Nov 01 2021

CHIME21: How Interoperability Increases Efficiency and Transparency in Healthcare

Digital health leaders discussed how artificial intelligence and data sharing can improve clinician workflows at the CHIME21 Fall Forum.

Interoperability is of growing importance in healthcare as more patient data is collected and as new rules and regulations require increased transparency and ease of access to this data. Healthcare leaders discussed this trend at the recent CHIME21 Fall Forum.

Experts shared the ways that technology integration with the electronic health record is improving workflows for clinicians, and how the flow of information between providers needs to be improved to adhere to requirements laid out in the 21st Century Cures Act.

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How Ambient Technology Can Optimize EHR Documentation

SCL Health in Broomfield, Colo., deployed Nuance Communications’ Dragon Ambient eXperience, which uses natural language processing technology backed by artificial intelligence to turn a conversation between a clinician and patient into a medical note.

Craig Richardville, chief innovation and digital officer at SCL Health, talked about the program in the digital CHIME21 session “New Times, New Solutions: Getting All the Juice Out of the Squeeze: Optimizing Documentation in the EHR with Ambient.”

He said the technology is exciting for a few reasons: It re-engages the provider with the patient, since there’s no longer a mobile device or written chart between them, and it increases workflow efficiencies.

“We’re an Epic shop. If you’re very proficient at using the Epic system, then this may not be the answer for you. We were looking for an avenue to improve documentation,” Richardville said.

Craig Richardville

Craig Richardville, chief innovation and digital officer at SCL Health, explains why the organization implemented Nuance Communication's Dragon Ambient eXperience technology.

To determine its first cohort of 25 provider users, SCL Health looked at signal data, a description of how each provider uses the system and where providers spent time within it. The team focused on people who were spending lots of time on documentation or who were doing documentation before or after work.

SCL Health has found more accurate documentation and more precise billing codes with the new technology. However, clinicians can access the recording from the cloud if they want to do quality assurance of the transcription. Richardville said a major benefit is that the technology is intuitive, not invasive, and patients may see it as modern within the healthcare environment.

He emphasized that the Nuance technology is not required. He said it’s important for a healthcare organization to determine whether the solution would be a provider expense or if the hospital would provide it to retain and recruit providers.

So far, SCL Health’s adoption rate is 60 percent within the first cohort, and Richardville said it saves each provider 60 to 90 minutes per day. As the program continues, he hopes more providers will adopt it and see its benefits.

SCL Health included a variety of practices and specialist types in the first cohort and found that adoption was higher among specialists, especially cardiology and orthopedics, than among primary care physicians. He thinks this stems from the more limited terminology used in specialties, and that primary care adoption may grow with time as the vocabulary expands.

RELATED: Find out why NLP could be a game changer for EHR workflows.

How the 21st Century Cures Act Affects Healthcare IT Leaders

“Imagine you got into a car accident and are being treated at a hospital you haven’t been to, where they don’t have your records, and you have a medical device that makes it so you can’t get an MRI,” said Donna Houlne, vice president and clinical officer at Infor. “Wouldn’t it be amazing if your records were already at that ER, and the clinicians knew your history and background without having to ask questions?”

That’s what interoperability can do — and what healthcare could look like soon.

In a CHIME21 digital session titled “Realized Interoperability: Who is Knocking at the Digital Front Door? Interoperability,” Houlne and Judy Murphy, former chief nursing officer for IBM Global Healthcare and former chief nursing officer and director of the Office of Clinical Quality and Safety at the Office of the National Coordinator for Health Information Technology (ONC), discussed why healthcare IT leaders need to start planning for increased operability.

Murphy explained that the ONC’s Cures Act Final Rule will require healthcare organizations to provide all health information to patients next year, and to facilitate an ecosystem of data flowing freely between providers. Currently, she said, a packet of data is sent from provider A to provider B, and that data is usually stored separately from patient data in the EHR.

“A clinician would have to go into the historic log in the electronic record to see the information,” Murphy said. “That’s outside the typical clinician workflow.”

CHIME21

Nurse executive Judy Murphy (right) explains how the 21st Century Cures Act will impact interoperability in healthcare.

The Fast Healthcare Interoperability Resources standard would enable that information to be taken out of the data packet, likely as a PDF, and placed into the flow sheet used by the clinician. Murphy said this will be critically important as healthcare organizations continue to collect more patient data. All the data will live in the EHR flow sheet accessible across providers rather than in a separate place.

Houlne pointed out that artificial intelligence will be useful in managing the influx of data, as case managers can handle 500 to 750 patients at once and don’t have time to sift through data to find trends.

“What good is a platform if you can’t sort the information by patient or patient population to be able to put resources or clinicians on a patient who needs them?” she asked.

“The care manager doesn’t know which patients to go and see. They have to decide who they need to see today. It’s the same thing with care gaps in a primary care setting. We know not everyone is having their mammograms, colonoscopies or annual visits,” Murphy said. “How do we know which people to reach out to who need it the most? These tools and interoperability help us build that.”

Consumers are also demanding interoperability. They want the same experience in healthcare that they’re getting in retail or banking. Houlne said patients aren’t willing to put up with the red tape anymore.

Murphy said that when patients get invested in their care, they take on more responsibility. Having access to their data will enable patients to think more about their health and realize that health and healthcare span the continuum of life.

MORE FROM CHIME21: Why understanding connected device risk leads to robust security strategies.

Keep this page bookmarked for our ongoing virtual coverage of CHIME21. Follow us on Twitter @HealthTechMag and join the conversation using the #CHIME21Fall hashtag.

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