An Improved Healthcare System Is Possible with Interoperability

Shane Whitlatch, General Manager, Healthcare, FairWarning
MARCH 11, 2019
interoperability,healthcare interoperability,semantic interoperability

Healthcare IT systems are becoming increasingly convoluted. More data, more connected devices and more regulations require more systems, which ideally can communicate and exchange data — not just within a healthcare organization but among organizations. This is the idea behind healthcare interoperability. According to HIMSS, interoperability is about the extent to which systems and devices can exchange data and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and present that data so that a user understands the information and can use it in their treatment and operations decisions.

HIMSS goes on to describe three progressive levels of health IT interoperability. First is “foundational” interoperability. It enables one IT system to receive a data exchange from another and does not require the ability for the receiving information technology system to interpret the data.

The next step up is “structural” interoperability. It determines the structure or format of the data exchange (i.e., the message format standards) where there is uniform movement of healthcare data from one system to another. Structural interoperability ensures that data exchanges between information technology systems can be interpreted at the data field level.

The final and highest level is “semantic” interoperability. It this situation, two or more systems or elements can exchange and use information. Semantic interoperability takes advantage of both the data exchange structure and the codification of the data. This level of interoperability supports the electronic exchange of patient summary information among caregivers and other authorized parties via potentially disconnected electronic health record (EHR) systems and other networks to improve quality, safety, efficiency and efficacy of healthcare delivery.

Interoperability becomes optimal when it includes data processing and interpretation, with the goal of delivering actionable information to the end user, such as clinicians and the patients themselves.


Benefits of Interoperability

The premise of interoperability is making patient care and data safety better. Other goals include improved care coordination and experiences for patients, lowered healthcare costs and more robust public health data.

But how does interoperability accomplish these objectives? Here are the five key benefits of healthcare system interoperability through better information data exchange:


1. Greater patient safety

In this day and age, medical errors should be rare. A Johns Hopkins study determined that 44 percent of medical error deaths were preventable. By creating and implementing advanced interoperability, with the aim to capture and interpret data across systems and applications, healthcare organizations can better prevent errors due to missing or incomplete patient data. If an error does occur, advanced interoperability enables healthcare organizations to pinpoint the cause.

Healthcare providers might not be able to exchange data with external affiliates and systems even if they have excellent interoperability within their own enterprise. Lacking data on a patient’s vital signs and history — including allergies, medications or pre-existing conditions — healthcare organizations may be prone to fatal errors.

However, if these organizations can exchange and examine data, care providers can analyze the exact cause of a medical error to detect trends in the decision making leading up to the error. Once a pattern has been identified, healthcare organizations can begin remediating these issues to prevent future errors.


2. Improved patient experiences and coordination of care

The healthcare industry provides a stunning example of inefficiency in today’s digital world. The multiple providers who may be caring for a patient do not have their care coordinated. Patients must often do administrative tasks like search for documents, fill out multiple forms, re-explain their symptoms or medical history and sort out insurance (both before and often after receiving care). In fact, the Office of the National Coordinator for Health IT revealed research that suggests only 46 percent of hospitals had electronic access at the point of care to the patient information they required from outside providers or sources.

Interoperability can vastly improve this process, giving patients faster, more accurate and coordinated treatment and enhancing their overall experience.


3. More accurate public health data

Where interoperability is present, IT systems can interact in such a way that faster and more accurate collection and interpretation of public health data are possible. This can help organizations answer pressing questions for both patients and providers. The opioid crisis provides an excellent example of why healthcare needs more robust public health data to understand the scope of that problem and continue ways to more effectively address and resolve the crisis. By facilitating the sharing and interpretation of such data, interoperability allows healthcare organizations to collectively educate one another on predicting and preventing outbreaks.


4. Reduced costs and higher productivity

Improved care and hospital safety are outcomes of system interoperability. This ability to exchange data could save the U.S. healthcare system more than $30 billion a year, according to an estimate from the West Health Institute (WHI), which recently testified before Congress. Interoperability also gives organizations the opportunity to save time with every patient encounter by getting the right data to the patient, the provider and affiliate at the right time, every time.


5. Better patient privacy and security

Patient privacy and security are the primary care and regulatory issues to consider when implementing interoperability. This is not an easy task, but it can help enhance the privacy and security of patient data by requiring organizations to fully assess where their protected health information (PHI) resides and with whom it needs to be shared. When organizations enter data into systems that cannot communicate with one another, for example, it becomes difficult to track all systems that touch PHI, as required by the HIPAA Security Rule. It can be even tougher to track users with access to an EHR or affiliated applications: In a study of 1 million FairWarning users, 26 percent of users were found to be poorly known or unknown to the care provider.

By promoting the interoperability of human resource management systems such as Lawson or Peoplesoft with your EHR, though, you can better identify users, track their access and more effectively manage access rights. When PHI is entered into secure, interoperable systems, organizations gain a better idea of where their data live and who has access to it, helping them secure patient data and protect privacy.


Worth the Effort

The American Hospital Association, the Association of American Medical Colleges and several other organizations released a report in January that called for interoperability, arguing that it gives patients peace of mind because they know their providers’ decisions are based on the best, most complete information possible. Interoperability could form the foundation for a significantly improvement in both patient care and experiences. Healthcare processes would become streamlined. It takes work to achieve true healthcare systems interoperability, but it’s a worthwhile undertaking.

Shane Whitlatch is General Manager for Healthcare at FairWarning, where he is responsible for guiding the strategic vision and companywide direction for FairWarning’s healthcare business.

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