Integration Station - Episode 2

SHOW NOTES

In this episode of MST Solutions’ Integration Station podcast, we have a quick discussion with our VP of Health Care and Life Sciences, Venkat Elapully. 

Venkat breaks down what interoperability is, the patient and provider needs and CMS (Centers for Medicare and Medicaid Services) directives that are leading major health care organizations and insurance companies to embrace interoperability technology. In addition, we discuss the measurable benefits, logistical challenges with implementation, and where technologies like Vlocity Health and the Salesforce ecosystem can greatly reduce time to value. 

HIGHLIGHTS
  • “Interoperability basically defines the standards and APIs, where the patient data can be accessed across [EHR’s].”
  • “CMS is mandating that patients should have access to his own information.” 
  • “There’s a lot of disparity between standards for the different EHR’s that organizations are using.” 

 

RESOURCES
Transcript

Jennifer Capestany: Good afternoon and welcome to our second episode of MSTs Integration Station. We’re taking another deep dive into healthcare industry– one of our major verticals. Joining me today is our VP of healthcare practice, Venkat Elapully. And we’re going to be focusing just for a short while on interoperability – basically creating a 360-degree view of the patient for better care. 

Jennifer Capestany: But I want to start with a look into what interoperability really means. It seems like such a big buzzword. What are the different aspects around what people think of, Venkat, when they say interoperability in health care? 

Venkat Elapully: Interoperability basically defines the standards and APIs, where the patient data can be accessed across [EHR’s]. So, at end of the day, as a patient, I need to have access to my own data. And then if I am going to change my insurance guy, I should be able to take my data, whatever I have on my health history, and then go to the new insurance company and say, this is what my data is, rather than redoing every test and everything that has been done by the previous insurance company thereby reducing the cost. 

Venkat Elapully: So, if the insurance carriers can freely exchange data amongst them regarding the patient, then that could transform to better patient care and at the same time, reducing the costs because the data for the particular patient is already available.  

Jennifer Capestany: Got it. So, I feel like there’s actually a few drivers there. So, it leads me to my next question, because I hear in your answer patient empowerment, but I also hear streamlined costs, information where it’s needed, when it’s needed across systems. Can you tell me a little bit about what are those driving factors behind why so many health organizations are pushing towards interoperability technology into their systems? 

Venkat Elapully: So, this is coming from the CMS mandate. And then CMS is mandating that patients should have access to his own information, right? It is not that the insurance company is pushing for that now that CMS is mandating, so every insurance carrier needs to develop make sure this particular patient information is available in a format called “Standards” which is the HL7’s standards, which basically FHIR stands for Fast Healthcare Interoperability Resources. 

Venkat Elapully: And then CMS has provided some implementation guide. And the standard, so how this needs to be implemented. So basically, these are the APIs that needs to be implemented by each and every insurance carrier so that the patients can have access to their own data. So that’s the major push coming from the CMS. 

Jennifer Capestany: Right, and to bring it into technology- one of the easy ways that we’ve been formulating solutions around this problem is with some of Salesforce Vlocity’s out of the box features, which I think is helping to streamline implementation of that technology and one of the things, our team found was that there was a lot of disparity between standards for the different EHRs that organizations are using. 

Jennifer Capestany: Does technology have a good answer for that? It didn’t seem to up to now, what do you think now? 

Venkat Elapully: Yeah. So now that we have standards defined like FHIR standards defined by CMS, so, every health payer will expose the patient data in the form of a FHIR API which we can access and then load it into any EMR system that the new hospital has. So basically, it is a standard claims systems or health systems and different EMR systems where you can access the patient data from a different EMR into this CMR, we can upload it and then we can have a single view of the patient. 

Jennifer Capestany: So even if one organization has standardized to HL7 FHIR and another hasn’t, through the technology that we’ve been developing using Salesforce Vlocity, that doesn’t actually matter, doesn’t it?  

Venkat Elapully: Yeah, the system is able to take this information from different EHRs, reformat it to the standard that’s needed and then plop it where it needs to go. 

Jennifer Capestany: So, it seems like there’s a lot of exciting applications around that.  

Venkat Elapully: Yep. Exactly. 

Jennifer Capestany: Pretty cool. I think that it’s probably a pretty good stopping point here. And hopefully we can get you to join us on a different episode to break down some more of these different pain points and challenges around healthcare and the drive to use technology to really improve lives, not just on the patient side, but also the payer provider side. So, thank you Venkat very much. 

Venkat Elapully: Thanks, Jennifer. 

Jennifer Capestany: All right. And as always, if you have any questions at all to the viewers and the listeners, just send those over, either use the comment box or the comments section below, and we will get back to you with an answer. Thank you. 

Questions? Ask them here, and we'll do our best to answer.