The Collective Blog of Health IT

Episode 266: Episode 266: From Clipboard to Connected Care: A Conversation with Altera Digital Health and EHRA's Leigh Burchell

Healthcare has spent years investing in interoperability, digital health, and technologies designed to make the patient experience easier. But as new initiatives move from ideas and policy into implementation, an important question remains: How do we make sure innovation actually works for the people and organizations expected to use it?

That question was at the center of a recent WEDI podcast conversation (#266) Michael McNutt had with Leigh Burchell, Vice President at Altera Digital Health and Chair of the Electronic Health Record Association (EHRA).

Burchell brings a unique perspective to the conversation, having worked on both the payer and health IT sides of health care. For her, the ultimate goal of health IT is not simply better technology—it is improving an industry that directly affects patient outcomes.

Beyond the clipboard

The health care industry's desire to eliminate paper-based processes is hardly new, but initiatives such as the “Kill the Clipboard” pledge represent a broader vision for making healthcare more digital and giving patients greater control over their information.

The goals are compelling: reduce paperwork, make information easier to access and share, and use technology to simplify the health care experience.

But achieving those goals requires more than building the technology.

Patients have to be willing and able to use it. Providers have to see value in changing established workflows. And organizations need the financial resources and incentives to make those changes possible.

As Burchell pointed out, technology developers can create solutions, but successful adoption ultimately depends on both patient engagement and provider buy-in.

That may be one of the biggest challenges facing health care innovation today: building something that can work is not the same as building something people will use.

Innovation needs guardrails

There is another challenge that becomes increasingly important as health care technology evolves: standards.

Standards can sometimes seem like a constraint on innovation. In health care, however, they can provide the guardrails that allow innovation to scale.

Burchell expressed concern that allowing individual stakeholders to develop one-off approaches without agreed-upon standards could create inconsistencies across the ecosystem. Instead of making health care more connected, different approaches could create new barriers between systems, organizations, providers, and patients.

The issue isn't whether health care should innovate. It should.

The question is how we innovate in a way that preserves interoperability.

Standards provide a common foundation while still allowing organizations to innovate within that framework. Without that foundation, the industry risks creating a new digital divide—not only between organizations with different levels of technology capabilities, but also among the patients and providers who ultimately have to navigate those systems.

The digital divide isn't just about technology

The conversation around digital health often focuses on whether organizations have the technology they need. But Burchell highlighted another dimension of the digital divide: whether people actually have the resources and support to use that technology.

Rural organizations, safety-net providers, and small independent physician practices can face significant funding and infrastructure challenges. Asking these organizations to implement new technology without providing adequate support can unintentionally widen the gap between organizations that have the resources to innovate and those that don't.

That is particularly important as health care moves toward more sophisticated forms of interoperability and digital workflows.

For smaller practices, the challenge isn't necessarily understanding the value of interoperability. It may be finding the funding, staff, time, and technical support needed to implement it.

Burchell pointed to the potential role of organizations such as CMS, HRSA, and the Indian Health Service in providing grants, reimbursement support, or other mechanisms to help organizations keep pace.

If interoperability is intended to benefit the entire health care system, the ability to participate cannot depend solely on an organization's size or resources.

From connectivity to adoption

Another important takeaway from the conversation is that connectivity alone doesn't guarantee a better patient experience.

Health care has made significant progress connecting systems and making information available. But the next challenge is making sure patients and providers actually use—and benefit from—that connectivity.

Burchell raised questions about patient engagement with existing digital tools, noting that many patients do not regularly use patient portals and that many health apps are abandoned shortly after adoption.

That raises an important question for every new digital health initiative:

What problem are we solving for the patient or provider, and why will they actually use the solution?

The answer cannot simply be that the technology is available.

For patients, the value needs to be clear and the experience needs to be easier than the process it replaces. For providers, the technology needs to fit into workflows rather than create additional administrative burden.

What CMS-0057 means for the EHR ecosystem

These same issues come into play as the industry moves toward electronic prior authorization under CMS-0057.

From the EHR perspective, implementing electronic prior authorization isn't simply a matter of connecting one system to another. It requires changes to workflows and coordination among EHR vendors, providers, and payers.

The success of ePriorAuth will ultimately be measured by what happens in the real world: Can providers complete the process more efficiently? Can payers receive the information they need? Can patients experience fewer delays and less administrative friction?

Getting there will require collaboration across the ecosystem—and continued attention to standards so that organizations aren't building disconnected solutions to solve the same problem.

Making innovation work for everyone

Health care doesn't have to choose between innovation and standards. Nor should it have to choose between technological advancement and accessibility.

The opportunity is to build an ecosystem where standards create a common foundation, innovation happens within that framework, and organizations have the resources they need to participate.

That means thinking beyond the technology itself.

It means asking whether patients will use it. Whether providers can afford to implement it. Whether workflows actually improve. Whether systems can communicate with one another. And whether the organizations with the fewest resources are being given a realistic path to participate.

The next era of health care interoperability will not be defined simply by how much technology the industry can deploy. It will be defined by whether that technology actually makes health care easier to navigate, easier to deliver, and more connected for everyone.

As Burchell's perspective makes clear, the goal shouldn't be to slow innovation down. It should be to make sure that innovation moves forward in a way that brings the entire health care ecosystem with it.

Listen to Michael’s conversation with Leigh Burchell of Altera Digital Health and the EHRA at www.wedi.org/category/podcasts