1 00:00:00,015 --> 00:00:00,765 - Hello everyone. 2 00:00:00,795 --> 00:00:03,325 This is Erica Spicer Mason with Becker's Healthcare. 3 00:00:03,535 --> 00:00:05,525 Thank you so much for tuning into the Becker's 4 00:00:05,525 --> 00:00:06,765 Healthcare podcast series. 5 00:00:07,375 --> 00:00:09,885 Today I'm pleased to be joined by Brian Dros Deitz, 6 00:00:10,225 --> 00:00:13,045 the Senior Vice President and General Manager of Acute 7 00:00:13,045 --> 00:00:15,125 and Payer Markets at PointClickCare. 8 00:00:15,815 --> 00:00:18,165 Today, we'll discuss interoperability models, 9 00:00:18,665 --> 00:00:19,965 how they've evolved over time, 10 00:00:20,065 --> 00:00:21,925 and the effect that they're having on the care 11 00:00:21,925 --> 00:00:23,045 that patients receive. 12 00:00:23,995 --> 00:00:26,165 With that, Brian, welcome to the podcast. 13 00:00:26,295 --> 00:00:27,885 Thank you so much for being with us today. 14 00:00:28,525 --> 00:00:30,985 - Thanks for having me, Erica. Thrilled to be here today. 15 00:00:32,045 --> 00:00:33,345 - Really happy to have you on. 16 00:00:33,485 --> 00:00:36,105 And before we get into our discussion, would you like 17 00:00:36,105 --> 00:00:38,425 to share just a little bit more about yourself, your role, 18 00:00:39,145 --> 00:00:40,745 whatever you'd like to share with our listeners? 19 00:00:41,415 --> 00:00:43,465 - Sure, sure. Happy to just set a little context. 20 00:00:43,725 --> 00:00:47,065 So, uh, I, I oversee the hospital 21 00:00:47,085 --> 00:00:49,945 and health plan business at PointClickCare. 22 00:00:50,525 --> 00:00:51,665 Uh, that's a business 23 00:00:51,665 --> 00:00:54,305 that PointClickCare has built up over time here. 24 00:00:54,765 --> 00:00:58,865 Uh, essentially a nationwide care coordination network, uh, 25 00:00:58,975 --> 00:01:02,305 that is entirely underpinned by interoperability. 26 00:01:02,685 --> 00:01:04,105 Uh, so today we're connected 27 00:01:04,105 --> 00:01:06,625 to more than 3,100 hospital systems. 28 00:01:07,285 --> 00:01:10,465 Uh, we have roughly the same footprint in the ambulatory 29 00:01:10,475 --> 00:01:11,505 space, uh, 30 00:01:11,565 --> 00:01:14,785 and we're working with more than 200 different risk 31 00:01:14,785 --> 00:01:15,905 risk-bearing providers. 32 00:01:16,285 --> 00:01:18,105 Uh, on the health plan side, we're working 33 00:01:18,105 --> 00:01:22,425 with every major plan, uh, across all their key markets, uh, 34 00:01:22,485 --> 00:01:24,825 and again, really driven by interoperability. 35 00:01:26,275 --> 00:01:27,845 - Fantastic. Thanks so much, Brian, 36 00:01:28,225 --> 00:01:30,565 and really appreciate the overview of PointClick Care 37 00:01:31,185 --> 00:01:33,565 and mentioning that it's essentially a nationwide 38 00:01:33,635 --> 00:01:35,005 care coordination network. 39 00:01:35,915 --> 00:01:38,765 It's hard to hear the term care coordination anymore without 40 00:01:38,765 --> 00:01:41,005 talking about or hearing about interoperability. 41 00:01:41,265 --> 00:01:42,965 So, um, to start off, 42 00:01:43,045 --> 00:01:45,325 I was wondering if you could tell us just a little bit about 43 00:01:45,425 --> 00:01:47,925 how initiatives to improve interoperability 44 00:01:47,985 --> 00:01:49,245 across the healthcare industry. 45 00:01:49,745 --> 00:01:50,845 How have they shifted over time? 46 00:01:52,185 --> 00:01:54,955 - Yeah, so I'm, I've, uh, I've seen, 47 00:01:55,105 --> 00:01:56,395 seen this movie a few times 48 00:01:56,535 --> 00:01:59,115 and have been, been around the block having been in the, 49 00:01:59,215 --> 00:02:01,675 the industry for 20 plus years. 