This article is initially available on our podcast. Click here to listen.
Interoperability is a subject that comes up frequently. One of the subjects that comes up under this is that the Cures Act has been around for several years. However, while delayed, it is now in an enforcement phase, will it solve all of our interoperability problems? Perhaps, even more importantly, is it going to solve all of our ETL problems, meaning Extraction, Transformation, Loading, getting data out of these systems, and using that financial information to run a provider organization more effectively? That’s a big question.
How are you impacted?
Part of this depends upon who you are. If you are a patient, I think this will significantly help people get access to information because it is so disparate right now. Still, who knows how fast it is going to move and so on? Indeed, it’s moving in the right direction of helping patients access their data. That is this giant diaspora of all over the world and so many different providers’ little silos.
It should also help clinicians, physicians, and related clinicians access patient health information to make better decisions. And certainly, it should give rise to the ability to use more complex systems that aggregate and analyze data from many different places to provide differential diagnosis or other artificial intelligence types of clinical support for providers. It’s also likely to help payers. That’s a whole separate conversation, but there’s a good chance it’s going to do that.
Getting to the meat of the Cures Act
If we look at what the Cures Act addresses, it’s basically about making sure information is shared and getting rid of people blocking the sharing of this information. Key things there are like assessment and treatment plan, clinical notes, health issues or concerns, lab tests results, medications, prescriptions, procedures, surgeries, those types of things, primary health monitoring data, vital signs. Those are key things that it’s designed to make sure that people don’t stop the transfer of health information.
What you’ll notice, though, is that, conspicuous by its absence, there is no financial data in there. That’s significant. Given the importance of controlling costs in our healthcare system and how much emphasis there has supposedly been over recent years, it’s extraordinary that there’s nothing about financial data in there.
I’m sure that payers who have extraordinarily lobbying capability fought to make sure that they kept this out of this bill. Again, this is five years ago. I’m certain providers as an organization, as an industry, probably did the same thing. Why? I mean, again, who wants transparency?
How will it change interoperability?
Even with all of those things, is the Cures Act going to make a significant difference? Is it going to solve interoperability issues? Now, there’s this giant loophole that says, “Nah, unless you have an IT problem.” Payers are famous for having IT problems. What’s clear, though, is that many of those are, at the very least, tolerated or allowed because it benefits them to have “IT problems” that keep them from being able to exchange data or even to be able to process claims more quickly.
Sometimes, it’s even worse than that. It’s not only tolerated. It’s probably incentivized or even designed because they don’t want to solve all these problems. Now, some of them – they do. They may do the things that will benefit them, but many things – they will not.
To sum it up
Even with giant IT organizations, EHR systems, think of the 100-pound gorillas like Cerner and Epic, and more. The penalty is a million dollars for a violation. Prove that that’s the case. Nonetheless, what’s a million dollars for a breach to a multi-billion dollar organization like Epic? They’re the 800-pound gorilla (and they tried to keep from sharing information, they’ve been one of the famous ones who have not been willing to open up), assuming you can even prove something is the case? So, on net, I wouldn’t hold my breath.