Interoperability in Healthcare

September 14, 2018 by Heather Stuit, Healthcare Systems Analyst

Interoperability in healthcare is the ability to share patient information across different information technology systems.  The first component is the ability to securely transport the data and the second component is the ability to interpret and use the exchanged data.  Interoperability ensures that healthcare systems can collect, share, and receive patient data with other healthcare providers, regardless of the application vendor.  

Levels of Health Information Technology Interoperability: 

  • Functional Interoperability (Basic) – Data from one information technology system is received by another and the receiving information technology system does not have the ability to interpret the data. 

  • Structural Interoperability (Intermediate) – Data exchanged between information technology systems can be interpreted at the data field level.

  • Semantic Interoperability (Advanced) – Utilizes both the structuring of the data exchange and the codification of the data so that receiving systems can interpret and use the data. This level of interoperability supports the electronic exchange of patient information among caregivers and other authorized parties. 

Benefits of Interoperability in Healthcare: 

  • Increased Patient Safety - Secure sharing of patient healthcare information electronically between the various providers and healthcare settings enable providers to make informed decisions. The information is available in a searchable form that minimizes delays caused by searching through charts or trying to decipher illegible handwriting. This reduces the risk of missing or misreading data and making a wrong diagnosis due to not having access to all the information available. The real-time transfer of patient health information can have a real impact on the patient’s health. For example, if a patient is rushed to the emergency room, the physicians have instant access to the patient’s medical record which could include their list of medications and allergies. 

  • Improved Patient Access to Their Own Health Data - Patients benefit from having electronic access to their own medical records. For example, a patient could visit the doctor, submit samples for testing, and then view the test results on their computer as soon as results are available. And they can follow up with their provider electronically if they have questions or concerns so that an unnecessary follow-up office visit might be avoided.  

  • Decreases Cost of Healthcare - Some studies point to a reduction of up to $100 billion per year as a result of EHR interoperability. Primary cost savings are from the reduction of malpractice lawsuits, unnecessary hospital stays and patient visits, and the elimination of inapplicable testing and unnecessary procedures. Interoperability also creates opportunities for preventative measures to be adopted on a larger scale which can reduce long-term healthcare costs. 

  • Increases employee productivity - Rather than needing to send and receive patient data via fax or email, that data would be immediately available electronically, thus decreasing the workload on support staff. Resources typically tied up in administrative tasks could be shifted to increase focus on patient care. 

  • Improved Public Health Data - Sharing health data allows for accurate collection and interpretation of public health data. This will assist with tracking and predicting the spread of contagious ailments to limit their spread and increase the effectiveness of treatment. This creates opportunities for preventative measures to be adopted on a larger scale, potentially reducing long-term healthcare costs. 

Challenges to Achieving Interoperability in Healthcare: 

  • Developing a standardized way of identifying patients – There are ongoing initiatives to promote the use of national patient identifiers and develop automated patient matching solutions. Assigning a unique patient identifier to every individual in the country would enable healthcare organizations and providers to exchange health information and patient health records accurately. Accurate patient matching methodologies would ensure the completeness of a patient’s record, even if different patient identifiers were assigned to the patient, due to services being provided by multiple non-related healthcare organizations.  

  • Enforcing industry-wide interoperability measurement standards – Although there is agreement on the importance of health IT standardization, organizations often interpret and enforce these standards differently.  Lack of interoperability standards or poorly enforced standards can obstruct seamless health data exchange and is one of the biggest challenges to interoperability advancement today. The expansion of healthcare organization-led alliances designed to facilitate exchange and promote standardization will assist in surmounting the lack of standardization between care settings. 

  • Ending information blocking and data sharing impediments - Despite Congress deeming the practice illegal, information blocking is still a prevalent problem in health data exchange. A study published earlier this year surveyed 60 HIE leaders and found that information blocking is widespread, and policies put in place to curb the practice have been ineffective. Efforts to further impede information blocking are underway. Current ONC efforts and bills in Congress pursue enforcement by authorizing the OIG to investigate and establish deterrents to information blocking. If successful, reducing information blocking will help ensure that data follow patients across provider organizations, which is essential to improving the quality and efficiency of care.  

Interoperability Vision for the Future

All individuals, their families and health care providers will be able to send, receive, find and use electronic health information in a manner that is appropriate, secure, timely and reliable to support the health and wellness of individuals through informed, shared decision-making. 

An interoperable health IT ecosystem will support critical public health functions, including real-time case reporting, disease surveillance and disaster response. Additionally, interoperability can support data aggregation for research, which can lead to improved clinical guidelines and practices.

The work and collaborative efforts of all stakeholders over the next 10 years will yield interoperability achievements in a variety of areas that, in turn, will advance the industry toward a learning health system. This will encourage the creation of new knowledge that can be consumed by a wide variety of electronic health information systems. This knowledge will support effective decision-making and lead to improved health outcomes.