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Expert Commentary: Interoperability Unifi ed patient information

management is ‘the healthcare Internet’ Healthcare is an activity, a process, a matrix of supply- chain-type exercises. Thus the concept of a hub – a central entity that owns, stores and passes on data – can often act as a bottleneck to innovation because that setup almost forces the focus on superfi cial content issues and/or ownership of the transport capability.

John Kelley is chief information offi cer at NaviNet. For more information on NaviNet solutions:

Instead, we should be looking for a healthcare infor- mation-sharing model that enables patient information to exist in many places, and allows it to be pulled together at any time throughout the care continuum, from any location. It’s time to think about applying the federated model to healthcare. In this model, data owners keep their data, but it is exchanged via a platform that securely gets the right data to the right party at the right time. In healthcare, this relatively new concept is called uni-

fi ed patient-information management (UPIM). UPIM is a patient-centric approach to information management that is based on the notion that patients’ administrative, fi nancial and clinical information – though held in various places (HIT systems in various care settings) – can be accessed by a provider from a central location. UPIM is similar to kiosk banking: the data resides somewhere safe, but the user can use any ATM in the world to pull in necessary data when needed. Platforms for UPIM sup- port application integration (integration between systems such as EMR, practice management, payer and patient communications) and workfl ow integration (seamless transfer of patient data between administrative, clinical and fi nancial processes).

A platform for UPIM is similar to Just as an customer receives a box with products in it from various vendors, the platform for UPIM enables the user to get healthcare data from various sources. And similar to a multi-media content service provider, the platform enables the user to get all kinds of content from many sources and use it on many devices. How? The platform for UPIM provides critical foun- dational elements, such as robust security architecture, common user interface and navigation, and applica- tion and workfl ow integration toolsets. In a sense, the platform screens and certifi es applications, services and data, making sure they are secure and that they can work together. This means that HIT vendors and service providers can plug their applications into the platform, which manages the data and system interoperability and information exchange; the end user then only needs to log in once to navigate between all the applications and systems running on the platform and access the data that is passed between them.

34 February 2011

UPIM enables information to pass seamlessly from one organization to the next. No single organization or hub owns or controls the data. Transport costs are low or nil. UPIM makes all the content debates up to now a moot point.

Workfl ow interoperability requires next-generation innovation and value Platforms for UPIM enable content interoperability by supporting capabilities, solutions and tools that make it possible for providers and healthcare professionals to avail themselves of the patient content that exists. But the most valuable benefi t that UPIM brings is workfl ow interoperability, which enables stakeholders to get and receive information about processes particular to their organizations, specialties, roles and needs. UPIM acts as a fi lter to allow the user to make sense of patient data. UPIM knows, in a sense, why the user is requesting a particular piece of information, and contextually provides all the related patient information that could be helpful to the user at that juncture.

Today, there is no consensus as to the best transport method. One reason may be because many vendors and other interested organizations are more concerned about fi guring out ways to collect tolls on the transportation or exchange of patient information, which can tend to shut down innovation on the content side.

For example, the UPIM system may present the user with a 360-degree view of a revenue cycle management process, showing not only the status of a claim but also where the claim submission went wrong (improper cod- ing, for instance). Or, a provider performs an eligibility and benefi t check for a patient and along with deliver- ing back the E&B information from the health plan communication system, the system for UPIM may also deliver a piece of patient-specifi c clinical information from another application or data provider, which can inform the physician’s encounter with that patient and improve quality of care.

As we begin 2011 with renewed energy and hope for a year of promising HIT development adoption, let’s collectively encourage the industry to look at interoperability through a new lens of flexible, multi-channel, multi-platform and multi-vendor innovation.


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