Interoperability. We’ve been talking about it in healthcare for more than a decade, but as for progress? Well… while there have been advances in some areas, it’s clear we have a long way to go.
Today, the need for interoperability is even greater than it was before. It’s becoming increasingly clear that as new payment models emerge and healthcare shifts towards a population-oriented view, free and timely exchange of data will be critical. Let’s take a look.
HIMSS first defined interoperability in 2005 as “the ability of two or more systems or their components to exchange information and to use the information that has been exchanged.” The organization’s Integration and Interoperability Steering Committee further refined this definition to “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.”
In 2013, HIMSS discussed the three levels of interoperability:
- Foundational interoperability: Data exchange from one IT system to another. It does not require the receiving IT system to interpret the data.
- Structural interoperability: Uniform movement from one IT system to another such that “the clinical or operational purpose and meaning of the data is preserved and unaltered.” This level of interoperability ensures that data exchanges between systems can be interpreted at the data field level.
- Semantic interoperability: This high level of interoperability is the ability for systems to not only be able to exchange information, but also to be able to use the information that has been exchanged.
It is this last level of interoperability that is least available today, but most needed in the new healthcare landscape.
“Driving Interoperability Forward”
Interoperability was front and center at the New England HIMSS Health IT Advocacy and HIE Day, held earlier this month. At the event, various speakers discussed where we are with interoperability today, and where we need to go so interoperability can support change in the healthcare system.
Here are a few takeaways:
- Interoperability efforts must be useful, usable, and provide trust: Larry Garber of Reliant Medical Group, based in Massachusetts, discussed how his organization of independent physicians has created a more interoperable information exchange with area hospitals. Dr. Garber’s keys to success in an interoperability (or any IT) project are: the project must provide value to all stakeholders, it must fit into real-world workflows, and it must provide trust among stakeholders. Dr. Garber says that in the value-based care world, interoperability is even more important, in that free information exchange across the healthcare spectrum is necessary to provide quality care.
- Data needs to be timely: Renee Broadbent of Holon Solutions discussed the impact that interoperability has on clinical practice. She talked about how population health and value-based care are making it critical to share information more efficiently, effectively, and safely. Data – such as clinical, claims, social determinants of health (SDOH), and patient-reported outcomes – needs to be shared in a timely way across ecosystems. And it needs to be in front of physicians when they need it so they can make informed decisions.
- Semantic interoperability: John D’Amore of Diameter Health discussed the need for semantic interoperability. That is the ability to import “utterances” from one computer to another and to have them not just available for viewing, but to be able to be used for decision support, business rules, and data queries. This type of interoperability results in data that powers quality measurement, which in turn, results in revenue for healthcare providers.
New developments in interoperability
One of the speakers at the New England HIMSS event, Renee Broadbent, spoke about some successes in interoperability. One of these successes is the Sequuoia Project. Just recently, the Sequoia Project made headlines as it has created a new public-private partnership with an aim to solve interoperability challenges.
While there are no easy solutions to interoperability, it is critical that all of healthcare works to make different types of technology talk to each other – not just at the viewing level, but at the level of truly understanding other information. As healthcare moves to new payment models, the insights provided by a freer exchange of data will result not only in financial benefits for hospitals, but more importantly, in better patient care.