Coming Soon…21st Century Health Care

It’s an inspiring time to be in health care, because we’re on the cusp of delivering to customers a personalized, secure and seamless experience. It’s known as interoperability.

Interoperability is when your doctor has a complete picture of your health, including things like your health history, medication history, specialists you have seen, and even your urgent care visits. The doctor (and you) can view your health records in a simple, easy-to-view format assisted with analytics, similar to how you might see your financial and banking records online. 

Thanks to innovative technology, people have come to expect a similar personalized and seamless experience in nearly all aspects of their daily lives – how they manage their finances, stay connected, shop and book travel. The health care industry and government are poised to usher in this new experience for millions of consumers through interoperability.

Progress is contagious

Government and industry are working together to achieve interoperability, which could also help reduce health care costs by $371 billion a year.

This past March, Seema Verma, the Administrator of CMS, delivered a forward-facing address about the federal government’s interoperability efforts at the annual HIMSS conference. The goal is to give patients more control over their own health information.

After Seema’s keynote, I had the privilege of participating with her in a media conference call to provide my perspective on how the industry can partner with government to achieve interoperability and how Humana is using analytics to support physician and clinician efforts to help our customers modify unhealthy behaviors.

Interoperability is going to usher in an era of connected health care focused on the consumer. I look at these key developments with a sense of optimism:

Interoperability represents a powerful, exciting and positive change that’s good for consumers, their health, and all of us who are innovating to make this happen. We now have a standard for interoperability, and it is being widely embraced. Fast Healthcare Interoperability Resources (FHIR) is essential for stimulating innovation and thereby bringing interoperability into health care. FHIR can also enable patient information to be shared between hospitals, physicians and other health care entities and will fuel innovation, thereby powering the consumer transformation needed in health care.

For example, earlier this year Apple used the FHIR standard to launch Health Records, which will enable people to collect their individual data. Apple is basically “making a Health Records API available to developers and medical researchers in an effort to create an ecosystem of apps leveraging health care data designed to help consumers better manage their medications, nutrition plans, as well as diagnosed diseases.”

This Apple initiative will further allow “patients of more than 500 hospitals and clinics to access medical information from various institutions organized into one view on their iPhone.” When you think about how CMS is using the Blue Button initiative to address claims, these two major moves can really ignite interoperability.

Thanks to structural changes, interoperability is set to open more doors, which will unleash a flood of innovation. Back in the seventies and eighties, significant structural changes took place in the banking industry, unleashing a flood of innovation that led to the online banking and investing services we have today.

Like consumer banking, health care companies will compete for the consumer’s business, which will spark innovation. CMS says consumers must own their data, which will empower them and help them choose which companies can securely access their health care information.

In order for interoperability to progress, we must de-monetize while democratizing the sharing of consumer data, as opposed to viewing it as a business opportunity to charge consumers, or even each other in the industry, for this data. Interoperability represents a shift from what’s good for industry to what’s good for consumers.

Interoperability represents another step toward consumer-driven health. Years ago, government and industry took a great step forward with consumer choice with Medicare Advantage, the private form of health coverage for people over 65 that’s now embraced by 20 million of the 61 million Americans enrolled in Medicare.

Medicare Advantage is well known for the holistic approach it takes to address chronic conditions. That’s important, because six in 10 Medicare beneficiaries are living with more than one chronic condition. Medicare Advantage has been so successful because of the intense competition among industry, which has led to a climate of innovation.

Given the health challenges noted above, interoperability, like the care system integration of Medicare Advantage, is designed to drive this holistic approach to patient care, which puts the consumer at the center of the health care experience. Interoperability will also empower primary care physicians to better coordinate care among unhealthy patient populations because it will enhance their ability to securely access patient data in real-time, which will lead to more personalized, specialized care.

The Inspiring Road Forward

Interoperability is about how industry and government are working to make health care better and easier by doing what’s right for the consumer.

It will help millions of Americans improve their health by enabling them and their physicians to securely access their data so they have a real-time, holistic view of their health.

By driving innovation, working together and doing what’s right for the consumer, interoperability will help create a healthier future built on the needs of the people we serve.