Let me be completely upfront about this. The first draft of this piece was written using the ChatGPT AI system. If you’re wondering how well it did, the answer is that what it gave me had the basic information I wanted to include, but it was dry, clunky, and lacked perspective. It required extensive edits throughout and several sections needed to be entirely re-written. Did it save time? Did it jump-start the process? To both questions, a resounding no!
Many opinions have been swirling about this technology for the past several weeks, but whether we like or dislike the idea of this technology may be immaterial. The fact is if technology is easy to use and improves our lives – like the iPhone appears to – then it is here to stay. Electronic health record (EHR) systems are like ChatGPT; we can see their utility and imagine how they will facilitate care that saves and improves patients’ lives, but they’re not all the way there, not yet. But we need to get them there – and quickly. We can.
Information is not only today’s currency; access to it is also often the difference between life and death in medicine. We have all seen firsthand how fragmentation in the health ecosystem overwhelms professionals at the front lines of patient care. Unable to access siloed information, providers often lack the background to make timely, life-sustaining decisions. This leads to poorer patient outcomes, added costs, and health professional burnout. It results in health disparities unaddressed and the inability to engage effectively in treatable noncommunicable illnesses.
Providers and payers operate within silos, with little economic incentive to collaborate. The resulting fragmentation means that patients often fall through gaps in care as their cases are handed off from one team to another. The need to foster coordination between health stakeholders and technology has great potential, but culture and old habits can crush change.
Too Busy to Read Patient Records
As hospital floor shifts change, health professionals have little time to “get up to speed” on their patient responsibilities – and nurses are often assigned to different floors on successive shifts, making it difficult for them to gain experiential knowledge of a patient’s needs. This makes the EHR the only way to learn about their charges, which is a tenuous situation.
I know this too well. During the last 12 days of my physician father-in-law’s life, a nurse at a leading hospital replied to my questions about his care with a worrying admission: “I don’t have time to read patient records.” That admission is symptomatic of systemic failures. EHRs are not standardized; patient data cannot easily be shared between providers or accessed by patients visiting multiple hospitals. This leads to duplicative tests and procedures and can lead to medical errors and misdiagnoses, sometimes with catastrophic consequences.
For the sake of patient’s lives and health, that technology needs to be easier to use and needs to improve patients’ lives. There must be interoperability between health systems and technology platforms.
Solutions from Government and the Private Sector
Thomas Mason, MD, Chief Medical Officer, U.S. Department of Health and Human Services, Office of the National Coordinator for Health IT, a long-time public health advocate, is among the nation’s leading experts addressing the challenges of patient care, technology, and information. Dr. Mason believes that interoperability is crucial for delivering quality care to patients. He’ll share his thoughts at the upcoming American Telemedicine Association meeting in San Antonio about The State of Interoperability in Transforming Healthcare with fellow industry expert Ardy Arianpour, a passionate entrepreneur and CEO of Seqster, a healthcare data management platform.
“Interoperability is essential for improving patient outcomes and reducing healthcare costs,” says Dr. Mason. “When providers can access complete and accurate patient information, they can make better-informed decisions about their care.”
Arianpour agrees. “The lack of interoperability between healthcare systems remains a major challenge. Electronic health records are not standardized, making it difficult for healthcare providers to exchange patient data.” To overcome this challenge, Arianpour believes telemedicine and remote patient care are essential tools. “Telemedicine can help to bridge the gap between patients and providers by allowing them to communicate remotely. This improves patient access to care and makes it easier for providers to monitor their patient’s health and deliver timely interventions.”
However, telemedicine and remote patient care are only part of the solution. Too often, the patient clinical data needed for prior authorization for payer approvals operate across different data systems with different electronic standards for storing the information. That adds to the physicians’ workflow and delays patient care. True interoperability – meaning seamless data exchange between health systems – is the key to curing fragmentation in the health ecosystem and providing genuine, patient-centered care.
In short, the system has to revolve around the patient, not the platform. Right now, it just…doesn’t.
Patients are not empowered to take control of their medical destiny. Many lack access to reliable health information, and those with chronic conditions often struggle to manage their records. Instead of being at the center of care, they are often on the outside, looking in.
So, what can be done to address this isolation? Can it be solved by better coding and coordination of technology by technologists? Or must there be more to it?
Taking Action, Making Changes
To bring existing technology forward to the point where it breaks information logjams, heals fragmentation, and puts patients back at the center of care, five solutions need to be prioritized:
- We need to break down the silos within the health provider community, improving and leveraging technology so that it supports collaboration between providers and payers to ensure patients receive seamless, coordinated care that keeps them healthier.
- We have to remember that hospital staff are often overworked and sometimes, managed less than optimally. As we’ve seen, they may lack time to read patient histories. Perhaps using AI developments that can provide concise patient histories with prioritized care notes – programs like Chat GPT, for instance – can help convey what is critical for providers to know.
- We need to harmonize clinical and administrative data systems to improve workflow and eliminate time-consuming, payer-specific requirements that providers often must address before delivering efficient care.
- We need to invest in interoperable technology that allows for the seamless exchange of patient data between providers. This will improve patient outcomes and reduce healthcare costs by eliminating duplicative tests and procedures.
- Finally, patients also need to be empowered to take control of their health. This means providing user-friendly interfaces that give patients access to reliable health information and the tools to manage their care, which connect to EMRs and patient portals. This is particularly important for people living with the challenges of chronic conditions.
Our healthcare system needs to be more cohesive, efficient, and cost-effective. While we have spent billions developing the technological tools we are confident can help drive this system-wide improvement, we must face the reality that the situation is worsening. We are spending more and seeing patient outcomes decline.
Riffing on iconic advertising giant David Ogilvy, innovation theorist John Nosta writes, “GPT is like a lamp post to an intoxicated person at night. It provides support but not illumination.” Interoperability is designed to lift up health professionals and patients – healers and those seeking to be healed. If so, it will soon illuminate the best path to care once we harken to the words of Dr. Thomas Mason and Ardy Arianpour.
Maybe it’s time we start with this simple idea; if the technological solutions we develop don’t make patients’ and health professionals’ lives easier, it’s as though they were never created.
[Special thanks to authors John Bianchi and Cullen Burnell for their review of this article.]