January 6, 2020
The ability for the health care industry to effectively utilize separate information systems in a way that integrates those systems and allows for the exchange and cooperative use of critical data, is more important than ever, and interoperability will only continue to gain momentum as we move into 2020 and beyond.
With that in mind, let’s dive into where interoperability stands, today, and where it might be headed.
There are four levels of interoperability – foundational, structural, semantic and organizational1.
Foundational refers to the ability of one system to communicated with another, while structural “defines the format, syntax and organization of data exchange.” Semantic helps tie data together in a way that provides common meaning and understanding to data, and organizational refers to ways the health care industry, the government, and more are working to provide considerations and standards surrounding interoperability.
While interoperability is, in theory, the future of patient care and patient-data transfer, a survey conducted by the Office of the National Coordinator for Health Information Technology (ONC) found that in both 2015 and 2017, only about 10% of physicians “engaged in all four domains of interoperability” – send, receive, find and integrate.
The same survey suggested that the small percentage of physicians who do participate in all four domains are more likely to have patient info available electronically from outside sources, providing a glimpse into the benefits of adopting full interoperability.
Currently, the Interoperability Standards Advisory process is the ONC’s main way of attempting to spur the industry toward dialogue about “the identification, assessment, and public awareness of interoperability standards and implementation specifications” and of addressing key needs surrounding interoperability.
While interoperability is growing, obstacles still exist in the form of non-standardized patient information, changing payment incentives, confusion surrounding privacy laws and hesitance regarding the security of data exchange.
It’s clear that increased interoperability is needed in the health care industry – lower costs, better care, increased efficiency and more will almost certainly result from interoperability’s continued growth.
To get there, however, the industry will need to consider four pillars of interoperability2:
New regulations like the 21st Century Cares Act are aimed at increasing patient access to their own data, and creating more informed and cared-for patients is the ultimate goal. However, if providers aren’t prepared and knowledgeable about how to comply with these standards, they could be in for a nasty surprise in the form of penalties. Entering 2020, it’s critical that providers looking to increase interoperability are aware of the steps they’ll need to take to do it the right way and with a patient-focused mindset.
As patients receive more access to their data, it’s critical that modern forms of providing that access are considered. Moving into 2020, patients will look to be able to access their records in a variety of ways, including in real-time using their smartphones. Security also needs to be a key consideration – while patients will relish this ease of access, they could also be hindered or turned away completely if they don’t feel the process is airtight.
The Statewide Health Information Network for New York is a tremendous example of the kind of shared access needed around the country – when care providers have quick and thorough access to patient information as part of a network like SHIN-NY, they’re empowered to make faster and more complete decisions for patients. It’s important, then, that the industry continues to push for the creation of more organizations like SHIN-NY.
While EHR-to-EHR communication is the most common of the four pillars, this communication is often still lagging behind. Internal EHR capabilities are getting votes of confidence around the country, but the sharing of data between parties is still limping along. In fact, according to a survey conducted by the Center for Connected Medicine (CCM), only 37% of respondents said they “can successfully share information with other health systems.”