The U.S. has a lower life expectancy and higher rate of premature death than any other wealthy country. This is despite the fact that we spend nearly twice as much per capita on healthcare.
Exorbitant costs and disappointing outcomes are signs that our healthcare system needs to change. Our current fee-based system is a framework for misaligned incentives that prioritize profit over patient care.
Value-based care promises to right the wrongs of fee-based healthcare. But today, we’re a long way from a value-based system. One way to get there faster? Prioritize access to data.
Here are three steps that will help boost data connectivity and make widespread value-based care a reality.
1. Finish the data sharing job
Currently, EHR data is siloed. Each EMR has in it only the data that its own particular medical group has typed about that patient.
As Americans, we die having had almost 19 doctors. So most of the care we receive is administered by providers who are missing the majority of the data that exists on us. It’s like the parable of the blind men and the elephant — providers are working with an incomplete picture.
Data sharing is now required by law, but that doesn’t mean it’s happening or happening efficiently.
However, sharing is only part of the problem. Full data sharing is a lot like everyone getting a full copy of everyone else’s trash when it’s taken to the curb. It’s messy as heck. Luckily, we are in the AI age where sophisticated agents can read lots of “trashy” records and make them into one logically consistent, readable, sensical object.
Once that’s done, software companies can easily stand up workflows that automatically begin executing some of the longitudinal care work that doesn’t often get done today:
- Population stratification: Which patients need our attention most, whether they call us or not
- Referral tracking: We know more about where our Domino’s pizza is than we do about our patients.
- Getting up to speed and staying current on patients’ medical histories
Picture this: A PCP receives an alert that their patient has just been discharged from an ER in another network. Instantly, they’re able to see notes from the ER doctor, including the medication prescribed to their patient.
The PCP has all the information they need to call the patient, check on their wellbeing, and answer any questions. Thanks to that real-time data, the PCP is able to make sure the patient understands their post-discharge care plan and will likely prevent a costly readmission.
2. Give patients more access to data
Once providers — for the first time ever — have a clean, logically joined picture of their patients, they will be in a great place to publish useful, patient-facing summaries.
Thank god. People really want access to their own health data. And when they get it, you can believe they will use it: health and wellness apps reached 3.6 billion downloads in 2024 alone. They’re hot! And yet they’re devoid of the rich medical record data that exists on people … imagine when that gets fixed!
Right now, patients who want to see their full medical records have to log in to each of their providers’ portals and assemble the details themselves. This can take hours. Every new visit would require a manual update to their “data tracker.”
Having all their health data in one place, updated in real time, would be a game-changer. Doubly so if health and wellness app data were also integrated.
Overlays on the data could provide valuable insights that would empower patients to take control of their health –– without costly professional intervention.
For example, a patient’s fitness tracker might set a standard goal of 5,000 steps per day right now. But if the app had access to the patient’s medical data, it could customize that goal. It may note that they have a family history of cardiovascular disease and recommend increasing their step goal as a preventative measure.
The app might even ping the PCP to validate the recommendation — something the PCP could do in minutes, without an office visit.
Giving patients access to their medical data gives them power over their health, so they can make changes that lead to better outcomes.
3. Reduce regulation to increase competition
So what’s holding us back from making this vision a reality today?
Healthcare, tech, and government leaders are currently working toward a more connected healthcare industry. But regulations that impede competition in healthcare are slowing the pace of progress.
We’d get to data connectivity faster by removing regulations like the Anti-Kickback Statute, which makes it a crime for anyone to offer or receive kickbacks meant to generate healthcare business.
The statute is meant to prioritize patients over profit, but it has the unintended effect of making innovation less lucrative.
Kickbacks exist in every other supply chain to connect people to the products and services they need. DoorDash connects restaurants with available delivery drivers in their area for a fee. Priceline connects travelers to hotels in return for a cut of the profits. AirBnB, Chase Bank, and Amazon use kickbacks. And so on.
The Anti-Kickback Statute means that companies building data solutions to increase healthcare connectivity can’t get paid through kickbacks. That loss of potential revenue makes it harder for them to grow volume and build a viable business model.
Increasing competition in healthcare could smooth the path for data innovators to create solutions that lower costs and help us achieve less expensive, value-based care.
More connection means more humanity in the system
I started my healthcare career as an EMT, working the night shift in New Orleans. This was an eye-opening experience.
My colleagues and I would give so much of ourselves to treat patients. But the sheer amount of inefficiency — unnecessary costs and cumbersome processes — was disheartening. The system doesn’t just waste dollars — it wastes humanity, too.
It felt like there were endless opportunities for improvement, so I turned my attention to making value-based healthcare a reality.
The way I see it, our best chance at achieving a system that puts the patient at the center of healthcare decisions is by making data accessible and usable to all providers. By giving providers the data they need to collaborate on patient care, we’ll put humanity back in the healthcare system.
Photo: Jordan Lye, Getty Images
Jonathan Bush is founder and CEO of Zus Health, a company building the first shared health data platform designed to accelerate healthcare data interoperability by providing easy-to-use patient data at the point of care. He sits on the board of Innovaccer, and is the co-founder and former CEO of athenahealth and former Executive Chairman of Firefly Health.
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