For all the technological advancements healthcare has made in the past years, it still appears to be remarkably stuck in an antiquated narrative. We have an abundance of technology, but still are unable to connect devices or software and figure out how to best use and optimize these offerings.
Helping to do that and find the most efficient and effective use of technology is an overarching goal of the Workgroup for Electronic Data Interchange, a public/private nonprofit organization. WEDI formed in 1991 under former HHS Secretary Louis Sullivan, MD, who called for a more automated healthcare environment. In 1996, the organization was named an advisor to HHS.
Here, Devin Jopp, EdD, president and CEO of WEDI, spoke with Becker's Hospital Review about WEDI's continued mission, where healthcare IT falters and rising challenges.
Editor's note: Interview has been lightly edited for length and clarity.
Question: Can you expand on the goals and mission of WEDI?
Dr. Devin Jopp: One of the things we spend a lot of time doing is driving down the cost of healthcare operations through collective action. We do that by convening innovative multiple stakeholders — payers, providers, vendors and government — to collectively solve healthcare's operational challenges. WEDI runs about 30 different workgroups that cut across [areas] like new payment models to transactions and code sets to ICD-10, and we even have some new ones around innovative encounters (telemedicine) and genomic data exchange. Ultimately, we work try to help healthcare work to ensure that we are improving the bottom line of organizations through automating these functions.
Q: How does being a public/private organization affect what you are able to achieve, as opposed to, for example, being just public or just private?
DJ: WEDI was initially conceived by the federal government by former HHS Secretary Louis Sullivan, who at the time saw a need to automate healthcare, since the industry was drowning in paper. What he did was very innovative. He turned to the private industry and asked industry executives to come together and tell the government what should be done. Ultimately, WEDI was named as an advisor to the Secretary of HHS in the HIPAA law on matters concerning healthcare information exchange. Fast forward to today and 20 years later we continue to be the one place that can pull together these diverse opinions and give a single voice and recommendations to the government.
Not only are we advisors to the government, but we're advisors to our member companies and our industry as a whole. We work to take the multi-stakeholder voices on key health IT implementation issues and go back to industry stakeholders to show them what they can do to improve their operation and ultimately their bottom line.
WEDI is in a unique position in that we can solve problems that one organization can't solve on its own. That's a real value in what WEDI brings to the table. The volume of stakeholders and the variety we have is critical. We also have a very strong government presence among our membership, including Veterans Affairs, CMS and 48 of the 50 state Medicaid agencies. It's a great compilation of organizations that all work together to improve healthcare operations.
Q: What do you see as the biggest issue facing health IT today?
DJ: The biggest one clearly is interoperability, or lack of interoperability. The question is not necessarily how to get interoperability to everything, because we seem to be out there as an industry on home plate trying to hit a home run. I believe that we need to prioritize what kind of data and for who do we really need to share.
The second one: I think we have a rising problem on [connecting] EHRs to the administrative data systems. It's all under the bucket of interoperability. Data must travel through new pathways between EHRs and administrative systems like billing that we don't even know about yet. A lot of these stem from new payment models. As an example, gaps in care are something that every organization involved in new payment models is struggling with. How do you get the quality data out of the clinical system to the payer and then get those gaps in the dollar amounts associated with that back to the clinical system to then be followed up on? Payment models are demanding quality data to move faster. We need the information to be able to flow more easily so we can make important decisions on these in the new payment model.
Q: Can you expand on the link between interoperability and payment models? What does the industry need to do, and where do processes currently stand?
DJ: A lot of the data today is being manually processed: An example would be bundled payments. Much of that data is being requested in Excel spreadsheets from payers. That's a pretty big step backwards in the automation process. Collectively, we must engineer the rail road tracks that will allow us to move quality and cost data together. We're seeing a lot of innovation around this area, particularly in the ACO market. However, the question is how to do we make sure that we’re not reinventing solutions over and over again but can solve it using one common approach.
Q: There are currently a handful of new payment models, like private versus public ACOs, bundled payments and so forth. Do you predict all these new models will remain viable or will the field whittle down?
DJ: We're going to narrow down to a much narrower set of new payment models. The good news is that will also help us normalize their operations, so we're not trying to scale a multitude of different payment models. When you start looking at some of the data, not only from Medicare but also some of the data coming from private ACOs, we're learning very quickly what's working and what's not.
Q: While there isn't an endpoint to interoperability, where would you say the industry currently stands on the continuous journey and development of this type of data exchange?
DJ: We recently conducted a survey on the value of a health information exchange. We found once you get outside of the hospital system, the value of health information exchange is lower as you move toward the nonaffiliated institution. I'm a big believer that business value has to drive interoperability. You can't buy your way out of it.
At WEDI, we've developed an industry effort called the Virtual Clipboard. We have a workgroup working on a pilot using a mobile device as a swipe-in device where it reads your insurance information as part of the first phase. Over time, we see that morphing into being your personal health vault of essential information along with your insurance information and even eventually replacing the HIPAA forms and becoming a payment method. That's interoperability that's impacting the patient where they feel the most pain today — the check-in process. Interoperability is great, but if the data is bad right on the front end, what good is moving the data? As an industry, we have not gone a good job of prioritizing the use cases and value of interoperability. We don't necessarily need a home run on interoperability. We need to get on first base and prioritize the cases.
Twenty years ago we started this in the administrative arena. There's a network of data that moves relatively seamlessly across providers and payers. They built that network because there was value. People needed to get paid, and we saw the value of the data. There was no meaningful use money given to these companies to do it, though I’m sure that would have helped accelerate efforts if they had. But value drove it. Clinical data exchange needs evolve to follow a similar pathway. Let's scale forward now. Why would you want to move backward?
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