Patient 360: Bringing Disparate Information into One View

Individual-centered care is the radical idea that a patient’s input should be an integral part of the care team. It’s a concept that appears self-evident and a necessary construct at first glance, but it’s also revolutionary when compared to the context of our systemic-based healthcare environment.

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A look at the top six funded healthcare value propositions in 2017 revealed that consumer health information led the list. The interest in health data and how to make the best use of it stems from the fact that this information provides the opportunity for patients to take charge of their own healthcare experience — and also for practitioners to have a window into the patient’s condition. It’s a window that aids both in the care of an individual patient and provides a panorama into the population as a whole.

A New Definition for Patient Zero

Analytics now offer the opportunity for each individual patient to live at the gravitational center of their own healthcare universe. The frequency and types of data that can be collected are immense. From electronic health records (EHRs) to wearables to payer systems, the raw information is there to model the exact nature of a patient’s healthcare experience, not only where it has been but where it is heading.

As an example, think of a patient with diabetes as the center hub of a wheel. One spoke is a sensor collecting real-time glucose levels. Another spoke is the patient health record that receives wireless data from the sensor. A third spoke is the analytics processing the information, looking at blood sugar spikes in comparison to the patient’s history and contrasting with trends from the diabetic population as a whole. Other spokes include the primary care physician, specialists and hospitals that refine the care plan based on this information. But through all of this, the patient remains at the center. They have complete visibility into their own health, they have fluid communication with everyone connected to their care, and they are a very active participant in their own healthcare decisions.

Interoperability Turns the Wheel

The only way this wheel of patient-centered care can maintain its integrity is if each spoke is sharing patient data seamlessly and without restriction. Bottlenecks currently exist in the form of vendors locking their “piece” of a patient away in proprietary systems. Survey data actually suggest that interoperability issues are a significant area of worry for half of the respondents.

To effectively clarify a 360-degree view of a patient and empower the patient to use this view to build better health, an open-source environment must be used in every single technology that is connected to the sphere of healthcare. Currently an effective, open-source platform is Substitutable Medical Applications and Reusable Technologies (SMART), combined with Fast Healthcare Interoperability Resources (FHIR). SMART was developed by and is run out of Boston Children’s Hospital Computational Health Informatics Program and the Harvard Medical School Department of Biomedical Informatics. The FHIR health information exchange standard is being developed by Health Level Seven International. These types of open technologies will enable fast deployment of care best practices across intersecting areas of healthcare.

Patient-Centricity Is a New World

Beyond interoperability, the 360 patient also presents some additional considerations. The new transparency afforded to patients could lead them to question the recommendations of their clinicians. But it can also lead to greater trust, as patients can have a better understanding of the driving forces behind important medical decisions. One of the biggest advantages of patients now accessing their own analytics-refined data is that they can see how each of their decisions affects their own health. When they understand the “why” behind a healthy lifestyle choice, they are much more likely to take a step in that direction.

And when third-party applications are anchored to a singular platform and connected to a patient’s EHR, clinicians gain a full view of patient’s longitudinal record including behavioral data, socioeconomic data and more. That’s why data-driven analytics may be what everyone is thinking today, but maybe we should all think in terms of patient-driven analytics as the foundation for healthier, happier and more engaged patients. This should be the ultimate destination where analytics is headed in the future.

Harshal Shah is senior director of healthcare for Persistent Systems. He has spent more than a decade in the healthcare industry, working to define strategies and design informatics solutions for digital health enterprises focused on next-generation informatics. Follow him on LinkedIn and Twitter.

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