Interoperability is not a new concept but in an era when so many complex systems are networked together we keep hearing about it often in different ways. Interoperability is the ability of computerized systems, irrespective of their make and model, to connect and communicate with one another readily.
Modern economies rely on computer systems that can exchange information between applications, databases, and other computers. This makes interoperability the focal point of attention in every sector of the economy, including healthcare.
What is interoperability in healthcare?
A key element of continuous care collaboration and advanced data analytics is interoperability. It enables seamless communication and exchange of information between electronic health records (EHRs) and other healthcare data management systems. Having an effective health information exchange (HIE) in place delivers patient data to clinicians and care teams quickly and securely - regardless of where the patient receives care or services.
As defined by the Healthcare Information and Management Systems Society (HIMSS) board, there are four levels of interoperability in health information technology:
- Foundational Interoperability : Foundational interoperability allows an information system to exchange data with another information system. The information exchanged will be instantly available for use as the receiving system does not have to interpret the data.
- Structural Interoperability : Structural interoperability specifies the data exchange format. This involves standards that govern the format of messages being sent from one system to another, so that the operational or clinical purpose of the information is explicit.
- Semantic Interoperability : This level provides connection between two systems. Information can easily be exchanged and used across two or more separate systems or components of systems. The structure of data exchange and how it is codified in the semantic interoperability enables medical providers to exchange patient data between systems using completely different EHR software solutions from different vendors.
- Organizational Interoperability : This level of interoperability involves governance, policy, social, legal and organizational aspects of information exchange to ensure secure, timely and seamless communication and use of data within and between organizations, entities and individuals. Each constituent of the organizational interoperability enables shared consent, integrated processes, and secured exchange. To achieve interoperability and establish a single source of truth rather than having portions of patient records dispersed across institutions and systems, it’s crucial to manage these levels appropriately. This helps to aggregate all the available patient information in a central hub, allowing care teams to readily access and view the same data.
Why is interoperability crucial for healthcare industry?
Care continuum plays a critical role for patients suffering from chronic conditions or in acute situations requiring multiple healthcare providers. Interoperability is beneficial for enabling greater efficiency in patient care transitions by organizing and making accessible medical information of patients anywhere, across any system. When data is presented consistently, no matter where it comes from, practitioners can focus on patients' care, treatment plans, and make better decisions about treatment quickly rather than spending hours creating or mining data from disconnected, difficult, and varied sources. This in turn leads increased level of patient engagement and better outcomes.
According to a research by West Health Institute (WHI), it is estimated that a lack of interoperability costs the U.S. health system over $30 billion each year. Lack of interoperability in healthcare compromises patient safety, contributes to clinician burnout, and wastes billions of dollars annually. In addition to these, the lack of interoperability also prevents development within the healthcare industry which is the biggest missed opportunity for the health interoperability ecosystem. For example, when a patient falls ill while on a vacation or a business trip, they might not have access to their entire medical history to help the doctor understand their case. This might delay the best course of treatment and immediate medical aid.
What are the benefits of interoperability in healthcare for patients and providers?
As so many of our systems and equipment are connected by wires and wireless networks, it is important that we all stay abreast of advancements in interoperability in government and industry. Let’s explore how interoperability benefits both the patients and the providers in the healthcare ecosystem.
- Improves quality of patient care : Lack of access to health data points through integrated healthcare IT systems can be dangerous and extremely inconvenient. When providers have access to all the relevant patient information, they can focus on the patients to make the best decisions, enhance patient outcomes and provide the most effective care.
- Increases efficiency with reduced error : In the absence of interoperability, healthcare staffs end up spending an excessive amount of time faxing and manually coordinating data exchange. Patient safety and health could be jeopardized by data input errors made by humans. With interoperability, it is possible to streamline certain processes, eliminate most manual data entry, minimize errors, and make time for other tasks.
- Delivers value-based care : Data, insights, and tools provided by interoperability optimize time and resources, enabling providers to work more efficiently and effectively. Interoperability makes healthcare more efficient by reducing the number of redundant patient tests ordered and facilitating faster communication between specialists and referring physicians.
- Secures and protects patients’ data : Data is more secure when there are fewer touches of paper and data involved. Interoperability acts as a virtual, secure, and central repository for patients’ data to prevent leaks and vulnerabilities attempted by unauthorized devices/individuals.
- Research and innovation : A robust interoperability standard and seamless health information exchange can be helpful when it comes to improving data quantity and quality used in clinical research. These data sets, when aggregated and analysed by clinically focused data scientists using traditional analytics and machine learning, can potentially generate new hypotheses that can benefit all of us. Interoperability standards such as Fast Healthcare Interoperability Resources (FHIR) are accelerating research and innovation in the healthcare industry thanks to great attention from FDA, CDC, and NIH.
Top 4 healthcare interoperability challenges
Let’s take a look at the top 5 interoperability challenges within the healthcare industry which often leads to innovators avoiding the healthcare market altogether.
- Various healthcare systems operating in silos : With many healthcare systems operating, it becomes imperative to collect, store, manage, and share data using proprietary formats and protocols. This makes multiple EHR, diagnostic, and other healthcare systems interacting with one another time-consuming and complex.
- Lack of standardization of terminology and normalization of data : In the absence of interoperability standards or with poorly enforced standards, seamless health data exchange can be impeded leading to complicated transactions and creating additional barriers to flow of information.
- Interoperability measurement standards are not consistent industry-wide : Different stakeholders often have different interoperability measurement standards. Owing to the increasing number of interoperability improvement initiatives underway across the industry, it becomes challenging to assess and track the progress of these initiatives in a consistent manner.
- Blocking of information and data-sharing : Several providers are hesitant to share patient data for a variety of reasons, including fear of adverse repercussions. The eradication of information blocking will help improve the quality and efficiency of care by ensuring access to patients’ data across organizations.
For the healthcare industry to deliver value-based healthcare and address prevalent challenges, it’s crucial that clinical data flows freely with real-time data exchange across networks.
Interoperability in Healthcare: Current State and Road Ahead
Interoperability in healthcare combines all aspects of the patient experience into a comprehensive profile to facilitate seamless health-related information exchange among caregivers and patients. To this end, even though healthcare providers have made progress towards understanding and defining interoperability standards, there’s still much work left owing to changing federal regulations, evolving technological advancement, changing care needs and new challenges posed by the COVID-19 pandemic.
In today’s health interoperability ecosystem, to experience the greatest success, drive better decision making and deliver better outcomes, healthcare organizations need IT systems and software applications along with the latest healthcare data interoperability principles to communicate and exchange patient data efficiently and securely.