Why Is Interoperability Important in Healthcare

The idea of making EHRs work together, known as healthcare data interoperability, has become a hot topic due to healthcare standards and regulations such as the Cures Act Final Rule. This act, signed by President Obama, mandates that EHR systems must incorporate APIs to enable seamless data exchange. It emphasizes the importance of making healthcare data available to all stakeholders. Practices that impede data sharing may be considered ‘information blockers’ and can face civil fines of up to $1 million.

Now, let’s delve deeper into clinical data interoperability. We will define interoperability in healthcare, provide an overview of its standards, and discuss the core benefits and challenges.

What is Interoperability in Healthcare Information Systems (HIS)?

Interoperability is the ability of different systems, devices, and apps to collaborate and share information. It means they can access, exchange, and integrate data, even if they come from different organizations, regions, or countries.

In healthcare information systems, interoperability aims to streamline data exchange and reduce redundancies experienced by patients, providers, and payers. The outcome? A more efficient, coordinated, safe, and accurate patient experience.

Moreover, interoperability leads to fewer clinical errors, lower costs, and increased payer margins.

Examples of Interoperability in Healthcare

Here are the three schematic examples of the interoperability of healthcare systems:

Example #1: Appointment Check

Patients can use mobile or web applications to check their appointments quickly. Here’s how it works:

  1. The patient submits a request through the application.
  2. The application sends the request to the hospital information system (HIS).
  3. The HIS uses standardized messages to communicate with the electronic medical record (EMR).
  4. The EMR retrieves the patient’s appointment information and sends it back to the HIS.
  5. The application receives the appointment details, and the patient can view them.
Example #1: Appointment Check 
Patients can use mobile or web applications to check their appointments quickly. Here's how it works:

The patient submits a request through the application.
The application sends the request to the hospital information system (HIS).
The HIS uses standardized messages to communicate with the electronic medical record (EMR).
The EMR retrieves the patient's appointment information and sends it back to the HIS.
The application receives the appointment details, and the patient can view them.

Example #2: Hospital Transfer

When a patient needs a transfer to another hospital, the process can be simplified through interoperability. Here are the steps:

  1. Doctor #1 initiates a transfer request using their EMR.
  2. The EMR sends a standardized message to the EMR of the receiving hospital.
  3. The clinical data of the patient is transferred to the receiving EMR.
  4. Doctor #2 at the receiving hospital reviews and approves the transfer request.
  5. A standardized message sends The approval status back to Doctor #1.
Example #2: Hospital Transfer 
When a patient needs a transfer to another hospital, the process can be simplified through interoperability. Here are the steps:

Doctor #1 initiates a transfer request using their EMR.
The EMR sends a standardized message to the EMR of the receiving hospital.
The clinical data of the patient is transferred to the receiving EMR.
Doctor #2 at the receiving hospital reviews and approves the transfer request.
A standardized message sends The approval status back to Doctor #1.

Example #3: Lab Test Results Request

Doctors can request lab test results to provide prompt answers to their patients. The process involves:

  1. Patients ask their doctor to analyze their lab test results.
  2. The doctor submits a request using their EMR.
  3. The EMR sends a standardized request to the laboratory.
  4. The laboratory generates a standardized report and sends it back to the EMR.
  5. The doctor reviews the lab test results within the EMR and provides answers to the patients.
Example #3: Lab Test Results Request
Doctors can request lab test results to provide prompt answers to their patients. The process involves:

Patients ask their doctor to analyze their lab test results.
The doctor submits a request using their EMR.
The EMR sends a standardized request to the laboratory.
The laboratory generates a standardized report and sends it back to the EMR.
The doctor reviews the lab test results within the EMR and provides answers to the patients.

These examples show how interoperability helps in healthcare process improvement.

How Does Interoperability Impact Healthcare Delivery?

Interoperability enables providers to access prescription lists, discharge summaries, hospital admissions, lab test results, and healthcare plans. With access to this data, healthcare providers can make optimal healthcare decisions.

It reduces the likelihood of duplicated processes and tests. Interoperability also reduces administrative costs associated with manual and faxing workflows, while allowing organizations to enhance the efficiency of healthcare operations. This is because it minimizes errors.

Healthcare Interoperability Standards

Different categories of standards are used for interoperability in healthcare systems. The main ones are vocabulary/terminology, content, transport, privacy and security, and identifiers. Let’s overview them one by one.