50 00:02:02,015 --> 00:02:05,595 And it's been amazing to see the progress over time. 51 00:02:06,015 --> 00:02:08,075 You know, those that, uh, have not been around 52 00:02:08,135 --> 00:02:11,555 as long would, would still probably lament with, uh, 53 00:02:11,905 --> 00:02:14,155 with all the challenges that, that we see. 54 00:02:14,615 --> 00:02:18,395 Um, you know, really interoperability has been a journey 55 00:02:18,535 --> 00:02:20,195 for this industry as a whole. 56 00:02:20,205 --> 00:02:24,635 Going way back, uh, to, you know, what, what were best 57 00:02:24,635 --> 00:02:25,795 of breed EMRs. 58 00:02:26,255 --> 00:02:28,355 Uh, there's been massive consolidation there. 59 00:02:28,865 --> 00:02:32,635 There's been, uh, quite a bit of different policy that 60 00:02:32,665 --> 00:02:35,395 that has been, uh, put in place as well. 61 00:02:35,815 --> 00:02:39,555 Policy, I think, has really helped to raise the bar around 62 00:02:40,215 --> 00:02:42,275 interoperability and data sharing. 63 00:02:42,415 --> 00:02:44,955 And, you know, while, while that has been in the mix, 64 00:02:45,175 --> 00:02:46,435 you know, call it the free market 65 00:02:46,775 --> 00:02:50,955 and, um, uh, a whole variety of other different types 66 00:02:50,955 --> 00:02:53,675 of data sharing programs have, have come up. 67 00:02:54,175 --> 00:02:56,755 You know, when we think about interoperability today, 68 00:02:57,175 --> 00:03:01,205 we typically see the, the HIE space as really one of the, 69 00:03:01,225 --> 00:03:03,125 the key spaces, and that is one, 70 00:03:03,465 --> 00:03:05,685 the health information exchange, uh, market. 71 00:03:05,715 --> 00:03:09,125 That that is one that we participate in quite a bit, 72 00:03:09,505 --> 00:03:11,045 and that is evolving. 73 00:03:11,195 --> 00:03:14,405 It's, it's evolved tremendously over the past 10 years 74 00:03:14,425 --> 00:03:18,285 and certainly has its, uh, its benefits and its challenges. 75 00:03:18,745 --> 00:03:19,925 You know, as we look forward, 76 00:03:19,935 --> 00:03:22,605 there are some new things happening as well with, uh, 77 00:03:22,665 --> 00:03:24,285 new policy that's coming out as well. 78 00:03:24,425 --> 00:03:28,285 So, uh, really interesting time where, uh, all 79 00:03:28,285 --> 00:03:30,005 of these different interoperability 80 00:03:30,105 --> 00:03:31,925 models continue to evolve. 81 00:03:33,325 --> 00:03:34,945 - Thanks so much for the overview, 82 00:03:35,285 --> 00:03:37,145 and it's interesting how you bring up 83 00:03:37,145 --> 00:03:40,185 that piece about policy, kind of helping to raise the bar 84 00:03:40,245 --> 00:03:43,585 or accelerate some of these efforts toward interoperability. 85 00:03:43,705 --> 00:03:45,745 I think that's such an important, uh, 86 00:03:45,745 --> 00:03:47,145 historical point to make. 87 00:03:47,925 --> 00:03:49,785 And so considering the history 88 00:03:49,805 --> 00:03:51,585 and kind of where we've, how far we've come 89 00:03:51,735 --> 00:03:55,545 with interoperability, what new models can we expect 90 00:03:55,565 --> 00:03:57,425 to see emerge in the near future? 