Health Care in the Age of Interoperability: The Potential and Challenges

It is hard to conceive of a better rationale for healthcare interoperability than the management of chronic disease. People in advanced, industrialized countries are living longer, and chronic disease rates among the elderly are on the rise in part because of lifestyle issues, such as obesity and inadequate exercise. As a result, the care of chronic diseases (such as hypertension, heart disease, diabetes, chronic lung disease, and chronic kidney disease) accounts for well over 90% of spending by Medicare, the U.S. health insurance program for people age 65 and over. The Agency for Healthcare Research and Quality has found that the top 5% of patients with four or more chronic diseases are responsible for 30% of all Medicare chronic disease spending. While just 17% of Medicare patients live with more than six chronic conditions, they account for half of all spending on beneficiaries with chronic disease.