Healthcare Interoperability Standards
Vocabulary/Terminology Standards (e.g.  CPT, ICD-10, LOINC, and SNOMED-CT)
Content Standards (e.g. C-CDA, HL7 V2, and HL7 CDA)
Transport Standards (e.g. DICOM, FHIR )
Privacy and Security Standards  (e.g. HIPAA, GDPR)
Identifier Standards (e.g. EMPI, NPI)
Vocabulary/Terminology Standards

These interoperability standards in healthcare ensure that concepts in health information are represented clearly and consistently between different systems. They include codes and classifications for medical procedures, diseases, drugs, and other health-related terms. Examples of such standards are CPT, ICD-10, LOINC, and SNOMED-CT.

Content Standards

Content standards define the structure and organization of electronic documents exchanged between systems. They provide guidelines on how data should be formatted and organized within these exchanges. Examples include C-CDA, HL7 V2, and HL7 CDA.

Transport Standards

Transport standards address the format and methods of exchanging health information between computer systems. They define protocols and architectures for secure and efficient data transfer. Examples include DICOM for medical imaging, Direct Standard for secure messaging, and FHIR for electronic health information exchange.

Privacy and Security Standards

Data security and privacy standards protect individuals’ rights over their health information. HIPAA in the US and GDPR in Europe are examples of privacy regulations, while the HIPAA Security Rule provides guidelines for securing electronically protected health information.

Identifier Standards

Identifier standards help ensure accurate identification and matching of health records. Examples include EMPI for patient identification within healthcare organizations, MRN for unique patient identification during hospital stays, and NPI for identifying healthcare providers.

Benefits of Interoperability in Healthcare

Interoperability in healthcare benefits patients by ensuring they receive improved care. It allows their healthcare providers to access all their medical information, including diagnoses, treatments, and medications. For providers, interoperability means faster and easier access to patient information, making their tasks more efficient and effective. 

Decreased Errors

Medical errors, a significant concern in healthcare, contribute to many preventable deaths. Medical error ranks as the third leading cause of death in the United States (pre-pandemic), with 44% of these deaths considered preventable, as highlighted by a study published in The BMJ. While not all medical errors stem from inaccuracies in medical records, it is evident that some errors can be attributed to them. Data entry errors, particularly in medical records, often result in duplicate patient records, compromising the accuracy of patient matching and leading to inefficiencies such as redundant lab tests. Addressing these errors through improved interoperability can help mitigate risks, enhance patient safety, and optimize healthcare system resources.

Improved Patient-Centric Care

Achieving interoperability across this continuum of care becomes vital as it allows all providers to access a patient’s complete medical history, enabling them to deliver optimal and comprehensive care. A survey of U.S. health system executives and finance leaders revealed that 52% of respondents believed data sharing to be the technology with the most significant positive impact on the patient experience, emphasizing the transformative potential of interoperability in enhancing patient care outcomes.

52% of health system executives and finance leaders believed data sharing to be the technology with the most significant positive impact on the patient experience

Invoicing And Billing Process Simplification

According to Business Payment Coalition, adopting electronic invoices can lead to significant cost savings, with estimates suggesting that businesses can save $4 to $8 per invoice. For healthcare providers, such as a hospital issuing 2,500 invoices monthly, this translates to potential savings of $10,000 to $20,000 per month, highlighting the financial benefits of interoperability in making the invoicing and billing process easier and more efficient.

Invoicing And Billing Process Simplification
$4 to $8 per invoice = $10,000 to $20,000 per month*
assuming the healthcare provider is issuing 2,500 invoices monthly

Challenges to Achieving Interoperability in Healthcare

Interoperability issues in healthcare have serious consequences, like compromised patient safety, increased clinician burnout, and significant financial losses. A study revealed that the lack of healthcare data interoperability costs the United States health system more than $30 billion annually.

Inconsistent Information in Multiple Sources

Providers store data in various locations and systems, resulting in fragmented and disparate data sets. This lack of standardized and harmonized information hampers the seamless exchange and integration of data across different platforms. It leads to inefficiencies and wasted time for health IT departments as they struggle to reconcile and synchronize data from different sources.

Verifying Electronic Patient Information Requests

As mandated by law, ensuring patient health records’ privacy and security is paramount. Providers face the challenge of determining when it is permissible to process electronic requests for patient information. Simply relying on the approval of their EHR provider is insufficient, especially with the introduction of new training and certification requirements under the Cures Act Final Rule.

Challenges to Achieving Interoperability in Healthcare
Inconsistent Information in Multiple Sources
Data storage in various locations and systems that results in fragmented and disparate data sets

Verifying Electronic Patient Information Requests
It is a challenge to determine when it is permissible to process electronic requests for patient information.

Overcoming a Company's Reluctance to Share Data
A vested interest of some vendors in withholding data from other providers

Hiring Interoperability Management Professionals is Expensive
It is a demanding task that requires significant time, expertise, and cost
Overcoming a Company’s Reluctance to Share Data

Specific stakeholders may have a vested interest in withholding data from other providers. For instance, hospital systems may compete with urgent care clinics for patients. It leads to limited motivation to share data when requested by these clinics through the hospital’s EHR system. Yet, the law mandates that health data should be accessible across organizational boundaries and to patients themselves.

