Capstone Summary
Maddie Rouhana
Embedded Files
Paper
(still waiting to be officially published)
The Need to Standardize Healthcare Data
Introduction
Value based care is a buzzword in healthcare. What does this really mean and how do we get there? The first step: correctly linking patient data across organizations. Patients and doctors need to be able to access medical records in an organized, standardized process.
In a study by the PEW research center in 2020, nearly all participants wished they had access to their medical records. These 98 participants were even more concerned that their providers did not have their updated information. In 2017, 82 of the 83 top ranked hospitals in the U.S. had a fee for patients to receive their own medical records. Not only is it difficult and expensive for patients to gain access to medical records, but medical professionals also struggle to receive medical history that is critical to evaluating their patients.
This is a blaring example of hypocrisy in the U.S. healthcare system. Although individuals are constantly reminded to be proactive about their health, they are not able to gain access to their own medical records. In addition, providers also struggle with this, obstructing the medical care available as they are not aware of their patient’s history. Medical data is flawed in how it is shared to both patients and between providers. This paper investigates existing gaps in processes, solutions that are currently in progress, and the potential impacts of upgrading this system.
Gaps in Current Process
Population health data management is a pillar of value-based care. However, it is estimated that over 80 percent of valuable healthcare information is missing or locked in an unstructured form; there is not a standard process of medical record collection and preservation. For reference, the National Library of Medicine studies found roughly 80 percent of allergies in medical records are recorded incorrectly and only 50 percent of medications were documented properly.
CEO of NextGate, a global leader in healthcare enterprise, Andy Arodits, says “incomplete or inaccurate data in one’s health record can be detrimental to patient safety and a significant barrier to delivering coordinated, patient-centric care.” On top of that, healthcare is constantly changing. Patients and physicians change their name and move locations; payers’ organizations merge; new drugs are created; and personalized care models are developed. Healthcare data has to evolve and adapt to give patients the best possible outcomes. The EHR (Electronic Health Records) leaders said that linking and matching patient data in EHR systems is a challenge that would help lower costs, enhance clinical decision making, and improve patient safety.
Current Movements
There are a plethora of analytics and healthcare solution companies working to address discrepancies in the healthcare system. One of the biggest challenges, however, is the lack of data. For a lot of companies, they only have access to claims data, which is messy and incomplete. With the implementation of different technology, more data will become available and allow for further improvements in healthcare.
HL7, Health Level 7, is an organization leading the movement towards standardizing healthcare data. HL7 is a non-profit that aims to connect systems and interfaces in a way that maintains their integrity. This is also important as patients value having their medical records stored in a secure location. The organization created FHIR, Fast Healthcare Interoperability Resources, along with Apple and CMS, to establish a FHIR patient-centric mobile solutions app. The app was created with the specific goals of creating a more user-friendly way of viewing EHRs. The FHIR app allows patients to view their charts, see eligibility for preventative care measures, and track their claims. It is also a SMART, Sustainable Medical Application Reusable Technology, that is open and standards-based; it is structured in a way that allows for human readability and is the future of clinical interoperability in healthcare.
Conclusion
Patients and providers struggle to access medical records and data. There are fees and clunky processes that result in missing and inaccurate data. This leads to lower quality medical care. However, data standardization can combat these issues.
The impact of data standardization will be dramatic. Movements like HL7 and FHIR are leading the field towards a more organized and centralized approach. The bottom line is that when healthcare providers have access to complete and accurate information, patients receive better medical care. With correct allergies, medication, and patient history available to both providers and patients, there will be fewer trips to the emergency room, less healthcare expenses, and most importantly, better outcomes.
Works Cited
Beaton, Thomas. “70% Of Providers See Data Sharing as Key to Value-Based Care.” HealthPayerIntelligence, 15 Feb. 2018.
Carroll, Linda. For U.S. Patients, Access to Medical Records Often Difficult and Costly. 9 Oct. 2018. “HL7 FHIR - Future of Interoperability & Application Development in Healthcare.” InterSystems
Corporation, 17 Mar. 2021.
Hopkins, Brenda. “Exchanging Healthcare Data: A Look at 3 Standards Competing to Provide
Interoperability.” AJMC, 5 Feb. 2020.
Lagasse, Jeff. “Better Data Sharing between Payers, Providers Can Move the Needle on Social
Determinants of Health.” Healthcare Finance News, 24 Mar. 2020.
The Pew Charitable Trusts. Patients Seek Better Exchange of Health Data among Their Care Providers.
17 Mar. 2020.
Sukumar, Sreenivas R., et al. “Quality of Big Data in Health Care.” International Journal of Health Care Quality Assurance, Emerald Group Publishing Limited, 13 July 2015.
Visuals
(throughout the year)
Figure 1: The graph above depicts health expenditure as percentage of GDP for the six countries. It was created with WHO data and Microsoft Excel.
Figure 2: This graph reflects GDP in U.S. dollars for the six countries; it provides more context for spending in each country. It was created with WHO data and Microsoft Excel.
Figure 3: This graph shows healthcare spending in the six countries. It is in terms of U.S. dollars and ranges from 2000 to 2017. It was created with WHO data and Microsoft Excel. It is interesting that Austria, the Netherlands, and Canada follow very similar patterns.
Figure 4: This graph shows the percentage of healthcare spending that is spent on private spending. Canada and Austria seem to have similar patterns of steady low private spending while other countries have unique trends. This visual was created with WHO data and Microsoft Excel.
Figure 5: Above is a word cloud made with Voyant. It contains tweets pulled from Twitter with SocioViz. The data set is 8091 tweets that contained “Canada healthcare” from December 1 to December 12, 2020. The added stop words are “healthcare,” “https,” “t.co,” “amp,” and “people.”
Figure 6: Above is a word cloud made with Voyant. It contains tweets pulled from Twitter with SocioViz. The data set is 3239 tweets that contained “United States healthcare” from December 1 to December 12, 2020. The added stop words are “healthcare,” “https,” “t.co,” “united,” “states” and “6w1r1szzb1.” It is intriguing to compare these two word bubbles as the U.S. seems to have more negative connotations associated with healthcare.
Figure 7: Above is a word cloud made with Voyant. It contains tweets pulled from Twitter with SocioViz. The data set is 800 tweets that contained “my medical records” in April, 2021. It validates the findings that people value their confidential and private medical records.
Figure 8: Above is a word cloud made with Voyant. It contains tweets pulled from Twitter with SocioViz. The data set is 900 tweets that contained "access to medical records” in April, 2021. It validates the findings that there is a difficult request process to recieve medical records.
It is important to note that one of the most valuable outcomes of my capstone study has been that I used my new healthcare knowledge to find and secure a job at Arcadia Health! I will be a reporting analyst on their cusomter insights team; I am excited to use claims data to identify how providers can improve outcomes and spending for their patients.
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