What is Interoperability?
Interoperability in healthcare is the ability for various healthcare information technology (HIT) to exchange, interpret and use data cohesively.
Since the American Recovery and Reinvestment Act (ARRA) was enacted in 2009, healthcare providers have been forced to switch from paper to electronic health records. Among many other industry-changing factors, ARRA outlined expectations for health information technology (HIT) to electronically exchange data. This has been a major development in healthcare in recent years and arguably the leading force pushing the industry towards interoperability today.
The various software available in the industry is developed in silos leading to disjointed communications when paired. Integrations work to an extent, but the intent of interoperability is to have a holistic view of patients despite the variance in technologies used across practices, hospitals, pharmacies, etc.
In an article released by the Healthcare Information and Management Systems Society (HIMSS):
“Data exchange schema and standards should permit data to be shared across clinician, lab, hospital, pharmacy, and patient regardless of the application or application vendor.
Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.”
HIMSS continues the article by discussing the three levels of health information technology interoperability.
Why is Interoperability Important?
Interoperability is critical in healthcare because individuals receive care from numerous clinicians who operate in multiple healthcare systems and may be on several payer panels. The importance of continuous patient data flow cannot be overstated.
Here’s why healthcare interoperability is important: During the COVID-19 epidemic, home-based treatment for individuals with chronic conditions was critical. Many patients could capture specific physiological characteristics (e.g., temperature, blood pressure, weight, and breathing rate) and wirelessly communicate that healthcare data to their medical record, where physicians could access and monitor it, thanks to interoperable medical devices. These patients would have otherwise gone neglected when stay-at-home orders were widespread. Because of the convenience, many of these patients have continued to employ remote patient monitoring throughout the epidemic. Furthermore, when patients stay healthy, provider and payer organizations gain.
Levels of Health Information Technology (HIT) Interoperability
Regarding interoperability in healthcare, not all levels are created equal. Interoperability is classified into four levels: fundamental, structural, semantic, and organizational. In addition, there is a backdrop layer called “interoperability governance” and a cross-cutting element of the four levels called “integrated public service governance.”
Foundational interoperability refers to the ability of one information system to exchange data with another. The focal point with foundational interoperability is that the receiving system does not have to interpret the data it receives.
Structural interoperability is of medium complexity and defines the data structure of the information being passed between systems. This standardized message formatting allows data to be interpreted at the individual field level. Structural data is “preserved and unaltered”, according to HIMSS.
Semantic interoperability is the most complex and sought-after form of exchanging healthcare data. In this model, multiple systems can exchange data and use it to its fullest extent. This includes the exchange, interpretation, and use of data across disparate systems.
Governance, policy, social, legal, and organizational issues are all part of organizational interoperability, which enables secure, frictionless, and timely data exchange between and among organizations, entities, and people.
The greatest and most reliable level of interoperability currently accessible is semantic interoperability. At this level, two or more systems or components can communicate with each other and make use of the information they exchange.
Benefits of Interoperability
The exchange of information in healthcare, as with all other facets of modern life, is critical to our advancement. Interoperability addresses that need while simultaneously increasing the quality of care received, improving healthcare efficiency, and even financial incentivization.
Promotes Patient Education
Interoperability in healthcare can also encourage patient engagement and patient education. Consider the primary care physician who may provide a patient who has just received diabetes diagnosis training resources via the patient portal. This activity would be labor-intensive and laborious without interoperability between the educational system and the electronic health records.
Boosts Productivity, Reduces Costs and Enriches the Patient Experience
Healthcare interoperability may boost productivity while reducing costs and mistakes by facilitating the exchange of vital health information across medical practices, payers, laboratories, suppliers, and public health registries. This not only significantly improves the lives of healthcare workers and professionals, but it also helps patients have a better overall experience.
Reduced Physician Burnout
Healthcare EHR adoption has raised executive and physician burnout, unlike other industries where the digital revolution has reduced administrative and physician tiredness. Increasing regulatory compliance requirements, a lack of interoperability, and the sheer amount of software solutions have added to the workload for physicians and administrators alike. Reduced paperwork for employees and eliminating the need for manual data entry are significant advantages of healthcare interoperability.
Quality of Care
Most patients receive care from a series of clinics, independent practices, and hospitals. Those individual interactions make up the entirety of their medical history, otherwise known as the Continuum of Care. This history documents past symptoms, procedures, allergies, complications, etc. Not having access to all of those data points due to the lack of integrated healthcare IT systems is dangerous at most and at the least extremely inconvenient for the patient. Full visibility and access to patient data for both the healthcare institution and the patient is the primary benefit of interoperability.
By having real-time results at their fingertips medical practices can cut down on repetitive tasks and drastically increase margins by treating more patients and increasing the quality of care they receive. Patients will have more control over their own data, removing a significant amount of that administrative burden. The remaining administrative and clinical functions will be streamlined due to accurate data and insights.
Financial Incentives & Reimbursements
Meaningful Use, which offered incentives to practices that adopted EHR electronic health records set the tone for interoperability between systems and its alignment with financial incentives. This will continue to play a major role in future developments in value-based care, such as MIPS/MACRA, amplifying the relationship between patient outcomes and financial performance.