result in some sort of business disadvantage).
- Economic Incentive – there is no direct economic incentive for those who possess the data (and bear the cost of creating/communicating it) to share it with those who need it (and who benefit from it).
- Control – organizations that share their data want to have a sense of control regarding what is being shared with whom.
Achieving data liquidity in the sprawling systems that make up the U.S. healthcare economy requires a combination of rethinking the applied technology to make it easier and less expensive, while closing the adoption gap by giving the participants in data exchange solid business reasons to do so. Without addressing the economic issues and retaining a strong privacy compliance footprint, no amount of technology will overcome the market entropy noted above.