Unleashing The Power of Communications for Healthcare
There has been a lot of talk in Health IT circles about process automation, especially using Artificial Intelligence (AI), to accelerate tasks and bring new efficiencies to hospital operations. These appear to be demonstrating real ROI and (I hope) are beginning to make a dent in healthcare costs.
I’d like to step back and consider what is driving these advancements. At a macro level, this is all about computing power.
For consumers, there has been huge traction in health apps and wearables, along with substantial activity around the use of Personal Health Records (PHR). Big-Tech players and start-ups alike are trying to make strides here.
Photo by Luca Bravo
For healthcare delivery organizations, EHRs remain the dominant foundational technology. But new capabilities, such as AI and Analytics (with or without Natural Language Processing (NLP)), are being used to analyze a medical record in the EHR and produce otherwise difficult-to-discover data elements or insights. Another technology gaining a foothold is Robotic Process Automation (RPA)—in which the computer “learns” the keystrokes, mouse clicks, and other steps a human would take in an existing system. The computer then takes over some or all of an operation. So we are making good strides in expanding the use and value of computing power.
But what about communications power?
In other industries, computing was transformed by the internet from “intra-company islands” to a global communications revolution. The ‘killer apps’ in B2B communications were initially email, file sharing, and chat. Later, it was CRM followed by hyper-connected communication and collaboration apps such as Slack, Microsoft Teams, and Google Workspace.
If any person in business needs to communicate with any other person, they only need an email address. Text via mobile phones is also an initial enablement technology. In both cases, the addresses (or phone numbers) are unique and serve as a digital identity bridge. Both have become foundational in B2B communications and serve as “pre-existing infrastructure” for CRM and subsequent advances for the more sophisticated communications and collaboration capabilities mentioned above.
But clinical healthcare cannot rely on these simple tools without running afoul of regulations governing the sharing of protected health information (PHI) between healthcare providers. It is bad enough that email and texting are out of the question for healthcare PHI communication at a national scale, but without them, or something analogous, there can be no other more advanced communication and collaboration that operate ubiquitously. Put another way, in industries outside of healthcare, each person needs only to satisfy two requirements to digitally collaborate outside of their organization:
Have a digital address (email/phone) or comprehensive and accurate directory to locate any person (or organization) with whom they want to communicate. I call this the ‘directory problem’—how to accurately name and locate any healthcare recipient digitally.
Decide how much private, sensitive, or secret information they want to share with the recipient. This is the ‘privacy problem’—determining whether the communications channel and the technology at both ends are secure enough and whether the receiving party has an appropriate level of trust.
Healthcare organizations do not enjoy any ubiquitous method of digital communication that can reach the vast majority of external clinicians or provider organizations. It's not just that email or texting have been unavailable for clinical communication nationwide. Nothing more advanced works as intended due to identity, privacy, security, and regulatory requirements that are too complex for one organization to solve on its own.
The Direct Protocol, for example, was set up to address many directory and privacy issues, and it is an outstanding standard. Direct is especially good at proving and binding the identity of individual recipients, like doctors, and where it is being used, it can be leveraged as part of a more expansive and reliable system. Unfortunately, most clinical communication is not doctor-centric, it is patient-centric, or addressed to a workflow, or managed by a clerical staff, or part of another business process or care pathway. And, though Direct is technically available in every certified EHR, in practice, it is not functional for the majority of healthcare practices in the country due to the variable capabilities of the EHRs. For example, among the top 5 EHRs, some will reject the message portion of a Direct message. Most will process the attachment only if it is one of several particular CCDA types. All have different rules and file types and communication capabilities.
All of this is why healthcare organizations have previously relied on point-to-point setups between collaborating organizations. Still, this strategy can’t work at a national scale between providers without pre-existing relationships. Regional HIEs have met some success, and national exchange collaboratives are attempting to expand reach, but none of them solves either the Directory problem or the privacy problem across the board. And none provides reliable delivery in the same sense that email or texting do—if something is sent by email or text, it will be delivered well over 99% of the time. So, U.S. healthcare has a “delivery problem.”
Fortunately, this is now changing—and rapidly.
At careMESH, for example, we transcend these limitations by solving the directory problem, privacy problem, and delivery problem. We provide the baseline infrastructure for any-to-any communications, along with advanced care team collaboration and analytics capabilities. Achieving this meant building the needed foundational technologies:
National Provider Directory - Available via upload or API and including 5.2M individual clinicians and over 100K healthcare organizations.
Cloud-Based Infrastructure - To ensure best-in-class reliability and information security both in transit and at rest.
Healthcare-Grade Security - careMESH meets and exceeds federal and state security and privacy regulations, and has best-in-class security, identity proofing, authentication and rigorous security to ensure transactions are trustworthy.
Delivery Management - To every U.S. practitioner and provider organization; including all file types such as notifications, notes, CCDAs, medical records, images, workflow elements, and more.
Recipient Preference Options - All careMESH recipients set their own preferences for how messages are handled, who should receive them, to which workflow address or other delivery channel, etc.
Interoperability & APIs - We work with Epic, Cerner, MEDITECH, and VistA, as well as ambulatory EHRs. The intuitive careMESH U/I acts as a universal backup with a message and patient record viewer for all users.
Automated Workflows - Notifications and processes that expand communications beyond the capabilities and reach of the EHR.
Reporting & Analytics - Include message delivery reports, usage trends, and other analytics to drive resource- and revenue planning.
There was a lot of discussion about digital transformation at HIMSS21 last week in Las Vegas, and it is not for the faint of heart. But truly transformative tools to help us realize national data exchange, telehealth, and better patient engagement require secure and ubiquitous communications across healthcare.
CRM systems and robust analytics, as well as simpler requirements like task sharing, collaboration, and workflow management are not possible in clinical healthcare without opening our arms to reliable, safe, and compliant communication. Then, healthcare can finally become a modern, digital industry.
Would love to hear your comments and feedback — send me an email anytime.
Peter