Connectedness is the final frontier for healthcare. In many ways, the true breakthrough for innovation will come once interoperability becomes the default instead of the barrier it has been for several decades. With that focus, we recently compiled the six biggest ideas from the 2016 Datica Healthcare Innovation Series into a third annual report. The report explores the history behind the lack of interoperability, the role EHRs play, and what new data standards, like FHIR, can do ignite true transformation.
Since 2014, this continuing interview series has sought to understand how innovation happens in healthcare. Nine of the greatest minds in healthcare share their insights about data standards and integration principles in the complete 2016 annual report. These six ideas are a summation of the thoughts in the report.
Six Big Ideas
1. Innovation is a global endeavor.
“If you talk only to yourself, you stay the way you are… If you talk only to others in healthcare, you move with the pack… It’s only if you talk outside of your domain that you can leap boundaries.” — Mark Smith, MD
One truth about new ideas is they are typically the combination of existing ideas. Therefore the greatest innovations are spurred by bumping together diverse thinkers with diverse backgrounds. The more this happens, the higher probability true innovation will occur. The takeaway: global minds, often outside of healthcare, are some of the best sources of healthcare innovation at the national level.
2. Part of the challenge of technology adoption is due to the difficulty in understanding and absorbing the technology.
“When I talk to implementors in the FHIR community about this, there’s this thing that goes around about RESTful APIs — the 5-5-5 rule — 5 seconds to find the API, 5 minutes to understand what it was doing and 5 hours to have something working. But to that I add, 5 years to begin to understand healthcare.” — Grahame Grieve
Whether it’s the native complexity of the standard or the poor documentation that is behind the times, traditional data standards have not been inviting to energetic entrepreneurial problem solvers. The barrier to adoption is a subtle yet underrated consideration when wondering why interoperability isn’t better than its current state. The good news: FHIR tries to tackle this problem head on.
3. The pace of FHIR adoption has been insanely fast (by healthcare standards).
”[FHIR has] reached a point of adoption where there is enough critical mass to ensure that its APIs can be the standard and the usefulness of the platform can be assured.” -Charles Jaffe, MD, PhD
Healthcare is rightfully skeptical of the hot newness. For decades it has been told what new technology or process will save the day. While FHIR doesn’t solve all the problems, there is an industry view that FHIR truly is a breakthrough moment on interoperability. The data behind the swelling sentiment is the rate of adoption across sub-domains, across vendors, and across use cases, as well as being embraced by the government.
4. More data is not necessarily the answer to innovation because it’s often useless data.
“Doctors are rightfully skeptical in getting all your Fitbit or whatnot data because it doesn’t fit the way we generally use data.” -Ida Sim, MD, PhD
The unacceptable state of interoperability is often viewed as the biggest blocker to innovation. Exchanging data really is the key to the next healthcare transformation. Yet the other side of the coin—the deluge of data that is exchanged but is actually relatively useless—can be just as much of a depressant on innovation.
5. The EHR must be a partner to the rest of healthcare.
“The government has spent somewhere between twenty to thirty billion dollars on EMR deployment and there is a little bit of embarrassment and concern why these things aren’t interoperable.” -Dr. Mark Braunstein
Shared incentives have not always been present for EHR vendors. While they have been the core driver in the most important transformation so far—the digitization of health data—they have not behaved in a way that contributes to increased interoperability and true innovation. In their defense, it’s not necessarily their fault: the economic incentives have not been present, and Meaningful Use didn’t enforce it. But that does not excuse the growing sentiment that EHR vendors must embrace being at the forefront of the next wave of transformation.
6. Healthcare’s situations are unique.
“The challenges that we face are always the ones that have confronted us in my three plus decades for caring for patients—policy.” -Charles Jaffe, MD, PhD
This is not a ground-breaking thought: healthcare is unique from every other industry in the economy because of its combination of regulatory, economic, political, security, privacy, and complexity pressures—not to mention we are dealing with people’s lives, not tweets. But, it is important to be reminded that these situations exist, and healthcare innovation is predicated on managing the uniqueness up front.
We invite you to read the complete report for many more great insights on innovation.