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John Hoyt
Certainly that subject is what we call here social determinants of health. I found that in Europe, notably in Northern Europe, the Nordics, Finland, Sweden, Norway, Denmark, Iceland.
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John Hoyt
Yeah, that’s it. They are more oriented to collecting that holistic data as part of the electronic medical record. In fact, the tender for an EMR for Finland as of about 2016 required the bidders to collect and utilize social determinants of health. And in my conversations with people from the Ministry of Health of Finland.
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John Hoyt
They wanted it. They asked me questions like the following. Does your EMR collect information on your availability to get fresh vegetables and fruits nine months a year?
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John Hoyt
Can you walk to a grocery store to get fresh vegetables and fruits?
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John Hoyt
Are you going to a dentist? Has your child had any problems at school?
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John Hoyt
And I was just astounded that this was a routine expectation.
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John Hoyt
More than six years ago.
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John Hoyt
Uh, for part of the family, his medical history. So that was a good eye opener for me to determine to see how the Nordics perceive these things. They also clearly were ahead of the United States and information sharing. Yes, they have the privacy regulations, etcetera like we do. They know about our HIPPA laws because they have equivalents, but they see their. I’m gonna say this is my opinion.
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John Hoyt
They’re stronger in their commitment to health, is a public value. It’s a public service and thus sharing it is an absolute necessity and they don’t see other hospitals as strongly as we do as competitors, so.
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John Hoyt
You know, that’s what that’s how I was.
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John Hoyt
Of what I’m made aware of what was going on in in the Nordic countries and they’re sharing.
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John Hoyt
They are aware that the United States Healthcare is a competitive.
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John Hoyt
Game and they don’t perceive that as something they wish to do.
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John Hoyt
Interesting.
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Jordan Cooper
So for for our CIO in the United States who are listening to this episode.
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John Hoyt
Right.
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Jordan Cooper
Are there any? And given that we’re not going to be changing our general competitive environment in the United States and we’re not going to adopt AA, Northern European Social Democrat type, political, social, cultural, society, social norm, how would you suppose CIOs of American hospitals today can learn any lessons from what’s going on in other parts of the world?
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John Hoyt
I think the answer is somehow measuring continuity of care. Are we?
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John Hoyt
Still failing to complete a complete continuity of care record for patients if there are places where records are not being shared because they’re not available.
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John Hoyt
Then we have work to do and it is on the CIO leadership of CHIME and hymns to continually push for open sharing of a electronic medical records for the sake of continuity of care.
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Jordan Cooper
So on that topic.
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Jordan Cooper
You can’t share data unless you can technically share data. I wanna speak for a second about the role of interoperability in driving hims ratings and maturity models in relation to specifically with relation to semantic interoperability and the format of data elements. Can you speak about what hymns role has been in promoting interoperability where you see United States was where you see we are and where you think we need to be with interoperability.
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John Hoyt
Yes, hymns was one of the leaders, as was chime in the United States, and promoting interoperability and tearing down our walls and semantic interoperability is the goal to which we’re all heading. That is, do I understand the information that you just sent me electronically? And can I operate on it and what that means is if you send me allergy data from a patient that I did not have.
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John Hoyt
Can I then take that data and run it against a current prescriptions to see if all of a sudden we learned that a patient is in fact receiving a medication to which you just said he potentially could be allergic? So that is a huge goal and we have to to move forward with that. Another such interoperability, which we are not doing today.
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John Hoyt
It is regarding a patient consuming the medications to which the for which they’ve been prescribed. If you prescribe a medication.
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John Hoyt
And the patient never picks it up at the pharmacy. Are you aware of that?
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John Hoyt
You know the is there a query and response mechanism with the pharmacy benefit managers to do that? We’re not doing that yet in the United States.
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John Hoyt
If they do fill a prescription in 30 days, do they renew it? So those are the goals to which we are are should continue to strive because we are short on that here, is it Dylan, United States, it’s tough.
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John Hoyt
But we can do it.
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Jordan Cooper
So one thing that has been driving interoperability over the last decade and 1/2 and during all your time in leadership in hymns, was driving adoption of of meaningful use. The High Tech Act under President Bush and Obama driving general adoption, implementation use payments, meaningful use payments. So and that brings me to the topic of M RAM, which is an acronym from Hymns that stands for electronic medical record adoption models. You have inpatient outpatient models.
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Jordan Cooper
I think this is something that you worked on. In particular, would you please care to elaborate on HIMSS adoption models?
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John Hoyt
Absolutely. So we started with the inpatient EMR adoption model in 2008. We had our first top stage client. The model was actually introduced in 2005. We did not have a stage seven. That’s the top until 2008. I joined in 2008 and then I took over responsibility for the program in 2010, we.
0:8:24.660 –> 0:8:34.770
John Hoyt
Have modified the model periodically through the years as we have to and then we added an outpatient model and then we added an analytics model.
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John Hoyt
The EMR adoption model is a tool to compare yourself to others in how well you’re implementing and utilizing electronic medical records it.
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John Hoyt
Like all products.
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John Hoyt
It has a product lifecycle. the United States is now quite well adopted, past tense into electronic medical records. So as the model continues to be matured and modified by my successors.
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John Hoyt
It will have to work to retain its relevance, since the United States has so well and thoroughly adopted electronic medical records. I think the next issue is what we’re talking about. Interoperability and continuity of care and the hymns actually did under my direction create and interoperability, excuse me in a.
0:9:35.930 –> 0:9:51.960
John Hoyt
Our continuity of care maturity model and it was successful in Europe and in Southern Asia, has not been that widely adopted in the United States and there’s room for it to be more utilized in the US.
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