HIMSS23: Health equity could get a boost from interoperability
A digital divide creates a barrier for those who would wish to have fuller participation in their own care.
Left to right: Moderator Michael Marchant, Evelyn Gallego, Ammon Fillmore and Melissa Soliz talking about interoperability and health equity at HIMSS23 in Chicago Monday.
Photo: Jeff Lagasse/Healthcare Finance News
CHICAGO – Interoperability is frequently touted as a means of ensuring the exchange of important health information between healthcare entities, but it turns out that achieving this long sought-after goal may also be a means of advancing health equity, which has been an ongoing focus of the current administration.
The idea is that disparities in healthcare access and overall health outcomes aren't just affected by physical access to services. There remains a digital divide, creating a barrier for those who would wish to have fuller participation in their own care.
According to a panel of experts Monday at the HIMSS23 global conference here, an important first step in bridging this divide is ensuring broad interoperability of health data so patients and their caregivers can better plan their care, regardless of the platform or device they choose to use.
Evelyn Gallego, founder and CEO of EMI Advisors, said interoperability can be a means of addressing social determinants of health (SDOH), helping to close the equity gap.
"Health equity is not the same as social determinants of health, but the former helps along the latter," she said. "An interoperable data structure supports the seamless exchange of data between healthcare delivery, social care delivery and learning health systems. We need this data to flow."
To help it flow, provider directories have been established to support the integration of community information into health data so that individuals can connect with the information and share it in a secure manner with anyone they choose to.
Melissa Soliz, partner at Coppersmith Brockelman, pointed out that the United States Core Data for Interoperability (USCDI), which she called the "bedrock" of data-sharing frameworks, added an SDOH assessment in version 2, and also added categories for sexual orientation and gender identity.
"By collecting those data elements, that makes it so we can identify those folks who are in underserved populations," said Soliz.
An easy trap to fall into, the panel agreed, is that healthcare professionals often adopt the mindset of interoperability encompassing solely what's in the EHR record. But according to Ammon Fillmore, associate chief legal officer, information and technology at AdventHealth, there's much more data out there – and it's subject to far fewer regulations.
"We have these amazing data sets, and you don't have to involve lawyers to interact with them," said Fillmore. "We have such limited data in an interoperability environment that we tend to look for clusters and focus on that. Interoperability exposes data silos, and data deserts, where there isn't any data to be found. If you don't have the right data flowing through this, the interoperability value proposition becomes more difficult to execute."
Rethinking which data can and should be interoperable is a part of addressing health inequity, said Fillmore.
"Think back to the pandemic," he said. "In some states, there were real-time dashboards regarding what beds were available, etc. That's interoperability too. It's not just having data flowing; it's having bed counts. Think of what a real-time dashboard on dialysis could do."
Since having the right data can help identify the needs of these underserved communities, there are potential positive implications for public health and maternal health, and several other historically marginalized subcategories.
"Technology is a tool," said Soliz. "It's a means for implementing health equity. Patient access is important – you can really level the playing field."
Of course, there are legal challenges and considerations. Privacy, confidentiality – reaching health equity goals can be a complicated process. Depending on the specific circumstances, different legal standards may apply, and many states have their own health data laws.
"You have to do it in a way that's compliant," said Soliz. "It's hard to do, but you can do it and overcome it."
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