91 00:03:58,245 --> 00:03:59,425 I'd love to hear your thoughts on that. 92 00:03:59,575 --> 00:04:02,145 - Yeah, so, so centering back to that point 93 00:04:02,145 --> 00:04:05,905 around health information exchange, there is a, a, 94 00:04:06,065 --> 00:04:10,545 a new model, uh, that has come out, uh, policy driven, uh, 95 00:04:10,655 --> 00:04:14,225 it's referred to as, uh, TECA, uh, which stands 96 00:04:14,245 --> 00:04:17,105 for Trusted Exchange Framework and Common Agreement. 97 00:04:17,655 --> 00:04:21,585 This is really a new foundation in, in a version two 98 00:04:21,645 --> 00:04:22,665 or a version three 99 00:04:22,725 --> 00:04:26,385 of call it nationwide healthcare Interoperability, where 100 00:04:27,135 --> 00:04:29,985 whereby the policy is putting a bunch 101 00:04:29,985 --> 00:04:33,105 of foundational fundamental elements in place 102 00:04:33,695 --> 00:04:37,785 that will allow for much broader, uh, inconsistent 103 00:04:38,005 --> 00:04:42,985 and timely data exchange between, uh, payers and providers. 104 00:04:43,445 --> 00:04:46,625 Um, you know, it's, it's interesting to watch as this has, 105 00:04:47,245 --> 00:04:49,625 um, you know, it's still very early days 106 00:04:49,645 --> 00:04:53,385 and it, it is expected that it, it'll be, um, you know, 107 00:04:53,465 --> 00:04:56,465 a long on ramp till, till we get all 108 00:04:56,465 --> 00:04:58,185 of the expected value out of this. 109 00:04:58,325 --> 00:05:01,265 But in, in a lot of ways, uh, you know, it, 110 00:05:01,285 --> 00:05:04,545 it may have been, may even be viewed as burdensome by a lot 111 00:05:04,545 --> 00:05:06,985 of the, the folks that are operating, um, 112 00:05:07,085 --> 00:05:08,265 and sharing data today 113 00:05:08,265 --> 00:05:10,025 because there are new standards, 114 00:05:10,045 --> 00:05:11,865 new standards are difficult to implement. 115 00:05:12,365 --> 00:05:15,865 Uh, they're timely or, uh, costly, timely, uh, 116 00:05:16,165 --> 00:05:18,025 and, uh, resource intensive. 117 00:05:18,765 --> 00:05:22,665 But really this, uh, this new framework should set the stage 118 00:05:22,695 --> 00:05:26,785 with time for, um, a much more open market where, 119 00:05:26,785 --> 00:05:29,865 where data is far more available, timely 120 00:05:29,865 --> 00:05:33,865 and higher quality, uh, to those that are, uh, paying 121 00:05:33,925 --> 00:05:37,425 for care and, uh, ultimately administering the care. 122 00:05:37,965 --> 00:05:41,865 So early days for, for this framework, you know, we are, uh, 123 00:05:41,865 --> 00:05:44,225 we're, we're, we're tracking it closely, uh, 124 00:05:44,605 --> 00:05:46,505 and really interested to see 125 00:05:46,725 --> 00:05:50,185 how this will actually impact some of the major challenges 126 00:05:50,185 --> 00:05:51,785 that we see out in the market today. 127 00:05:52,045 --> 00:05:53,905 Uh, certainly early days right now. 128 00:05:53,965 --> 00:05:56,425 So I think, you know, some of those proof points are, 129 00:05:56,845 --> 00:05:59,805 are early stage, but, uh, we'll be very interesting to see 130 00:05:59,825 --> 00:06:01,805 how that, how that evolves. 131 00:06:03,445 --> 00:06:05,875 - Definitely exciting to consider 132 00:06:05,975 --> 00:06:08,835 how this could really change payer 133 00:06:08,895 --> 00:06:12,035 and provider collaboration, care delivery quality. 134 00:06:12,135 --> 00:06:13,395 You know, so many things come to mind. 135 00:06:13,935 --> 00:06:15,915 Sounds like we're in that growing pain stage, 136 00:06:15,935 --> 00:06:19,635 as you mentioned, but, um, in time it'll be fascinating 137 00:06:19,635 --> 00:06:20,755 to see how this all develops. 