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We shouldn’t let nostalgia cloud the real impact of interoperability in health care


We ought to be reminded of all the ways technology has made care better, safer, and more accessible for patients across the country.

Lynne Nowak, MD: ©Surescripts

Lynne Nowak, MD: ©Surescripts

We often feel nostalgic about past events and the positive memories we associate with certain times in our lives. We might remember how we used to go on summer vacations with our family to the same spot year after year – and long for what we remember as a simpler time. We might also remember a time when we could pick up the phone and call our family doctor—nights, weekends and holidays – whenever we needed them.

Researchers believe nostalgia, or glossing over the less-than positive parts of our past, is an evolutionary tactic for survival and likely has a number of other psychological benefits.

This romanticized version of the past is perhaps the reason why clinicians in a recent study seemingly agree that interoperability in health care is “substantial but incomplete” and there is only “moderate ease of using that information,” as noted in a recent Medical Economics article, Interoperability: some improvement, but much work remains.

I think this is a case where nostalgia has replaced the reality of what it was like to be a physician before technology. Perhaps the clinicians surveyed are nostalgic for a bygone era of caring for patients with seemingly fewer distractions and more time spent talking with patients about their health.

Even if those memories are accurate to a degree, we ought to be reminded of all the ways technology has made care better, safer, and more accessible for patients across the country.

A trip down memory lane

Despite the challenges that we continue to face in health care, it’s worth remembering how much progress has been made to emphasize patient safety and efficiency with innovative technology and a focus on advancing interoperability.

If you asked my kids what they remember about my work as a practicing physician, there’s no nostalgia in what they would say. Their memory of me caring for patients is the two foot tall stacks of paper charts and hours—nights—weekends and even “days off”, that were spent at the kitchen table writing out forms. This was a not-too-distant-reality for many physicians. But our patients trusted that we would dot every “i” and cross every “t”, so that’s what we did.

It was clear that we needed to do better for clinicians and the patients entrusting us with their care. This was a job for technology.

Looking back two decades ago, we remember how prescriptions were handwritten, requiring patients to bring the small square of paper to their pharmacist to fill. Today, clinicians prescribe electronically and in a recent report, Surescripts processed 2.5 billion electronic prescriptions in 2023 alone. That's billions of safer prescriptions, with enhanced security and standardized patient instructions that aren’t lost or stolen on the way to the pharmacy.

It’s just one example of how we’ve effectively changed – for the better--the way we care for patients.

Trust in health care that doesn’t require rose-colored glasses

Today, e-prescriptions aren’t the novelty they once were and we tend to forget the bad parts of the past, the lost paper prescriptions, the phone calls to the pharmacy and faxes.

Fortunately, we’ve made considerable progress. Our trust in technology working behind-the-scenes goes beyond e-prescriptions, replacing a number of previously manual, time-consuming and inefficient parts of a physician’s job.

It's partly thanks to the nearly 24 billion exchanges of patient clinical and benefit information Surescripts supported among prescribers, pharmacists, payers, and health systems in 2023. This means 2.14 million care providers and organizations trusted technology and advancements in interoperability that connected them to essential patient intelligence for more than 99% of the U.S. population.

This interoperability at scale also enabled clinicians to find and share 1.89 billion clinical documents last year with record locator and exchange technology, bringing clinicians 2.97 billion medication histories at the point of care, simplifying the medication review process and increasing patient safety.

Taking off our rose-colored glasses, we would see that before physicians had technology that could help identify prescription cost-barriers for patients, it's much more likely that patients would never pick up or begin the treatment we prescribed for them. That's the part nostalgia seems to forget.

Improved patient care that leaves nostalgia behind

While we know there is work to be done to make even greater advances in the exchange of clinical information, we shouldn’t lose sight of how advances in health intelligence sharing have allowed us to access a patient’s health record while they are sitting next to us in the exam room.

Nostalgia for the past doesn’t remember waiting for a fax from another office or digging through hundreds of pages of hand-written clinical notes—virtually starting from scratch in each patient visit. But maybe there is a place for nostalgia to help us remember the good parts of serving patients in the past – the parts worth keeping, like the personal relationships between clinicians and their patients, and the access patients had to care.

Technology and interoperability have the potential to restore this kind of health care by reducing administrative tasks that could alleviate clinician burnout and allow for more time connecting with patients about their health. It might also mean making care more accessible to patients, equipping clinicians with the technology they need to work collaboratively and fill gaps in communities facing primary care provider shortages.

We should let these memories inspire us to continue innovating and advancing interoperability so that health care truly is better than we remember it.

Lynne Nowak, M.D., is the first chief data and analytics officer at Surescripts. With nearly 30 years of healthcare experience, Nowak began her career as a physician, focused on helping people live healthier, happier lives. Since then, she has worked to find innovative ways to use data to improve how clinicians care for their patients. At Surescripts, she leads a team that is focused on providing faster access to clinical insights and optimizing the value of data, enhancing patient intelligence sharing that can lead to better informed, safer, and less costly care for patients and those who care for them.

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