If there was ever a time to discuss healthcare interoperability, it is now. Let us get together on the Healthcare Interoperability Journey to bring about a lasting change before it is too late
This is an exclusive interview conducted by the Editor Team of CIO News with Ankit Kumar Agarwal, Director – IT Delivery Services at NewWave Telecom & Technologies Inc.
What is your background?
My name is Ankit Kumar Agarwal. I am the Director of IT at NewWave Telecom & Technologies, Inc. I currently manage the healthcare interoperability product development and integration for the organization, which includes making healthcare claims and clinical information available to 5% of the US Medicare Advantage and Medicaid populations, leading to improved health outcomes and resulting in billions of dollars in yearly savings for the health insurance organisations and various federal and state agencies.
I have a humble background. Until the 12th grade, I attended a government-sponsored college. Just like millions of other students, I went through the tough competition and secured a spot for the bachelor’s in computer engineering course at a top-rated institute in Nagpur, Maharashtra. After completion of my bachelor’s degree, while most of my colleagues were determined to explore potential job opportunities, I was keen to continue the learning journey and went for higher studies in a specialised studies programme to pursue my master’s in business administration from a top university. My pursuit of excellence led me to Wharton’s Executive Program in Business Analytics.
It was during my MBA Summer Internship that my hard work got recognised by one of the topmost healthcare MNCs, where I worked on analysing the entire US provider segment data to improve healthcare outcomes for the US population.
How did you get into healthcare IT?
Healthcare and education have always been close to my heart. I was destined to work with people with critical health needs to assist them in their journey towards healthcare interoperability. I was determined to make healthcare accessible and affordable to the general public. I started my healthcare IT journey with one of the major US health insurance organizations, where I worked on business process reengineering efforts to have an impact on the health plan members. It’s been seventeen years since then, and I have never looked back.
What is your overall experience with US healthcare?
I completed a Fellowship in Healthcare Management from the Association of Health Insurance Plans (AHIP) in the USA. This experience helped build a strong foundation to help various commercial health plans and state Medicaid agencies streamline their business processes and improve the efficiency of their day-to-day operations.
One individual alone cannot bring a tsunami, and we all need support from like-minded folks to make a lasting impact. I volunteered to train nearly two hundred tech professionals in the US health sector to ensure that this group can work together to spread knowledge and positively impact the health outcomes of millions of Americans with chronic health conditions.
After a long and joyful journey, I decided to be part of the Medicaid Management System Modularization effort to cut down on the long and painful journey of various states’ Medicaid Management Information Systems implementations. This effort resulted in a major impact in the Medicaid world and reduced the overall implementation timeline from seven years on average to twenty-four months, benefiting millions of Medicaid enrolees across seven states. Some of my work involved supporting Workers’ Compensation, the Veterans Administration, and the Center for Medicare and Medicaid Services in streamlining some of their key initiatives.
During all of these years supporting various segments of US healthcare, I always felt the need for a concrete effort to reduce silos and increase health data interoperability.
I was invited to join a group of industry experts who work on defining the healthcare interoperability standards with Health Level Seven (HL7) by two of the best-known experts in the US healthcare interoperability segment, and I grabbed this opportunity with open hands. This started my healthcare interoperability journey with NewWave Telecom & Technologies, Inc. During this journey, I had the opportunity to work with the industry’s best to define the FHIR interoperability health standards, working with various health plans, health information exchanges, and state Medicaid agencies in their FHIR interoperability journey.
This all seems to be just a start, and I feel the urge to continue marching on the path to achieve the dream of creating a longitudinal health record, helping health administrators to improve the health outcomes and increase the life spans of the patients while making healthcare affordable for the entire US population.
I write regular articles on US healthcare trends, which are published by major trade publications. I also run a YouTube channel named “FHIR Ninja” and publish biweekly videos on the latest healthcare interoperability trends.
What are the challenges that you have faced in US healthcare?
The healthcare industry has always been a prominent target for cybercriminals worldwide. They can access high-value patient PHI and PII data and use it maliciously to disrupt the patient’s treatment routine and bring down uptime, which is critical. It has repercussions on patients, doctors, hospitals, and everything associated with the healthcare ecosystem.
Data security is one of the most pressing challenges facing the health care industry today. Cybercrime’s recent surge has led many health care organisations to realise that they need better security. The industry now understands the need for data security, but many obstacles remain.
Healthcare data is still maintained in its legacy format by various stakeholders, and the data remains in silos. There is an increasing need to implement healthcare interoperability to break down silos and create a longitudinal healthcare record for improved health outcomes.
Is health data interoperability a solution to these problems?
Health data interoperability is at the centre of various industry forums, including HL7 and Firball. All of the major healthcare stakeholders have understood the need and urgency for developing these standards in order to break down the silos and create longitudinal health records while allowing members to play an increasingly active role in deciding the end outcome. We are just starting, though healthcare interoperability is set to transform US healthcare with the introduction of TEFCA, burden reduction, the No Surprises Act, and other related regulations.
What is one thing that you hope to see the digital health field focus on or accomplish in the coming years?
My mission is to improve health data access for us as patients, caregivers, and health plan members. I want to enable us all to engage in our care as empowered team members. I want to see digital health applications develop business models that put us at the center, not as the product but rather as the customer that they serve. We need visibility into how health data is used without increasing administrative and cognitive burden while also resulting in major cost savings.
As a Health IT leader, what advice would you give to the youth considering a career in Healthcare Information Technology? What should they know about the industry before starting their career? What challenges they could face and how do they overcome the challenges?
Digital skills are a necessity to simply function in today’s world. If one has passion and a willingness to learn, then I would absolutely recommend people explore the opportunity by attending the master’s course in healthcare IT management. Let me tell everyone that healthcare IT is a complex segment, and it takes years to develop the required expertise that can help transform the life of a patient with a chronic condition. Patience, perseverance, and passion to implement cutting-edge solutions to continually improve health outcomes are the required skillsets to succeed in today’s world.
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