138 00:06:20,895 --> 00:06:23,035 So appreciate you highlighting all of that. 139 00:06:24,195 --> 00:06:26,695 So kind of bringing this back to, well, 140 00:06:26,695 --> 00:06:29,295 I know I said earlier, care coordination, it's hard 141 00:06:29,295 --> 00:06:31,455 to talk about that without talking about interoperability, 142 00:06:31,715 --> 00:06:34,055 and it's hard to talk about care coordination also without 143 00:06:34,055 --> 00:06:37,295 talking about value-based care nowadays, which is something 144 00:06:37,295 --> 00:06:39,135 that we know a lot of payer organizations 145 00:06:39,235 --> 00:06:40,895 and provider organizations are 146 00:06:40,895 --> 00:06:42,695 really shooting for right now. 147 00:06:43,275 --> 00:06:44,855 So how can everything 148 00:06:44,855 --> 00:06:46,855 that we've discussed really impact the ability 149 00:06:46,875 --> 00:06:48,415 to advance value-based care? 150 00:06:49,045 --> 00:06:51,695 - Yeah, it's, it's been a fascinating journey to see 151 00:06:51,715 --> 00:06:53,815 how value-based care has evolved 152 00:06:54,315 --> 00:06:58,535 and how the availability of data has in a lot of cases 153 00:06:59,125 --> 00:07:02,615 made or broken ultimately success in those, 154 00:07:02,615 --> 00:07:05,455 in those value-based care, uh, arrangements. 155 00:07:05,595 --> 00:07:08,095 So, uh, again, dating myself a little bit, 156 00:07:08,095 --> 00:07:12,615 but the early stage shared savings ACOs that go back 10, 157 00:07:13,155 --> 00:07:15,095 12 plus years back, 158 00:07:15,725 --> 00:07:18,575 they were hugely challenged in getting data 159 00:07:19,075 --> 00:07:20,215 to make the right decision 160 00:07:20,235 --> 00:07:21,855 for the right patient at the right time. 161 00:07:22,395 --> 00:07:23,575 Uh, because a lot 162 00:07:23,675 --> 00:07:26,255 of these different interoperability standards weren't in 163 00:07:26,255 --> 00:07:28,975 place, uh, you know, certain vendors weren't open 164 00:07:28,995 --> 00:07:30,055 to sharing data. 165 00:07:30,805 --> 00:07:34,735 Formats of data were, were, um, you know, difficult to map 166 00:07:34,795 --> 00:07:35,815 and to normalize. 167 00:07:36,315 --> 00:07:37,575 Uh, so, you know, what, 168 00:07:37,575 --> 00:07:40,375 what would show up in one system would show, uh, 169 00:07:40,475 --> 00:07:43,015 in the format which it showed up would be entirely different 170 00:07:43,035 --> 00:07:44,575 in a, uh, in a different system. 171 00:07:45,075 --> 00:07:48,815 Um, all of these different, uh, you know, policy changes 172 00:07:49,445 --> 00:07:52,895 that have pushed towards, you know, greater standards and, 173 00:07:52,895 --> 00:07:57,055 and more interoperability, uh, between, uh, vendors and, 174 00:07:57,075 --> 00:07:59,495 and different constituents in the, uh, 175 00:07:59,635 --> 00:08:02,295 in the value stream here, uh, ha have, have, 176 00:08:02,295 --> 00:08:04,815 have really pushed to, to open the doors. 177 00:08:05,755 --> 00:08:09,855 You know, again, dating myself a bit, the, the, the ACOs 10 178 00:08:09,855 --> 00:08:13,615 or 12 years ago had a really difficult time getting their 179 00:08:13,615 --> 00:08:16,935 hands on understanding anything that happened 180 00:08:16,935 --> 00:08:20,575 with the patient outside of the walls of their facility, uh, 181 00:08:20,835 --> 00:08:23,055 or, uh, if they're fortunate enough to be in a, a, 182 00:08:23,175 --> 00:08:26,015 a larger sort of regional system, what happened 183 00:08:26,015 --> 00:08:27,255 outside of that regional system. 