FHIR at core of Humana’s strategy for data sharing with providers

HL7’s Fast Healthcare Interoperability Resources standard is the linchpin of health insurer Humana’s efforts to support data sharing with provider organizations to improve care for its members.

Humana CEO and President Bruce Broussard told an earnings call earlier this month that interoperability is at the core of the payer’s corporate strategy, “which facilitates our relationship with our provider partners, while simplifying the experience of our members.”

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Signage is displayed outside the Humana Inc. office building in Louisville, Kentucky, U.S., on Saturday, Nov. 26, 2016. The Justice Department sued in July to block the union of Aetna Inc. and Humana Inc., saying they would reduce the number of large, national health care insurance providers, leading to increased costs for their clients. Photographer: Luke Sharrett/Bloomberg

As one of the nation’s largest health insurance companies, Humana is looking for ways to better leverage data as the healthcare industry moves from fee-for-service to value-based care.

FHIR is the standard that enables real-time exchange of data using the latest web standards, according to Patrick Murta, Humana’s solutions architecture fellow. By leveraging RESTful application programming interfaces, he contends that FHIR is starting to serve as the core functionality to support data access in healthcare and enabling health information exchange.

“Humana was a very early adopter of FHIR,” says Murta, who notes that the insurer is a founding member of the Da Vinci Project, a payer-provider initiative to leverage FHIR to exchange critical data required for value-based care delivery. “We have looked for opportunities to use FHIR as much as we can.”

The latest version of FHIR is Release 4—the normative version of the interoperability standard—which Humana has adopted for some recent implementations, including what the insurer contends is the first-known clinical decision support FHIR integration between a payer and provider via their clinical workflow.

“Our partner Signify Health is now using our OneMedList in connection with in-home assessments, giving them the ability to confirm in real time member adherence to their medication and more proactively identify potential adverse drug interventions and drug disease conflicts,” Broussard told analysts during this month’s earnings call.

The result is bi-directional sharing of a member’s most up-to-date medication information between Signify Health clinicians and Humana in real time. In addition to FHIR, Humana has integrated Clinical Decision Support (CDS) Hooks—an open-source request for patient data—into the process with Signify Health.

“We need to give our clinicians that go into homes for patients assessments the best possible data to make decisions in real time,” says Shane Henderson, Signify Health’s chief technology officer. “In this case, it’s specific to medications. The idea behind this is to synchronize the medication data with our iPad app from Humana’s core systems as soon as the appointment happens in the field.”

Going forward, Broussard revealed Humana’s plans to roll out the same type of FHIR-enabled functionality in 2020 to all Kindred at Home and other home health providers, including integration with the new Homecare Homebase system.

“The integration of technology like OneMedList with Kindred at Home is enabled by Humana's integration with the Homecare Homebase electronic medical record and practice management system,” according to Broussard. “The integration allows the prescription drug information gathered by the Kindred at Home nurse to become part of the Humana record, ensuring a more comprehensive record and reducing the likelihood of medication errors. This will accelerate our ability to proactively identify key clinical interventions while improving revenue capture and business and quality reporting.”

“We have a few other FHIR implementations coming down the pike,” concludes Murta. “We are looking at further opportunities to provide (Humana’s) Medication Profiles and additional information such as lab results and problem lists.

“We’re at an inflection point—we have the technology, industry cooperation and value-based care,” he adds. “Things are coming together so that we’re able to use this contemporary integration technology to help provide better experiences for our providers and our members—and, truly get to a point where we can achieve integrated care delivery.”

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