Hiring Interoperability Management Professionals is Expensive

Achieving interoperable EHRs can be a demanding task requiring significant time and expertise. In many healthcare settings, it is challenging for a single individual to dedicate themselves to this responsibility. Moreover, hiring a qualified professional to maintain EHR interoperability can be costly, especially for smaller organizations.

Conclusion

To sum up, interoperability in healthcare information systems has become increasingly important in 2023 due to the growing emphasis on seamless data exchange and accessibility of healthcare data. This helps healthcare organizations make informed decisions, track population trends in healthcare industry, and follow regulatory requirements. It also fosters uninterrupted care coordination as healthcare providers gain seamless access to complete and updated patient information, regardless of where patients receive treatment. This synergy helps avert unnecessary repetition of tests, reduces the likelihood of medical errors, and guarantees that treatments are firmly based on the most precise and up-to-date data available. Interoperability is a key enabler for a more connected and collaborative healthcare ecosystem.

FAQs

What are some best practices for implementing interoperability in healthcare?

Implementing interoperability in healthcare requires careful planning and adherence to best practices. Here are some key considerations:

  • Establish Сlear Goals

Define the objectives and outcomes you aim to achieve through interoperability. It may be seamless information exchange, improved care coordination, or enhanced patient engagement.

  • Adopt Industry Standards

Utilize widely accepted data-sharing standards like HL7 FHIR, DICOM, and SNOMED CT to ensure consistency and compatibility in exchanging health information.

  • Develop a Robust Infrastructure

Implement a reliable technology infrastructure supporting secure data exchange, including robust networking, storage, and integration capabilities.

  • Ensure Data Security and Privacy

Implement appropriate security measures to protect sensitive health information during transmission and storage. Adhere to privacy regulations like HIPAA and GDPR.

  • Promote Data Quality

Implement data governance practices to ensure the accuracy, completeness, and integrity of health data. Standardize data entry and validation processes to improve data quality.

  • Foster Collaboration and Partnerships

Collaborate with other healthcare organizations, vendors, and stakeholders to promote interoperability. Foster partnerships that support seamless data exchange and information sharing.

  • Engage Stakeholders and End-Users

Involve clinicians, administrators, and others in the design and implementation process to understand their needs and ensure the usability and adoption of interoperable systems.

  • Enable Patient Access and Engagement

Empower patients to access and manage their health information through portals, secure messaging, and other tools. Promote patient engagement in their care process.

  • Provide Training and Education

Offer comprehensive training and education programs to users of interoperable systems. You must ensure they understand the functionalities, benefits, and best practices.

  • Monitor and Evaluate Performance

Track the performance and impact of interoperable systems. It helps to identify areas for improvement and optimize the benefits achieved. Regularly assess the satisfaction and feedback of end-users.

What role do technology and data-sharing standards play in achieving interoperability?

Data-sharing standards establish a common framework and rules for structuring and formatting information. They define the syntax, semantics, and data elements required for effective system communication. 

Technology and data-sharing standards promote interoperability. It improves care coordination, facilitates research, and enhances healthcare delivery quality.

What is the future of interoperability in healthcare?

The future of interoperability in healthcare holds great potential for transformative advancements. Here are some key aspects that shape the future of healthcare interoperability:

  • Seamless Data Exchange

Interoperability enables the seamless exchange of health data among different systems. This will provide comprehensive patient records, enhanced care coordination, and improved decision-making.

 

  • Advanced Technologies

AI, ML, and NLP can automate data processing, assist in health data analytics, and support clinical decision-making. This leads to more efficient and precise healthcare delivery.

  • Patient Empowerment

Interoperability will empower patients by giving them better access to their health information. Patients can securely share their data with healthcare providers, participate in shared decision-making, and engage in their care management.

  • IoMT

Interoperability will enable the integration of IoMT with healthcare systems. Hence, proactive interventions, effective implementation of telemedicine, and remote monitoring become possible.

  • Interoperability Governance

Clear guidelines for data sharing, consent health data management, and interoperability standards will be crucial to building trust and protecting patient privacy.

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Written by:
Roman Konstantinov Roman Konstantinov Managing Partner & Co-Founder
Roman is the co-founder of Empeek who brings a breadth of knowledge to build, scale and transform healthcare organizations. He specializes in revitalizing struggling businesses and turning them into profitable enterprises. By emphasizing automation and effectively navigating the transition from startup to a sustainable and scalable model, Roman drives remarkable transformations to ensure long-term success.

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