The Challenges with Interoperability in the Healthcare Industry
Lack of interoperability causing barriers to the exchange of information across the Healthcare system has been a systemic issue for a long time. The Fast Health Interoperability Rules (FHIR) released by CMS coupled with the ongoing global pandemic has brought a sharp focus on this issue and forced the Healthcare System to finally reach for the holy grail of Interoperability. It is expected that the implementation of FHIR will foster deep integration of clinical, financial, administrative, and other data across the ecosystem driving a Longitudinal Patient Record, and finally providing patients the ownership of their health data. We believe such an interoperability will drive data transformation inside-out leading to an insight driven care system. An increasingly Interoperable world also means the advent of AI Avatars, advanced analytics with real time decision making, resulting in a deeper understanding of a patient’s clinical conditions, better treatment coordination & protocols, and improved access to care while reducing cost of care.
Interoperability is also an important tool facilitating measuring quality of care outcomes and driving member centricity through Longitudinal Patient Records. Today’s fragmented health system makes it difficult to achieve a longitudinal patient view often leading to a lack of holistic understanding of a patient’s health journey. An estimated 85% of hospitals have FHIR in their systems, but the benefits of using core data sets still remains a holy grail. It is also well known that the data landscape of Payers tends to be heterogeneous and hence there is no easy way of generating extracts dynamically for regulatory purposes as well as for business insight on cost and quality of care. With the focus shifting to Value Based Care, outcomes reporting and benchmarking against prevailing standards has becoming very important. FHIR helps the Health payers and regulators alike obtain aggregated clinical datasets across multiple providers for predictive modelling to understand care gaps and medical management in real time.
Capgemini’s Smart FHIR and LPR for Healthcare
Capgemini has leveraged FHIR by developing data integration wrappers integrated with Cloud based data lakes to solve core Healthcare business problems such as better understanding of Cost and Utilization, Care Gaps, Medical Management etc. Our solution helps in accelerating the payer’s journey towards implementing advanced health informatics with a scalable architecture at its core.
Capgemini’s FHIR solution has the ability to accelerate FHIR interoperability implementation by 30% as opposed to using platform-based approaches, which in the longer run may introduce additional heterogeneity in a payer data landscape that is already siloed.
For the most part, FHIR is looked at as an interoperability standard. At Capgemini, our solution is tailored with an objective of being more than an exchange standard, and a regulatory compliance mandated by CMS. Our framework coupled with our deep Healthcare domain expertise, uses FHIR as a mechanism to achieve insights and data platform innovation and a lever to fostering Digital Health.
Capgemini’s data centric FHIR solution enables Health payers to ensure patients’ access to their health data in real time and in a secure manner, enables clinicians to get a comprehensive picture of the patient health journey, and achieves regulatory compliance with the new CMS mandate. Our FHIR solution also facilitates rapid implementation of LPR and drives innovation in assembling data lakes and AI applications on the fly. The data domains that are brought together relate to a Patient’s condition, medication, care plan, procedure, observations, encounter history and demographics. Our solution is capable of integrating SDOH data, creating a holistic understanding of a patient and changing the traditional care delivery paradigm.
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