We sat down with James Bateman, CEO and Co-Founder of Medchart, to discuss the work he and his team are doing to advance consumer-mediated exchange in healthcare. It’s a focus area that’s seen some progress, but still has quite a bit of room for future growth and innovation.
Medchart is a fairly young organization, having been around for just five years. In that short time, James’ team has done incredible work connecting health information based on consumer-mediated exchange. His company focuses on the complexities around patient identity, consent and authorization, and aggregation of that data from different sources.
Like many entrepreneurs, James’ journey involves a personal story that made him want to help others in similar situations. When his father-in-law passed away, James’ family faced challenges coordinating health data when his father-in-law was being seen at various health institutions. Through that experience, he saw an opportunity for patients to use their own consent and authorization to enable a new approach to data operability — one that, in this case, saves family members the headache of tracking down data from multiple sources.
Historically, there hasn’t been much emphasis on patients within interoperability, and we wanted to get James’ take on that. He says it’s curious that patients haven’t been part of those conversations. He uses “curious” because there are three modes of data exchange that are widely accepted — and consumer-mediated exchange is one of them. The other two modes he refers to are query-based exchanges and Direct exchanges. It turns out consumer-mediated exchanges, which have been recognized and researched, still haven’t been done at scale. This could be because involving a third party (the consumer) to participate in data exchange introduces new challenges.
When trying to make improvements within the healthcare system, it makes sense to figure out the most efficient way for a doctor or member of the circle of care to have access to patient information with the least barriers. And perhaps adding that third party to the mix is worth the trouble of navigating those initial conversations.
Care providers are sometimes able to access patient data without their consent. That said, today’s world is full of use cases where that data could provide much greater value, and deliver a better patient experience or health outcome. These opportunities go beyond the traditional ways data interoperability is used in care delivery. James and his team are working to create more ways in which data can work harder for the patient.
He believes that now is the time to give individuals the option to authorize their data to flow to different systems. There’s been a push in recent years to have more transparency directly to the consumer and end user. James says the industry is getting to the level of maturity where that conversation needs to expand. Medchart is bringing this new idea to life by providing the interface between systems and networks that have been built through health exchanges, direct exchanges, etc. with their paradigm of consumer-mediated exchange.
“We don’t need to re-build everything from scratch. We can leverage all the technology we’ve built and now layer on the consumer participation, their authorization, [and] trusted identity consent methodologies to unlock a lot of the data and infrastructure for this additional use case that maybe it wasn’t originally designed for.”
It sounds like there’s a lot going on in this space and we wanted to hear a full progress report from our Interop Hero, as well as what other organizations are doing to help support these efforts.
To give us perspective, James explains how consumer-mediated exchange has been around for a very long time. It’s been a part of our everyday life in healthcare. The problem is we haven’t figured out a way to do it operationally at scale. The industry is still relying on older methods that don’t scale well, and that are often expensive and time consuming. If the industry is able to deliver on consumer-mediated exchange at the same scale as the state or national health information exchanges, it could open up a lot of opportunity for innovation.
We know the market is slowly progressing with everyone everywhere needing to comply with data regulations. The evolution of patient portals and private companies coming in to facilitate the consent process and connect data are two ways in which the industry has started to embrace a shift toward consumer-mediated exchange. Overall, James believes this body of work is still pretty fragmented. He describes these as the “early days,” implying there’s lots of room for future growth and innovation.
James says he’s hopeful that we’ll see consumer-mediated exchange come to scale in response to the 21st Century Cures Act and the Centers for Medicare and Medicaid Services Interoperability and Patient Access Final Rule. The government is saying consumer-mediated exchange is an important part of what the industry needs to support through healthcare technology.
“So, asking all the healthcare providers to respond to patient-authorized requests with application programming interface HL7® FHIR®-based responses is absolutely game changing. And now we’re going to see that emergence of being able to do consumer-mediated at scale.”
There’s clearly a lot to look forward to, and we’re thrilled to hear that there have already been significant strides made to bring this new methodology to scale. We wanted to hear more of James’ thoughts on the impact of the 21st Century Cures Act.
There are two concepts that come to mind when he thinks about this legislation and what it means for the future. The first is understanding the pathways and trends healthcare providers will take in order to meet their compliance requirements. The second is recognizing the opportunities that open up as a result of those trends where consumer-mediated exchange can power innovation in ways that were once not possible.
James is seeing healthcare institutions being bombarded with multiple resources offering to help them become compliant. He’s optimistic that we’ll see mass adoption and compliance as a result of the 21st Century Cures Act because there’s so much support for providers that have to accommodate this new legislation.
But because there are so many resources, he doesn’t see it solving the fragmentation issue. There are many ways to become compliant and we’ll likely see healthcare providers across the country take different pathways to get there.
“[This] is going to really intensify the need for a company, such as Medchart, who’s bringing in interoperability with all these end points — aggregating them, de-duping [them]…making that data accessible [and] useful. And, leveraging technologies like DirectTrustTM in order to speak to those endpoints. I think DirectTrust has a huge role in what’s going on in terms of how these healthcare providers are implementing.”
Once the market figures out how to comply with patient-authorized requests, organizations will need a partner like Medchart to come in, bring all this information together and make it digestible. That way, a service, app, or provider can have one simple entry point to access all their data.
James goes on to expand on his second thought: what type of opportunity does this unlock? Imagine a future where someone is engaging with a healthcare app about their health condition and that app lets them get a certain benefit if it fully understands their healthcare history. Ideally, the patient could give a quick consent for the app to have that data, which would be pulled directly from their provider’s electronic medical records (EMR).
Today, there are a few small app marketplaces that may be connected to specific EMRs, but they’re restricted to the data that’s in that ecosystem. James is hopeful that we’ll see that next wave of innovation at the same time consumer-mediated exchanges go to scale.
We, at DirectTrust, want to spread the word on this exciting body of work. James shares what people can take away from our conversation to advance consumer-mediated exchange in interoperability.
One message he has is to simply have an open mind. He recognizes that many organizations have already made the mental leap of being more transparent with their patients through the use of patient portals, for example. He believes those portals laid some of the groundwork to make transparency and patient authorization more acceptable. With the adoption of more consumer-mediated exchange, patient data will not only go to their portal, it will also go to other apps or services in which the patient authorizes their data to flow.
“I think having an open mind to continue to embrace that culture of transparency and openness with your patients [will help]. At the end of that, what’s going to happen is they will begin to trust you more. Because you will be a partner in their care and not just someone who is simply delivering it. And they’re really going to see that as you looking out for their best interest.”
Building that trust is crucial to the future of consumer-mediated exchange (and all healthcare interoperability). James believes success in this area is inevitable, as it seems to be the next natural step in a more person-centric healthcare system. After all, this approach ultimately benefits patients and outcomes across the healthcare system — which is always our end goal with interoperability.
Thank you to James Bateman at Medchart for sharing his experience and perspective with us!
Learn more about the Interoperability Hero Initiative and check out our second class of Interoperability Heroes.
This post was contributed by Alyssa Foggia-Hamm.