184 00:08:27,275 --> 00:08:30,815 But when you think about, uh, having to see specialists 185 00:08:31,555 --> 00:08:34,055 or seeing perhaps, uh, uh, 186 00:08:34,175 --> 00:08:37,775 a physician while you're on vacation outta state visibility 187 00:08:37,925 --> 00:08:40,655 into all of, all of the care that put 188 00:08:40,655 --> 00:08:44,095 and should happen was, was, was not possible. 189 00:08:44,605 --> 00:08:47,255 With the advent of these programs, 190 00:08:47,585 --> 00:08:51,095 we've certainly seen greater incentives for organizations 191 00:08:51,155 --> 00:08:54,135 to share, and now it's, it's really table stakes. 192 00:08:54,595 --> 00:08:56,765 Um, as I mentioned, we're, we're working 193 00:08:56,795 --> 00:08:59,845 with more than 200 different ACOs today, 194 00:09:00,525 --> 00:09:04,205 ultimately facilitating that data share what, what that, 195 00:09:04,475 --> 00:09:07,605 what that allows is really to make the right decision 196 00:09:07,665 --> 00:09:09,285 for the patient at that point in time. 197 00:09:09,905 --> 00:09:12,565 Um, and once that care is given, also ensuring 198 00:09:12,565 --> 00:09:15,365 that the right next thing happens, uh, and 199 00:09:15,365 --> 00:09:18,765 because we are facilitating that, that data share, we're, 200 00:09:18,765 --> 00:09:20,325 we're able to then sort of check the box 201 00:09:20,395 --> 00:09:23,765 that the right thing did happen, um, which all maps back 202 00:09:23,765 --> 00:09:26,845 to quality measures, which are, uh, just a huge underpinning 203 00:09:26,845 --> 00:09:28,325 of any value-based care program. 204 00:09:28,545 --> 00:09:30,925 So, um, you know, in short, 205 00:09:31,345 --> 00:09:33,645 the data sharing interoperability 206 00:09:34,265 --> 00:09:36,885 and uh, really having that full visibility 207 00:09:36,985 --> 00:09:41,165 of patients across the entirety of the spectrum of all, 208 00:09:41,265 --> 00:09:44,685 all healthcare services is absolutely necessary 209 00:09:44,945 --> 00:09:47,725 for success in a value-based care arrangement. 210 00:09:48,675 --> 00:09:50,205 - Yeah. Thanks so much, Brian. 211 00:09:50,335 --> 00:09:52,005 Appreciate that explanation 212 00:09:52,345 --> 00:09:57,045 and also how you highlighted the importance of serving 213 00:09:57,605 --> 00:10:00,005 patients at a point in time delivering, 214 00:10:00,325 --> 00:10:02,365 I think it was delivering the right care at the right point 215 00:10:02,365 --> 00:10:04,125 in time, uh, paraphrasing, 216 00:10:04,265 --> 00:10:08,045 but it's incredible to think about the possibilities 217 00:10:08,115 --> 00:10:10,885 that could come from that being the standard 218 00:10:11,225 --> 00:10:13,445 or, um, the norm across healthcare. 219 00:10:13,745 --> 00:10:16,085 So really appreciate all of the insights 220 00:10:16,505 --> 00:10:19,405 and historical context and framing for interoperability. 221 00:10:19,905 --> 00:10:22,325 Um, Brian, thanks again for giving us your time today. 222 00:10:23,425 --> 00:10:25,215 - Happy, happy to be here. Thanks for having me. 223 00:10:26,465 --> 00:10:28,395 - We'd also like to thank our podcast sponsor 224 00:10:28,695 --> 00:10:30,635 for today's episode point, click Care. 225 00:10:31,215 --> 00:10:33,435 You can tune into more podcasts from Becker's Healthcare 226 00:10:33,535 --> 00:10:36,235 by visiting our podcast page at becker's hospital 227 00:10:36,235 --> 00:10:37,115 review.com.