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    The challenges of data-sharing in value-based care

    Industry insider Q&A

    As Medicare and private payers move toward more value-based care reimbursements, physicians need information to both accurately report data and monitor complex patients across multiple providers. But with interoperability still years away, doctors often struggle to get the information they need. Physicians face many challenges when it comes to tracking quality data and finding solutions for getting the information needed even when technology isn’t compatible.


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    Medical Economics spoke with Nancy Pratt, a 20-year healthcare industry veteran and chief operating officer of AirStrip, a company that works on mobile interoperability solutions, about the challenges doctors face in tracking data across the healthcare industry.


    Medical Ecoomics: What are the biggest technological challenges facing physicians at smaller practices as the industry moves toward value-based care and the data tracking/reporting it requires?

    Nancy Pratt: Health IT innovations have been uneven in their geographical penetration, putting smaller practices with limited resources or breadth of influence at a distinct disadvantage. While many larger health systems in urban areas have access to smart predictive analytic platforms and data aggregation tools that will help them succeed in the transition to value-based care, many smaller, rural practices will struggle to keep pace because of their limited access to the latest health technology.


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    The value-based care transition poses a difficult question for practices of all sizes: who will fund and conduct this additional data collection and quality reporting, particularly as many care teams are already at their bandwidth? Evolving guidelines and requirements – such as MACRA – will improve how we deliver care, but may add to current reporting requirements, administrative burden and cost as we first implement them, further stretching small practices to their limits. Even while physicians rely on electronic health records (EHRs) to help report all this data, physicians view these systems as largely inadequate, and too much of a physician’s day is spent on data entry. Consequently, smaller practices will feel an amplified version of the challenges that larger health systems are working to overcome.


    ME: What are the obstacles to tracking patient data when a medically complex patient is crossing through various doctors’ offices and health systems?

    NP: Health systems across the country have spent valuable resources on implementing EHRs that have yet to fulfill their promise of uniting the disparate pieces of the care continuum. In some places, patients experience truly integrated care delivery. If they have an acute care encounter, then an outpatient procedure, and finally a diagnostic procedure, the care team has access to their respective information throughout the care episode. However, that is not the reality for everyone. Healthcare is still primarily a cottage industry of products, patching things together as they can.

    For example, consider a patient with pneumonia. Each of the patient’s multiple interactions with the healthcare system are recorded separately, including doctor’s visits, a radiology visit for a chest x-ray, a trip to the pharmacy, and so on. While common sense would encourage one grouping under the common denominator of pneumonia, health systems across the country have mostly been unable to do so. MACRA encourages providers to link these care episodes and related data, and rewards those who are able to expose and mend care inefficiencies.  

    The shift to value-based care ultimately aligns with patient-centric care. However, many practices are unable to access a patient’s data when needed to make quick, informed care decisions. Therefore, while patients have choices in their own care, many health systems are struggling to match expectations due to the difficulty in accessing a complete picture of the patient.

    Next: Will doctors ever see true interoperability?

    Todd Shryock
    Todd Shryock, contributing author


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