Moving Past the Edge of CIN – Part 2

Dave Levin MD

In a previous post, we explored the shift in healthcare reimbursement from traditional Fee-for-Service to a Value-based Care model. These new models of paying providers are making it possible to focus on both quality and quantity of care, and for providers to come together to design new and creative ways of delivering healthcare. In some cases, they are forming Clinically Integrated Networks (CINs) to organize and orchestrate care of specific problems or patient populations. For example, a group of orthopedic surgeons, a hospital, and a rehabilitation facility might all form a CIN to care for patients who need a hip or knee replacement. Key to the success of these CINs is the ability to connect their IT systems to share patient data. It also turns out to be one of the major barriers to overcome – especially when everyone is not on the same Electronic Medical Record (EMR) platform.

 

Let’s think of Healthcare IT like it’s 2016

Device for Healthcare IT

If we look at the digital economy, there is an obvious alternative to the single platform approach in healthcare technology. The rest of the technological world is adopting open APIs to connect, share, and collaborate. This is the underlying technology that lets both you and Amazon know exactly where that UPS package is at any moment. UPS and Amazon aren’t on a single platform, but they have opened up their platforms to each other using APIs. It’s doubtful they even care which platform the other is utilizing as long as they are able to work together. This is precisely how healthcare technology and EMR systems can and should work.

 

Connecting, Collaborating, and Spurring Innovation  

We know that this concept of open APIs in healthcare IT is possible because we do it every day here at Sansoro. This was the guiding vision behind the development of Emissary, our middleware software. Emissary provides modern, RESTful APIs via web services that allow interoperability between EMRs and other health information systems. This is the very same approach used in many other industries to connect differing applications. This scalable and extensible approach to EMR interoperability connects medical record silos to each other and with virtually any other application or device.

Physicians

In addition to the obvious benefits of fostering collaboration, this approach to EMR interoperability is a catalyst for rapid innovation. Make it easier for innovators to build, test, and integrate into a healthcare IT “ecosystem” and there will be an explosion of new ideas, products, and services. One of the most important reasons that there are more than 1.5 million applications in Apple’s App Store is that nearly anyone with desire and determination can build an app and integrate it into the Apple “ecosystem”. This same approach will work in healthcare information technology.

 

To the “Edge” and Beyond!

Now we can imagine a very different life at the “edge” of a CIN. In fact, we can imagine a CIN where there is no “edge” at all and more opportunities to introduce innovative products and services.

Returning to the joint replacement example from Part 1 of this post, we can see many ways an open API approach would be a game changer:

  • It no longer matters which EMR platform the CIN members utilize
  • We can collaborate without having to merge or switch platforms – just like Amazon and UPS
  • It becomes much easier to add “marginal value” providers – those “onesie-twosie” groups to the CIN
  • Data can be shared in real time between members of the CIN
  • Data can be collected easily from CIN members and used to drive performance improvement and research
  • New players can more easily enter the game. New kinds of support services and devices can be developed and integrated much more quickly, driving greater value at an even faster pace.

It’s an exciting and challenging time for healthcare technology. New financial models like value-based care are giving us the opportunity to redesign our healthcare system to achieve better outcomes at lower cost and with greater satisfaction for patients and providers. Knocking down technical barriers by deploying open APIs that allow for EMR interoperability are an essential ingredient for success. It’s time to set the “Borg Strategy” aside. We don’t need to be assimilated when we can collaborate in an open manner!

Dave Levin, MD is the Chief Medical Officer for Sansoro Health where he focuses on bringing true interoperability to healthcare. Dave is a nationally recognized speaker, author and the former CMIO for the Cleveland Clinic.