The Value of Interoperability in Healthcare: ROI for Health Data Exchange

Interoperability isn’t something we can touch, but when it’s not there we can definitely feel it. A 2020 paper from Deloitte compares it to plumbing: “It’s not sexy, it’s not visible, but when implemented correctly, it can enable a whole new world of care delivery and patient empowerment.” Radically interoperable data is the future, Deloitte says, but the challenge of making a business case for investing in the technology could block progress.

Before the Institute for Healthcare Improvement (IHI) established the Triple Aim in 2008, conventional wisdom told us that the goals of cost containment and enhancement of patient care were at odds. This framework was built on the idea that each aim – per capita cost, population health, and experience of care – reinforces the other, and the pursuit of the aims together is the only way to make progress on all of them.

When a fourth aim of provider satisfaction was added in 2014, it was argued that unchecked burnout would make the rest unsustainable. “The reasoning for adding equity as a fifth aim is similar: quality improvement without equity is a hollow victory,” wrote the authors of The Quintuple Aim for Health Care Improvement: A New Imperative to Advance Health Equity, published early this year in JAMA Network Journal. They maintain that better experience of care and better health for populations, the two aims related to health equity, rely on quality improvement efforts that cannot succeed without a focus on eliminating disparities.

Calls for health equity – which have been amplified since the COVID-19 pandemic began – are borne from the noble intentions of most people in the healthcare sector. But it’s not possible to separate the practice of medicine from the business of healthcare. Patient care is always job one, but without measures to curb spending the enterprise can and will not prosper. 

In many ways, healthcare IT has offered a lifeline. Interoperability in particular has many benefits that directly impact the cost and delivery of patient care, improving clinical outcomes, streamlining operations, and boosting the satisfaction levels of patients and providers. One study found that interoperability could save $30 billion annually, in addition to improving patient care and safety.

Making a business case for spending on HIT solutions like an interoperability platform starts with identifying the potential for return on investment (ROI). You may be convinced that an interoperability platform to facilitate seamless health data exchange is one of the best investments a physician practice, hospital, digital health provider, lab enterprise, or research facility can make. But persuading the holder of the purse strings to buy is another matter.

Let's take a look at some of the gains you can expect and the ROI that follows.

Interoperability Gain #1: Better Care

Cost savings/ROI: More data that is accessible, organized, and actionable has an immeasurable effect on care. But if you did want to measure it, there are several data points that can be collected – a reduction in unnecessary tests and treatment, to name just one. Not only can physicians see the patient’s entire medical history, along with supplemental data sources like social determinants of health (SDOH) in many cases, but they can share progress notes with other providers. Hospitals, in particular, have seen again and again a clear correlation between patient safety, quality improvement, and financial performance.

Interoperability Gain #2: Patient Satisfaction

Cost savings/ROI: If healthcare is a business, and it is, then patients are customers. Their experiences will inform future decisions about where to seek care, and in today’s world their choices are increasing exponentially all the time. Word of mouth is not to be discounted, and patient satisfaction is a valuable tool that can be used to increase revenue and growth.

Interoperability Gain #3: Provider Satisfaction

Cost savings/ROI: Better care makes patients happy and that makes providers happy. There’s also evidence that physicians are dissatisfied with the level of interoperability in EHRs, resulting in burnout levels that have caused some to leave the profession. Healthcare is threatened by a burnout crisis that will eventually lead to a staffing crisis if it’s not addressed. Increased interoperability is widely believed to be one of the best ways to help alleviate the administrative burden that contributes to burnout for healthcare professionals.

Interoperability Gain #4: Efficiency

Cost savings/ROI: An interoperability solution will create better workflows, eliminate paperwork burdens, and increase productivity by automating manual processes like quality reporting insurance authorization. Administrative burdens amount to as much as 25 percent of healthcare costs, so the opportunity for savings there is significant. Retrieving medical records and test results in real-time seamlessly results in overall efficiency that will spill into your entire enterprise, freeing up time and energy to focus on patients.

Interoperability Gain #5: Focus on Outcomes

Cost savings/ROI: The transition from fee-for-service to value-based care models being mandated by the Centers for Medicare & Medicaid Services (CMS) is heavily reliant on the exchange of actionable data. For it to work, physicians need aggregated data from every source including post-acute care, at-home care, and others. Information silos are not conducive to the value-based care models that may fail without investment in data governance. With reimbursements at stake, you can’t afford not to invest in interoperability. 

About Health Gorilla

Health Gorilla is an interoperability platform providing permitted access to actionable patient data. Customers use Health Gorilla to improve outcomes, streamline workflows, and create a more equitable healthcare ecosystem.

Unifying duplicative patient data and normalizing it into a single, actionable record gives providers the tools they need to deliver personalized care at scale.

Key features include:

  • Master Patient Index (MPI): Identify the appropriate patient by scanning multiple systems using heuristic matching algorithms, referential data sources, and demographic data.
  • Record Locator Services (RLS): Paired with the MPI, the RLS streamlines the process for discovering a patient and their health data. Increase efficiencies by indexing patient record locations and using them to optimize future queries.
  • Data Processing Engine: Aggregates, de-duplicates, and normalizes fragmented records into a standard FHIR format – resulting in a longitudinal, high-quality, and actionable record for each patient.

Using APIs built on Fast Healthcare Interoperability Resources (FHIR), our interoperability tools also facilitate the secure storage of clinical data, direct patient data into your platform in real-time, and safeguard patient data with permission-based access.

Talk to An Expert

If you are part of a healthcare organization and interested in expanding the interoperability of patient data available to your providers, the Health Gorilla team is here to help. We offer a comprehensive implementation plan which includes a dedicated implementation specialist and solutions architect who will work with you to configure the connection between our suite of APIs and your application. We tailor our implementation to your organization's unique clinical data workflows and provide access to the Health Gorilla development sandbox. Our team of experts is available to answer any questions through the testing and validation period. If you have any additional questions or are interested in a personalized demonstration based on your use case, please contact us.