If complete data interoperability is the future, how do we get there?
In recent months, we’ve discussed interoperability in healthcare data at length, first answering the what and then diving into the benefits to answer the why. In part 3 of our series, we dive into how to improve data interoperability, specifically in the world of sleep medicine. Data interoperability refers to the ability of health IT software to exchange data freely, without unnecessary constraints. More importantly, it’s the ability of the clinicians using those systems to easily have all the information they need to take the best care of their patients.
In the sleep world, examples might include the need for simple and secure access for RPSGTs to view patient study data remotely; or for a complex multi-state sleep management team to exchange scheduling and appointment information with the ancillary services office at a nearby hospital. There are many layers to this puzzle, and some are easier to manage than others.
Industry Buy-In: Sleep Professionals Need to Get on Board
Like everything in life, meaningful benefits are only going to come as a result of efforts to change the status quo. To make the right steps, it requires buy-in from everyone in the healthcare industry. For detractors, pushback stems from the changes being too complicated, too much work, a false economy mindset, or simply as unneeded because what’s in place “ain’t broke.” Systematically changing an entire industry is an arduous endeavor, but the benefits far outweigh the challenges, as we laid out in that second article.
Below, we lay out five key steps to creating interoperable systems within your sleep lab or health system that can help reduce costs and errors, increase accessibility, and improve patient care.
1. Digitize all records
The logical first step in making data accessible for all (with proper privacy restrictions, of course) is transforming it into an easily accessible format available to multiple parties. Electronic health records are the biggest factor. Paper-based health records can only be viewed by the person holding them, while digital records can be viewed by anyone with the digital file. As patients no longer visit the same health system for every encounter, it is vital for the various organizations to have an easily shareable digital healthcare record. While you can send and print files to have on hand, digital files are more efficient.
Consider the story we highlighted featuring Richard Piper, an IT director caring for his sick mother, who had to repeatedly fill out paper intake forms and sit for hours waiting for faxed records. Digital files would have saved a lot of pain and time for Rich and his mother, and for the doctors looking after them.
The second element is the formatting in which that EHR is accessed. After all, not all sleep centers, health systems, and private labs use the same sleep study viewing platforms, devices, or processes. With that in mind, for data to be truly interoperable, it must be accessible by multiple clinicians simultaneously and in multiple formats. Standard data formats for patient health information are outlined by HL7/FHIR. This is especially important as telemedicine expands and health systems and private practices alike need better ways to communicate information in the digital age.
Interoperable Data Improves Patient / Physician Communication
Take it from Dayana Arellano, an RPSGT who mentions a key interoperability issue in the private sleep clinic space: improving patient communication during social distancing while mitigating data privacy concerns.
“Even though we’re always focused on remaining 100% HIPAA compliant,” said Arellano. “[We were] asking what can we do to better connect with patients?” (Note: you can catch Dayana’s full story here.)
The question she poses is important to consider in healthcare. How can we provide better access to care? How can we answer patient queries virtually? And, can we do this all securely and efficiently? To answer all these questions, digital health records must be a part of the conversation. And unfortunately, while 96 percent of hospitals have digitized records, a little more than one in five still don’t leverage EHRs, per HealthIT.gov.
Here’s our bold take: four out of five isn’t good enough. This isn’t Trident gum. This is patient data access and it can save lives. Let’s get to 100 percent. To learn a little more about big data in sleep medicine, check out the review in the journal SLEEP, “Scaling Up Scientific Discovery in Sleep Medicine: The National Sleep Research Resource.”
2. Move apps/workloads to a cloud system
Digital health records stored via on-site servers is a good first step, but for access to be universal, cloud storage is going to be the standard. Cloud systems enable remote access, eliminate redundancies, and allow for more efficient data backups. A cloud system may give a lot of major health systems some queasy feelings. The apprehension around the cloud’s ability to safely store and protect data is common in all industries, but these feelings have little weight when examined in more detail.
In 2020, the cloud v. on-site debate has shifted heavily toward the fluffy white stuff. Moving applications to the cloud simplifies the need for siloed IT infrastructures at every health system. Cloud records are more secure, as unlike your on-site server, a flood or fire at your building won’t also result in data losses should entire servers be destroyed. And while cyber threats are mostly virtual, cloud services can’t be “hacked” on-site either.
Not only are cloud services more physically secure, data service providers now bring a wealth of cybersecurity expertise, but some are more suited for cloud security than others. Find yourself a cloud-focused organization that is HITRUST certified and has passed an SOC2 audit. Rather than managing dozens or (possibly hundreds) of siloed systems, each with various infrastructure vulnerabilities and make-shift integrations, work from one system in the cloud.
Cloud Technology Improves Data Interoperability
Cloud technology is making its way through every part of the healthcare process. Digital information may eventually replace physical readouts entirely, and those changes are already felt in sleep. With digital readouts replacing pages of data years ago, the industry saw a lot of pushback.
Per our own RPSGT and CCSH, Andrea Ramberg, “many in the sleep industry didn’t want to switch to digital platforms because they could physically hear changes made on paper during the tests. Literally, the physical action of scoring helped them identify certain patterns.”
Fear is often a determining factor in decisions. In fact, fear of change is very common, and situations like the one Andrea describes feel inevitable when looking at technological advances in sleep medicine. Even though moving away from paper scoring was scary, look at all the benefits digital scoring and recording enabled in sleep medicine. Digital backups, multiple copies of the record, instant transfers from scorer to physician, digital editing of sleep staging in various viewing platforms: all done via digital record in a fraction of the time as hand scoring and updating.
The simple truth is that digital records saved an immense amount of time as they were implemented, and similar time savings are now available at other stages in the sleep management process. Look at the booming expansion of sleep wearables, the improvement of automated sleep scoring, and the push for more home sleep apnea testing (HSAT) options. Today, enhanced AI sleep scoring solutions and improving home sleep apnea tests (HSATs) are pushing the sleep industry forward. As the consumer market expands, the opportunity is now to improve patient access with better data interoperability.
3. Partner with vendors who are interoperable
While the tone of this piece may feel hopeful, you should feel relieved that many healthtech vendors are already focused on interoperability. For sleep centers, a good place to start is in the areas we mentioned earlier: expanding HSATs, expanding telemedicine, and considering new scoring technologies. Many of these organizations and pioneers are looking to increase patient access to underserved communities.
For companies like Cadwell, Itamar, CleveMed, and others – HSATs are the focus of this improvement. These devices must be easily used by various sizes of operations, so a focus on interoperability is a must. Similarly, innovative automation tools must be compatible with different viewing platforms.
Take our own EnsoSleep AI sleep scoring solution. We are already interoperable with your current systems – regardless of what you’re running – because we’ve prioritized interoperability since we first began creating EnsoSleep in 2015. In our scenario, integrations are a constant focus of the engineering team, making sure we’re working directly within your existing workflow.
The final piece of the puzzle is a nationwide acceptance of more modern standards when it comes to data security and accessibility, and many companies are doing that today. From the HSAT revolution to the vast improvements to automated scoring, interoperability is a key to success.
What’s the Next Step for Sleep Medicine?
As we have discussed in this series, the benefits of an interoperable system are innumerable. From better patient care to simplifying the process for out-of-network care to unified access no matter the size of your operation, interoperability is critical to a more efficient healthcare system.
More complete and simple access to data is why we continually add partner integrations for our EnsoSleep solution. We are currently interoperable with all major viewing platforms. We want to simplify your sleep clinic workflow, and having a singular dashboard for centers big and small helps make that possible. Connect with us to talk about how together we improve patient care using interoperable data in sleep medicine.