It's almost 2023 – why are patient experiences still so terrible?  - MedCity News

I recently had a mysterious pain in my knee. After ignoring it for too long, I visited my chiropractor who sent me to an MRI imaging specialist.

I had to move my paperwork from the imaging company to my primary care doctor so they could refer me to an orthopedic specialist. Since they had no way of doing this electronically, I had to go to the doctor’s office in person, go in (during Covid), pick up a paper form and return it so they could request my scans.

Sound familiar?

Application programming interfaces (APIs) can create better patient experiences and improve health outcomes

We know that APIs—application programming interfaces, the digital building blocks that expose data points to modern applications—can be used to build solutions that measurably improve patient outcomes.

Take the stubborn and expensive problem of non-adherence to medication, for example. A Mississippi regional hospital is using a price transparency API to get more congestive heart failure patients to fill their prescriptions—building a tool that empowers prescribers and patients see prescription drug costs and discuss options at the point of care.

Price transparency and other FHIR APIs were forced by CMS and had uneven implementation, but it’s exciting to see that we have a problem in healthcare that we can actually solve by creating more complete and coherent systems.

Yet a recent sobering survey found that 61 percent of respondents have not had access to health care in the past year because using an online self-order system is too complicated. Why aren’t we making better use of APIs to improve our experiences?

Healthcare adoption of APIs is disjointed

As an industry, healthcare has fragmented its approach to API modernization and enablement, and the result is a lack of synergy.

Two factors have contributed to this: a narrow focus on compliance and an over-reliance on commercial off-the-shelf (COTS) technology. In the 2000s, CIOs decided that developing their own applications was inefficient, so they started buying different solutions and ended up with a set of application silos.

In early 2009, when ONC required electronic clinical records as part of the HITECH Act and patient portals became more common in the US, it became clear that clinical records were originally created only for clinicians; they are not intended to provide patient experiences. That’s how we ended up with patient portals built from a clinical perspective that they don’t really help the patient does the things the patient needs to do, such as scheduling appointments or transferring records.

So, health care organizations bought in More ▼ provider tools to help patients communicate with their doctor’s office, complete health history forms, or search for coverage and payment information.

But with this approach, data does not flow through these “islands of automation.” In contrast, using the FHIR API authorized by Interoperability Rule enables healthcare providers to use individual data points—reusable building blocks—to compose interoperable solutions.

A more composable data ecosystem would have allowed me, with my sore knee, to quickly transfer my MRI and get the orthopedic exam I needed, and maybe schedule and coordinate some telemedicine calls as well.

Don’t underestimate the power of experience

Contrast this with another recent personal experience: In the middle of Hurricane Nicole, my power went out. I took out my phone to Google Florida Power & Light. I was immediately prompted to switch to the mobile experience, where a button allowed me to report an outage and the site recognized my phone number and address, sending me updates when the situation changed.

Patients get great customer experiences elsewhere now they are also expected in healthcare. We would do well to learn from the business world’s obsession with customer experience. of Gartner Customer Experience Research Team argues, “Instead of exceeding customer expectations in the hope of mitigating the loss of customer loyalty, organizations should reduce the effort customers must make to solve their problems quickly and easily.”

A useful API doesn’t just update something in a database or retrieve something from it: it organizes information that flows across multiple applications and causes work to be done—approvals, changes enabled in other applications—to gather experience or a completed piece of work, such as filling a prescription.

People should be able to complete a task in one sitting. And in addition to failing to deliver beneficial patient experiences, this lack of synergy in healthcare and these growing data silos will ultimately lead to additional security weaknesses and higher costs for the industry in the long run.

The need for a Chief Patient Experience Officer

Big health systems have started naming names Chief Data Officers to manage the massive task of digitizing patient records and other clinical processes. They embraced data lakes and data scientists and realized that we need to treat data as an asset. But we still have a gap in people.

Healthcare organizations need more than a data officer; they need a Chief Patient Experience Officer who is empowered to break through application silos and assemble solutions that solve patient experience processes.

The FHIR APIs defined by CMS are just one data format designed for the rapid exchange of electronic health records. But as I mentioned earlier, electronic health data are primarily intended for clinical purposes. There is a larger category of APIs that will help us provide a simpler, more integrated process: Experience APIs.

Ann Experience API is a user-oriented API (typically a set of APIs joined together to provide a service) in accordance with the user experience or business capabilities. Essentially, it takes data points from the back end and brings them together so that the user – or patient – ​​can perform a logical action on the front end.

Experience APIs aren’t just a convenience. Delivering a better, more cohesive digital experience means we can offer higher quality care to more people; they are particularly useful for vulnerable populations for whom making multiple follow-up calls is a serious barrier to access.

Many organizations are still grappling with the mandate for good faith assessments or an expanded explanation of benefits and are hoping for delays in the upcoming rules. But these elements are also experience APIs: they will orchestrate a series of information, request-response and decisions across many different clinical providers and health plans.

Better digital experiences will also allow us to stem rising healthcare costs, as healthcare organizations are able to focus on delivering care rather than hounding people for information, payment or enrollment. What else, study shows improved experience can help organizations grow up their customer base.

We’re not there yet, but the promise of trial application programming interfaces (APIs) gives hope that in the future a patient can quickly understand what a torn meniscus repair would cost, with the information they need to choose a provider, schedule and adaptation respectively. (Thankfully, I finally got the care I needed from an orthopedic specialist.)

To achieve this, we need to go beyond simply putting the FHIR API on record: we need to look at the whole picture and process from an experience perspective. It’s time to take the experience seriously and look at it at the C level.

Photo: Axway

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