Healthcare information is among the most important types of data in the world because lives depend on it. As such, it is imperative that patient health data is easily and securely shared and accessed by healthcare professionals across various practices, fields, and facilities in a timely manner. When it comes to healthcare, time is much more than money; it can often be the difference between life and death. With the disparate systems currently in place, too much time is wasted in the exchange of medical records. The solution is interoperability.
Simply put, interoperability is the ability to exchange information between two different systems, and for those two systems to be able to use that information. However, interoperability is much more complex than this simple definition. The keys to understanding interoperability and how it can revolutionize the exchange of information in the healthcare industry include:
- The Definition of Interoperability
- Types of Interoperability
- Barriers to Interoperability
- The Future of Interoperability
As previously mentioned, interoperability refers to two or more systems exchanging information with each other and those systems’ ability to use the data that has been exchanged. Think of interoperability as an equation:
Exchange of Data Between Systems + Ability to Use that Data = Interoperability
In order to successfully achieve interoperability, both variables of the equation must be met. For instance, a person who speaks English could relay a message in English to a person who speaks Spanish, but if the Spanish-speaking person can’t interpret the message, has the communication truly been successful? The information was exchanged, but it wasn’t usable by both parties, so the answer is no. The same is true in the exchange of information between medical systems. The data must be usable once it has been exchanged. To better understand interoperability, let’s look at the different types of interoperability.
Types of Interoperability
Interoperability can be broken down into four main categories: organizational, semantic, syntactic, and technical. Each category is a critical component in the overall implementation and continuation of interoperability.
Organizational interoperability refers to steps organizations take to implement and maintain interoperability, as well as legislation and policies that govern and incentivize the exchange of data among healthcare providers. This includes the internal workflows, processes, and procedures healthcare organizations use to not only exchange information with each other, but also to comply with legal regulations regarding the exchange of such sensitive data.
The earlier example of an English-speaking person attempting to communicate with a Spanish-speaking person is a good way to conceptualize semantic interoperability. In order to use information, you must know what that information means. We’ve already established that the systems involved in the exchange of information must also be able to use that information once it’s been exchanged, and semantics plays a key role in that usability. Using the language barrier example, there can be confusion on the meaning of words within the same language as well. For instance, “bad” could be a negative descriptor of something, or it could be used in a positive connotation to imply something is cool or exciting. Semantic interoperability establishes a common language of medical terminologies and concepts that can be universally understood and used by healthcare professionals and medical systems.
Before the meaning of information can be discerned, the format in which the information is exchanged must be defined. This is where syntactic interoperability comes into play. International standards, such as HL7, help ensure health data is successfully exchanged using modern technology. If information is relayed in an incorrect format, it cannot be interpreted.
Technical interoperability is the easiest category to understand. It simply refers to the technology used in the exchange of information. This could be a computer, a mobile device, a thumb drive, or a host of other technologies used to relay a message from point A to point B.
Barriers to Interoperability
Before starting the journey to implementing interoperability, it’s important to understand the challenges. In a 2018 report to Congress, the ONC (Office of the National Coordinator for Health Information Technology) identified 6 major barriers to interoperability:
- Federal Documentation & Administrative Requirements – Outdated, unnecessary federal guidelines as well as a high amount of documentation required by commercial payers place a burden on IT departments.
- Federal Reporting Requirements – Reporting on irrelevant quality metrics costs healthcare providers time and money that could be put to better use.
- Financial – On top of the costs of federal reporting requirements, healthcare organizations also struggle with the costs of keeping up with ever-changing technology and regulations. A lack of financial incentives for organizations to share healthcare information with each other further hampers the move towards interoperability.
- IT System Design & Usability – Inconsistent UI designs across providers and misalignment with real-world processes and workflows impede the flow of information from one provider to another. Disparate systems used to store data also contributes to this issue.
- Technical – These barriers include any deficiencies in data quality, IT standards, and mismatched patient-data information. This is why the technical, semantic, and syntactic aspects of interoperability are so important.
- Trust – Healthcare providers are often reluctant to share patient information with other providers for legal and competitive reasons. Even if the other five barriers are overcome, providers must still be willing to share health data.
The Future of Interoperability
The journey towards interoperability is long and challenging. In fact, as Dr. Doug Fridsma, CEO of AMIA (American Medical Informatics Association) tells Healthcare IT News, “We’re never actually going to be done with this job.” The constant evolution of technology, the healthcare industry, and patient care in particular means the exchange of healthcare information will be constantly changing as well. So instead of looking at interoperability as an end goal, we should think of it as a goal to continually strive toward through innovation and collaboration.
There are many tools available to help overcome the challenges of interoperability. One innovative tool that can help you on your journey toward interoperability is iOrder, an order management software that helps eliminate coding errors, maximize reimbursements, and is interoperable with any referring physicians EHR without double entry. The revolution of health information exchange is upon us, and interoperability is leading the charge.