Interoperability 101: The Next Generation of Healthcare

The healthcare industry is swirling with health data, and healthcare has some significant strides in the past few years, right from genome sequencing and precision medicine to public policy and improvements in patient care. Yet the most-coveted, long-term goal remains to be realized- interoperability between health systems: a scenario where every healthcare system would speak the same language, information would flow seamlessly between healthcare organizations, and every organization, system, provider, and patient would have access to relevant clinical information at the right time.

Interoperability: a fundamental requirement

Healthcare organizations have come to a consensus that interoperability is going to be a fundamental requirement for ensuring EHR adoption, leaps in information sharing, and establishing a health IT infrastructure across the country.

As part of Medicare Access and CHIP Reauthorization Act, (MACRA), CMS has undertaken an initiative to support information exchange and promote interoperability in the following ways:

  • Provider-to-provider exchange through an electronic summary of care document.
  • Provider-to-patient exchange with the provision of electronic access to view, download or transmit information.
  • Provider-to-public health agency exchange through public health reporting.

The 21st Century Cures Act, one of the most significant healthcare bills passed aims to bring the world closer through a more seamlessly connected environment where data can be exchanged from one system to another without any loss of issues. It includes a number of measures that, if implemented correctly, would make interoperability a reality:

  • Making it easier for patients to access their own updated health information stored in EHRs.
  • Creating a new EHR reporting program, focusing on new standards for interoperability, security, and EHR certification.
  • Requiring the Government Accountability Office to ensure patient matching and redundancies.

Where do we stand?

True, healthcare interoperability has witnessed great progress. Yet providers and stakeholders face challenges in leveraging existing information sharing capabilities. Here are some facts and evidence that tell us where we are on the path to 100% interoperability:

  • According to a brief by the Office of National Coordinator for Health IT (ONC), only 60% of all hospitals use a health information exchange for data sharing.
  • About 50% of the hospitals face challenges when exchanging data across a different platform.
  • 36% of the hospitals reported their providers rarely or never use received electronic information when treating their patients.

Here are some challenges on the road to interoperability:

In a recent ONC report, it was mentioned that even if all the concerned stakeholders came to a common consensus, there would be two glaring challenges:

  1. Lack of agreement on a common standard for data exchange.
  2. Lack of properly equipped infrastructure to send and receive data country-wide.

Technology has a very significant role to play – it is critical that the technology and the standards in practice are updated and standardized to facilitate vital information flow required for comprehensive population health management. In addition, there are other barriers along the way:

  • Varying state privacy rules: The laws governing patient data sharing vary for every state which ultimately results in discord on sharing data across states.
  • Data exchange fees: Ideally, there should be no monetary value associated with data sharing. However, some vendors charge as much as $50,000 for end-to-end data sharing.
  • Secure data exchange infrastructure: It’s important to ensure smooth information exchange via standard secure messaging protocols, an EHR data repository, and complete registries.

The value of Interoperable health IT systems

Providers and vendors need to work together to figure out their clinical and business goals under value-based reimbursement arrangements and how they can leverage healthcare IT. A holistic health IT infrastructure would help providers with:

  • Increasing data fluidity across disparate systems
  • Capture inconsistent data carrying critical information
  • Perform a gap analysis and have a better understanding of data needs
  • Monitor the areas of improvement and shortfalls

To realize strategic goals associated with value-based reimbursement, providers and vendors should view and explore new alliances, legislations, resources, and IT infrastructure. The road to interoperability is a long one, and it can’t be achieved without making a commitment to improving information exchange. That said, interoperability is a complex puzzle, and the technology at our fingertips can and will help provide meaningful advances in obtaining better health outcomes and take one step closer to realizing their value-based reimbursement goals.

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