On June 9th-10th, DataMotion participated in the DirectTrust™ Summit, which hosted attendees and distinguished guest speakers from the healthcare industry. Below is an interview with Doug Rubino, DataMotion Business Development Director, Healthcare, who attended the Summit and kindly shared a quick overview of the event and some of his takeaways.
Q: Doug, we understand there was a lively “Ask Me Anything” (AMA) discussion. Could you share a bit about the topics discussed and your session takeaways?
Doug Rubino: On the topic of a healthcare provider directory, there were good questions and a related dialogue around the usability and governance components of a single directory, and its applicability to the patient and provider communities.
Another good question asked was on the topic of the usability of health information technology (HIT). The consensus was that who defines what is usable, and what is not usable, is impossible to define. Right now, is not so much certifying usability, but rather knowing that at a minimum, vendors are thinking about usability and can demonstrate such through user groups and other methods of soliciting feedback from their customers. It sounds like the following will be top-of-mind for the industry in 2021:
- Portability and patient-centric solutions
- Telehealth and virtual care
- Public health reporting and analytics
- Social Determinants of Health (SDOH) and the use of HIT to address the requirements thereof
- Patient-facing apps
There were also some excellent questions and dialogue around Trusted Exchange Network and Common Agreement(TEFCA), and collaboration among the government and private sector as we move forward. An example of this would be the implementation, and building on, the ADT Event Notifications.
Q: We’d definitely like to follow up on what’s next for ADT Event Notifications, but for now, what are some of the key takeaways that you have learned about the future of healthcare interoperability?
DR: One of the key themes of the future of interoperability is that of “closing the loop” and providing a truly seamless experience for healthcare providers, payers, vendors, and patients across the board. Over the past 25 years, there has been a tremendous amount of work and success in so many areas of interoperability. It is because of the decades of effort, we are not too far away from healthcare and related organizations, as well as regulatory bodies, becoming truly interoperable. When I say not too far away, I mean that this industry, which is really use-case driven, has considered a number of circumstances where interoperability is critical, and there is a model in mind. For instance, let’s talk about the banking industry. You are a customer at bank A, but if you use an ATM from banks B, C, D, or even E, you may still withdraw money (for a fee, of course) and see your account balances. Interoperability is really the same concept for healthcare—we want a patient, no matter where they are receiving care, to have that doctor immediately be able to pull their medical records from another care provider or organization with the same ease that the patient withdrew money from another bank’s ATM that morning for their coffee shop run.
Because of the continuing work and innovation by organizations like DirectTrust, Strategic Health Information Exchange Collaborative (SHIEC), HIEs, HISPs, and other key players in the healthcare vertical, we’re not too far away from achieving something with the same ease and at-your-fingertips information gathering as the banking model I mentioned.
Q: What are some challenges people are facing with the healthcare directories?
DR: When it comes down to basics, the challenges shared are really about three areas: governance, ownership, and the national standard. One challenge cited was about the accuracy of the data, and another challenge concerned the national standard with respect to the endpoint. For instance, one physician may list his personal Gmail address, while another may list his hospital employer, while a third physician may list a Direct Secure Messaging address. This is problematic because it may result in duplicate and overlaid values, and perhaps confusion over who to contact and how, potentially delaying care.
The usability questions mentioned earlier are also applicable with respect to patient use cases, e.g. how do we take the same national provider directory, and make it usable for a patient? While there were regulations released last year to fix some of the issues, there is still work to be done.
DataMotion, an active participant in DirectTrust, has helped with the endpoint issues in that we ensure that all listed addresses are legitimate, and by promoting the standard that the Direct address is the address at the endpoint. The actual issues, though, go beyond DirectTrust, and lie with the need to establish a true national standard, which is where TEFCA comes in.
Q: ADT (Admissions, Discharge and Transfer) notifications took effect in May. What’s next?
DR: What’s next really comes back to something I mentioned earlier—the theme of “closing the loop.” One way this is taking shape is the use of metadata (which is essentially data that gives context around other data) to better-inform the recipient organizations of the reason for a patient’s admission, discharge or transfer.
For example, a patient goes to a hospital with an ailment. After receiving the appropriate care, the patient is then discharged. That discharge notification should go to the patient’s general practitioner, any specialists, and the designated care team. But what’s next takes this a step further for an even more holistic care approach. When the patient is discharged, that notification includes the metadata that I mentioned a moment ago, providing the full context around the reason for the discharge, as well as other relevant information to the care team, so that they may follow up and continue to provide appropriate care. The anticipation is that this change will improve care coordination and thus, result in better patient outcomes.
The second part of this new aspect can go even further—particularly with those in underserved communities. The goal is to drive deeper penetration into a community via community groups and other human service organizations. Let’s take our recently-discharged patient. His GP and other caregivers have been alerted to his hospital stay, discharge, and the context around it. If our patient is in an underserved community, an outreach group will receive the notifications, and be able to arrange additional services to help with the patient outcome. For instance, securing food delivery from a local pantry, helping with transportation to appointments, and perhaps arranging a wellness check. In addition to medical care, ADT notifications will also help with satisfying basic needs surrounding the alert.
Q: Doug, as we wrap up, is there anything else you’d like to share about the conference or the future of the industry?
DR: Overall, the DirectTrust Summit was an informative and well-executed event. There were excellent panel presentations and some thought-provoking discussions. In addition to the clinical element, there was definitely a layer of inspiration, and examples of the positive change that is already coming out from all of the hard work and care in this area. One shining example of the need for a better patient experience and outcome was illustrated by a speaker, who shared her experience of being diagnosed with cancer at age 11. Now in her early twenties, she voiced how frustrating it was to have to continually share her background ad nauseum with doctors, on top of fighting her disease. Our goal for better interoperability, in short, is for the patient to focus on recovery and regaining health, and not worry about having to continually provide background information to care providers. We want to leave that aspect to the medical professionals, who should be able to access this information as easily as they withdraw cash from any ATM.
I know that I left with a lot of great new information, new perspectives, and excitement over the outstanding work being done in interoperability. There is a lot to look forward to!
Q: Doug, this was really informative, thank you for sharing your takeaways with us.
DR: It was a pleasure speaking with you, I’m looking forward to our next conversation about what’s happening in the industry, and the great innovations taking place.
We invite you to learn more about DataMotion’s Direct Secure Messaging solutions.