A trailblazer in healthcare interoperability: How Humana is leading the way, why this matters and what’s in store for the future

Humana was first in the industry to implement interoperability solutions, embedding them into the organization’s operational framework in 2017. Since then, Humana has remained at the forefront of the interoperability space, with more connected health systems and more interoperability solutions in market than any of its competitors.

Humana’s interoperability capabilities advance patient-centered care by streamlining provider workflows and reducing the administrative burden associated with accessing health data, freeing up time for providers and other healthcare workers.

For patients, this translates into fewer care delays and a more seamless experience at the point of care. When providers have timely access to more comprehensive patient information, care is enhanced, patient satisfaction improves and there’s a higher chance for better outcomes.

As a result of its relationship with a range of providers and the use of interoperable data exchange, Humana acts as a central health information hub. Data comes in from different sources, feeding into Humana’s primary systems, and Humana facilitates access to this information.

Consider a scenario where a member switches to a new primary care provider. Humana can connect with the member’s new doctor through electronic health record (EHR) partners, sharing all the medical information Humana has about the member, including information about previous health conditions.

Through interoperability connections, Humana can also obtain information about the patient from an EHR company. Even in situations where a member had different payers, it’s possible to get three years’ worth of historical health data—this information can then be sent to the patient’s doctor.

This is tremendously helpful for a new doctor who needs details regarding a patient’s medical history so they can make informed decisions and deliver optimal care. In many cases, information is funneled directly into the provider’s workflow, which allows them to refer to an EHR during the patient’s visit instead of waiting to review records that come in after the fact.

While huge strides have been made in interoperability, there is still work to be done. For example, patients and providers may benefit tremendously from intelligent healthcare ecosystems that incorporate medical device interoperability.

Medical device interoperability is critical because of the important role these devices can play in preventing negative patient outcomes. Although poor outcomes are sometimes unavoidable due to a lack of information or erroneous information at the point of care, in some cases a bad outcome could have been averted if the right information had been delivered directly to the system at the patient’s bedside.

From a Medicare perspective, there could be a use case for incorporating medical device interoperability into a larger data exchange framework. New rule changes, for example, may make it possible for Humana to use medical device readings to close a Stars gap or to confirm that a member’s preventive care has been properly completed.

Initial conversations have already taken place about connecting medical devices to enable access to patient data, as well as what would be required for that type of information to flow into Humana’s payer platform system. This indicates that a future state in which medical device interoperability as a reality may be on the horizon.