5 Ways to Drive Adoption and Help Unleash the Power of Health Care Data

By Jocelyn Keegan, Payer/Practice Lead 

Pooja Babbrah, PBM Services Practice Lead

In our work with clients and various health care sectors, we often hear frustration from stakeholders who have invested considerable time and money in a standard or technology but it isn’t being used. Part of the problem is that stakeholders wait until federal mandates are issued then check the compliance box and stop there. In fact, health care is notorious for waiting until federal regulations require the development and implementation of innovations as well as bread-and-butter solutions to business needs. 

However, the “if we are forced to build it, they will come” mentality simply doesn’t work. An example is the real-time benefit check (RTBC). The RTBC is an important way to help prescribers find the most affordable, therapeutically appropriate medication that is covered by the patient’s insurance. Uptake has been slow, despite the introduction of a 2020 federal rule requiring that Medicare Part D sponsors implement an electronic real-time benefit “tool” capable of integrating with at least one prescriber’s electronic prescribing system or electronic health record. The rule had two glaring omissions: it didn’t adopt the RTBC standard from the National Council for Prescription Drug Programs (NCPDP), which hinders interoperability, and it did not apply to providers and health plans. In fact, many RTBC solutions were developed that leveraged the NCPDP standard and could have been widely adopted by providers and health plans in the absence of a federal mandate. However, developers stopped short by not promoting their products to those potential users and helping them understand the benefits and value of the RTBC. In the meantime, millions of patients have experienced undue costs and frustration in trying to find affordable medications. Compliance with treatment regimens — and patient safety — have been put at risk because patients will not fill prescriptions that cost too much or will stretch doses until they can afford a refill.

We feel strongly that over-reliance on checking the regulatory box is not the way to move health care forward. So, what other things can be done to increase adoption and help unleash the power of health care data? Here are five opportunities.

1. Get the right stakeholders involved at the right time

As consumers, we have felt the frustration of well-meaning products that simply don’t work correctly or without a lot of effort. That can be prevented by getting the right stakeholders at the table at the right time. Health information technology (health IT) vendors and others need to make sure that end users, such as providers, are not left out of the process or are not underrepresented along the way. For example, providers should get involved early and often in the development and testing of Implementation guides. Bringing them in early can create value and spur adoption at the back end because they have made meaningful contributions to the final product. They also can help with accountability during implementation if they have been involved with vendors from the get-go.

That is why an open consensus model works: everyone’s voice can be heard, their concerns are addressed, and a better, workable product is created. To keep the process manageable, certain stakeholder groups can serve as proxies for individual constituents, although those proxies must be carefully chosen. In addition, investment is easier if stakeholders are asking for a particular product in a particular way.

2. Change management

Organizational change management is key to adoption. Many organizations do fairly well in managing technology changeovers but it can all be for naught if internal customers are not on board. That is why organizations need to plan for and conduct effective change management strategies that are companywide and not limited to the information technology department. There are many change management models in the literature, but they have common themes. Change needs to be iterative, incremental, have internal champions and clear, frequent communications about the business case for the change and status of the changeover. Change must be embedded in the organization — top down and from the bottom up — and resources must be provided. 

3. Storytelling using data metrics

Understandably, nobody wants to jump on a technology bandwagon unless they know where it is going and how — and if — it’s going to get there. Risk needs to be managed. Addressing those issues requires data and metrics. Even with a nascent technology, useful data can be culled from pilots, testing or beta implementations to explain results and prove something new works. Data is a powerful tool; explaining what it can do for care and costs will create interest in adoption by the rest of the industry. Creating clear visuals that tell the story is crucial. Success breeds success, which tamps down the fear of change and encourages people to move forward even with perceived or actual risks, knowing others have found success.

4. Improve communications and product rollout

Communications strategies and product rollout are important. Often, however, they are left to the end and not embedded in the entire project — not to mention being among the first things to get delayed or minimized when schedules and budgets get tight. The importance of improved communications cannot be overstated. Providers don’t speak the same language as developers; patients often are lacking in health literacy and  not technology savvy. Rollouts need to speak the language of the intended user, clearly explain how to use the product and understand its benefits. Uptick, adoption, getting people to try the new tool or join a new project always takes longer than expected. Getting a head start early in the project can help get appropriate early adopters on board and even help decide critical items pre-launch. Keep in mind that different communications and rollout strategies are needed for different audiences, both internal and external. For example, providers need to be educated — and perhaps incentivized — on how to implement new technologies and processes. 

5. Revisit HIPAA

The Health Information Portability and Accountability Act (HIPAA) was a landmark law that provided a foundation for today’s electronic capture and exchange of health information. But things have changed dramatically since HIPAA was enacted in 1996 — from standards to business models to technologies. For example, the internet is an indispensable tool to exchange information. Policy is beginning to shift to focus more on clinical data exchange rather than billing. Many people believe that HIPAA’s legacy is limited to privacy concerns while overlooking its impact on basic transactions and research. Moreover, HIPAA doesn’t apply to everyone. Certain health care providers subject to the government’s new information-blocking regulations (and any other actor that supports them) may not be covered entities or business associates under the HIPAA rules. It is time for the industry to separate the concepts of security and good technical design around authentication from the brick wall that has been HIPAA. We can all admit that HIPAA has been leveraged as a crutch for some stakeholders, allowing them to use HIPAA as a barrier to more fluid data exchange. All that can change if HIPAA is revisited and aligned with today’s technologies and business needs. Understanding the end users, purpose of use and how it aligns is foundational to all projects.

Looking ahead. Point-of-Care Partners (POCP) helps our clients understand what market trends, industry developments and regulations mean for them and their partners. We also develop market intelligence and strategies for implementation. Want to know more? Reach out to us at jocelyn.keegan@pocp.com and pooja.babbrah@pocp.com.