As the healthcare industry evolves toward value-based reimbursement, attaining true interoperability and integration between disparate patient care settings becomes more important than ever. Following are the steps a healthcare organization need to take to attain interoperability.

1. Implement an Electronic Health Record (EHR) System that supports your Organization’s current and future needs.

Interoperability in healthcare is the ability to share patient information across different information technology systems. To be competitive in today’s healthcare market, healthcare organizations benefit tremendously from implementing a tailor-made Electronic Health Record (EHR) system.

Electronic Health Record Software Benefits Include:

• Provides accurate and up-to-date information about patients at the point of care
• Enables quick access to patient records for coordinated care
• Improves patient and provider interaction and communication
• Enables safer prescribing
• Helps promote legible documentation and accurate, streamlined coding and billing
• Enhances privacy and security of patient data
• Enables providers to improve efficiency and meet their business goal

2. Integrate your EHR System with other mission-critical systems within your organization to receive real-time patient data electronically.

To provide informed patient care, there is a critical need to exchange information between dissimilar systems within your organization, such as hospital information systems and laboratory systems. Even with an implemented EHR system in place, there remains a critical need for exchanging patient health information between disparate systems and between different patient care settings.

The exchange of information takes place between systems by implementing Health Level 7 (HL7) interfaces. HL7 is the international standard for transferring clinical data between software applications. HL7 interfaces enables the sharing of patient demographic information, insurance information, billing information, documents, secure messages, orders and results between systems.

3. Integrate your EHR System with outside organizations for value-based care reimbursement requirements.

Reimbursement for health care services are evolving to value-based models, rather than the traditional fee-for-service model. The Centers for Medicare & Medicaid Services (CMS) has introduced an array of value-based care models. Eventually, CMS will tie all Medicare payments to value-based models.

Value-based models in use include:

• Accountable Care Organizations (ACO) – Consists of a network of physicians, hospitals and other healthcare providers that give coordinated care to Medicare beneficiaries. CMS designed the program to help providers ensure that patients receive the most appropriate care at the right time. ACOs also aim to prevent unnecessary and redundant services while reducing medical errors.
• Bundled payments – A Bundled payment is a single payment for services provided for an entire episode of care. Providers are collectively reimbursed for the expected costs to treat a specific condition that may include several physicians, settings of care, and procedures. For example, if a patient undergoes surgery, CMS would combine the set payment to the hospital, surgeon, and anesthesiologist, rather than paying each separately. The bundled payment is determined on historical prices.
• Patient-centered medical homes (PCMH) – The patient-centered medical home is a care delivery model that focuses on coordinating patient care through a primary care physician. The PCMH is designed to provide patients with a centralized care setting that manages the different needs of a patient. The PCMH certification indicates that providers deliver patient-centered care, team-based methods, population health management, personal care management, care coordination, and consistent quality care.

In conclusion, regardless of what value-based model is adopted by an organization, having access to comprehensive patient health data, generated from multiple healthcare settings, is paramount. Thus, investing in and executing an interoperability strategy will make certain that your organization maximizes reimbursement and thrives in today’s healthcare environment.

4. Partner with an experienced and dependable IT Services Team to provide Interoperability and Integration Services for your organization.

Executing on the critical need to establish interoperability with outside organizations can stress an organization’s already limited resources. By partnering with an outside IT Services Team, your goals can be met efficiently and satisfactorily.

Areas where an IT Services Partner can help are:

• EHR Selection
• EHR Implementation and Support
• HL7 Interface Development
• Integration Documentation
• Integration Testing Services
• Interface Maintenance
• Data Migration between EHR Systems
• 24/7 Service desk to support the users and providers

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