Better outcomes are possible when patients, providers and payers get critical information at the right time.

The way patients and their medical providers engage with the U.S. healthcare system today is reminiscent of those early, bumpy days in the shift to digital across the retail and banking industries. Big steps have been made, but there’s still work to be done to make it a fully satisfying—and seamless—experience.

“For urgent care, we have a good adoption rate with our patient portal, where patients can see lab results when we see them, and that’s improved satisfaction,” says Dr. John Kulin, managing member of Shore Urgent Care, in Northfield, New Jersey. But when COVID-19 hit, call volume overwhelmed the scheduling system, “and we got pushback from our patients,” he says. “We’ve had our positives and negatives.”

People expect information to flow smoothly and expediently. “It probably flows way too seamlessly in some aspects of our lives,” says Paul Brient, senior vice president and chief product officer at athenahealth. “But in the healthcare space, information doesn’t flow right.”

This information dysfunction is a burden on patients and clinicians alike. It keeps costs needlessly high and threatens positive health outcomes.

But change is on the horizon. Healthcare is primed for the type of radical transformation many other industries have undergone when it comes to accessibility and frictionless encounters. Over the next two years, Brient says, “we’ll be working very hard to bring patient engagement with the healthcare system on a par with consumer experiences in other sectors.”

The key to realizing that vision? Modern interoperability.

It starts with the right access

From a clinician’s perspective, “interoperability means you feel confident that you have all the information you need to take care of a patient’s needs,” Brient says, without “wading through a bunch of data-reconciliation challenges.”

The way it needs to work, he says, is that providers have the most relevant health data for the situation in front of them at the right time—“and not the 100-page version of it.”

“When you’re a physician caring for a patient, you’re constantly worried that you’re missing something,” Kulin says. “If we can reduce some keystrokes from the process of sorting through indiscriminate information for patients, it saves a huge amount of time and stress. And that helps us spend more time with them instead of with a screen, a computer or anything in between.”

When you are a patient seeking timely, efficient and proper care, interoperability looks like this: You show up for your doctor’s appointment (in person or virtual) and provide your credentials to gain immediate access to your health records. Your family history is there, along with any allergies you may have or medications you are on, surgeries you have had, and treatments you’ve undergone. All previous appointments with other providers are included. Unless there are any changes or updates, there is nothing for you to fill out. You meet with your doctor, who with a glance at a screen, is looking at the same information you have.

In this scenario, Brient gives the example of a doctor who has ordered an eye exam for a patient with diabetes: “Your doctor doesn’t have to ask you if you got the eye exam and how was it? They say, ‘Oh, I’m so glad you had your eye exam and that it’s normal and all is good.’ It’s not up to you—the patient—to provide the information that’s already there for the doctor to see.”

It’s a process at once natural and reassuring. “Unfortunately,” Brient says, “it’s not how it works today.”

A seamless exchange

The good news is the ability to have healthcare data follow patients wherever they go is within reach, giving them a seamless interaction with electronic health records, and at the same time vastly improving coordinated care across specialists and clinics.

Results from a 2019 survey of PCPs¹ found that primary care practices in the U.S. are not routinely exchanging information electronically outside their practice. Especially in the U.S., physicians do not typically receive timely notices or needed information for managing ongoing care from specialists, emergency medical teams or hospitals.

Bret Connor, senior vice president and chief customer officer at athenahealth, says, however, that an interoperable, open system is not only possible, it’s “the new frontier.”

“Interoperability is the core of how we build our software,” he says. Providers that join the athenahealth network “have access to a rich set of solutions that other software developers are building and connecting to our network,” he says. “We have over 750 open application information systems so that our Marketplace partners’ solutions as well as our customers’ proprietary technology can integrate with our system. Our partners and customers can pull data out of our system. They can push data back into our system, just like we would.” The technology is purpose-built to interact with and be informed by the entire continuum of healthcare data. “And that really is the essence of what an interoperable open system looks like,” Connor says.

One further dimension of interoperability is bringing in new actors. At athenahealth, Brient says, “we are working to bring payers into the tech equation.” Payers and providers, he explains, have historically been adversaries. “With value-based care, we’ve been trying to get the payers’ and the providers’ incentives more aligned.” What this means is that through an interoperable, open system, payer information is made available to clinicians, who then can make more informed decisions when scheduling referrals and ordering tests. 

Easy access to critical health information and the frictionless exchange of that data equip both patient and provider to advocate for the best health outcomes, in terms of treatments and costs.

“If your doctor really understands your whole health situation, if you don’t have to get redundant tests, if there’s seamless interaction with electronic data from payers to point of care and across care teams,” Brient says, “that’s better healthcare.”

Written in partnership with Wall Street Journal Custom Content

Wall Street Journal Custom Content is a unit of The Wall Street Journal advertising department. The Wall Street Journal news organization was not involved in the creation of this content.

¹ “2019 Commonwealth Fund International Health Policy Survey of Primary Care Physicians,” The Commonwealth Fund, December 10, 2019.