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5 Reasons Why Your Health IT Leader Must Embrace Real-Time Integration

The health IT leader who understands these five reasons puts their organization in an infinitely better spot than the one they found it in.

Why wouldn't a health IT leader concern themselves with real-time integration?

One reason might be that since healthcare data analytics have long been performed against claims data, which is inherently quite late, the health IT leader might not even be aware of the opportunity real-time integration represents.

Another reason might be that, since healthcare systems vary so widely from one vendor to another (the way EMRs often do), the health IT leader would have to develop a fresh approach to integration for every unique system their EMR touches, which is exceedingly difficult without a robust curated-healthcare-data platform.

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Yet another reason might be that the health IT leader is satisfied with merely having integration that's supported by a batch-oriented data warehouse, and they haven't been incentivized to investigate event-driven, real-time integration.Real-Time Integration

These are all mistakes no healthcare organization should tolerate. Here are five reasons why:

1. You're only as good as your data. If your data isn't real-time in nature, it's late. Period. Claims data doesn't come the moment an event occurs -- it comes 30-90 days later, which isn't actionable. If your data is old, your capacity to utilize it is compromised, in the same way that if your ingredients are stale, your capacity to make a fresh meal is compromised. For example, consider a care coordinator who -- as part of an effort to reduce the likelihood of their patients being readmitted too quickly -- seeks to isolate all of their patients identified as 30-day readmission risks. If the care coordinator's available data is more than 30 days old, their window of opportunity has already been lost, as some of these patients may have already been readmitted. In the future, for the care coordinator to do any better for other high-risk patients, all of that patient data must be up to date.

2. You're only as real-time as your weakest link. You have different data sources -- diagnostic data, procedure data, lab-results data, demographics data, etc. If any of those sources -- any one of them -- doesn't support real-time integration, your entire system is as weak as that non-supportive source. Take lab data -- very up to date, right? But, if you can't identify a specific patient against your global enterprise master patient index (EMPI) because it doesn't support real-time integration, it wouldn't matter how up to date that lab data is, because who knows who that data's for? Consider the example of a doctor's effort to satisfy a specific clinical quality measure -- NQF 0068, which measures the percentage of Ischemic Vascular Disease patients who use aspirin or other antithrombotics -- by providing up-to-date medication data. Even if those patients' diagnostic records are current and the doctor is capable of identifying them, some of the aspirin users might not be detected because of the latency of the non-real-time medication data, which will lead to the doctor spending unnecessary time and resources dealing with inaccurate alerts.

3. The data should be organized for slicing and dicing. In other words, if the data is normalized and disparate when you perform some analytics, de-normalizing it will require complex calculations. These will add up quickly, and the task of slicing and dicing the data so that you can squeeze additional intelligence out of it (e.g., to satisfy a clinical quality measure) will become incredibly difficult. Imagine a diabetic patient whose hemoglobin A1c (HbA1c) test result is 10% (a normal HbA1c is less than six%), but whose patient identifier is "ABC123" at the hospital at which they were diagnosed as a diabetic, and "XYZ789" at the laboratory to which their HbA1c test was sent. To successfully associate these two identifiers with one another, the patient's clinician will have to collate them under a single patient identifier by issuing a query to the EMPI. And while that may only take a few seconds, those few seconds will add up to countless hours if that process has to be repeated for hundreds or thousands of patients, which is precisely what clinical quality-measure reporting demands.

4. You can't stratify patients instantaneously without real-time integration. But with real-time integration, you can create innovative programs that harness the power of stratification and leverage the advantage of information being up to date. A doctor could (in a way that echoes an earlier example in this list) stratify their patient population into four or five risk categories and focus solely -- as the doctor receives the data -- on those patients who have been identified as 30-day readmission risks. Not only will this enable that doctor to make an instant decision about how to treat those high-risk patients, the doctor will now be empowered -- thanks to the real-time nature of the integration -- to divert any additional resources to lower-risk patients once the high-risk patients have been addressed.

5. To avoid disrupting your workflow, you should be able to handle patient data in context. And only real-time integration makes that possible. One thing I'm hearing from a lot of clinicians lately is that they don't want to curate data -- particularly the liable data that they bill from -- into their EMR because doing so would require the clinicians to curate it themselves, which is extremely time consuming. They want a separate system that provides biometrics, visualizations and curated EMR data in context, as well as the ability to quickly access an organized, filtered view of the patient's shared record via a single sign-on method, a widget on the desktop, a curated portal or some other approach that will keep the record firmly integrated into the clinical workflow. All clinicians can benefit from this level of real-time integration -- it will prevent their all-too-common impulse to forego curating patient data simply because they're too pressed for time.

The health IT leader who understands these five reasons puts their organization in an infinitely better spot than the one they found it in. While they may have their initial reasons why they haven't concerned themselves with real-time integration yet, any health IT leader who fully internalizes the five reasons above should quickly recognize the advantage it can create for their enterprise. And if you've got a health IT leader like that, take heart -- you've got a partner who's truly looking out for your business, one who recognizes the value of striving beyond "good enough" and toward a future where an essential feature like real-time integration isn't a nice-to-have, but a must-have.

Dave Bennett is EVP of product & strategy at Orion Health.

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