Interoperability is complicated – so complicated that it recently took a whole panel of industry experts to break down the idea of true interoperability, define its current path, and provide projections for what to expect for the future.
I was recently honored to swap insights with a distinguished group of interoperability authorities, including CommonWell Health Alliance Executive Director Jitin Asnaami, Indiana Health Information Exchange Vice President Chuck Christian, and ONC Director of the Standards Division Chuck Muir, plus healthcare attorney David Harlow who served as moderator.
Our conversation was far-reaching and considered the state of interoperability from three different angles: legislative, technical, and financial. While I am not sure we came to any definitive conclusions, other than agreeing that we still have work to do, the discussion was an important step forward in this industry conversation.
Here are 6 key take-aways– and why they matter more than ever as we head into 2019.
1) It’s more than just sending records: Most hospitals are currently able to send out clinical records to community-based physicians. However, only 60 percent of hospitals can easily consume and assimilate incoming information into their EHRs, according to a recent CHIME survey. Full interoperability requires this exchange to be a two-way street, so one of our biggest interoperability challenges is finding a way to deliver information in a format that is useful to the receiver.
2) Data exchange standards are critical: Don Rucker, the National Coordinator for HIT, has said that interoperability requires that providers can do four things with clinical data: send it, receive it, find it, and make use of it in workflows. To make this happen, we must agree to some set of data exchange standards and a mechanism that allows recipients to not only open up envelopes of data, but also make use of the envelopes’ contents. Recipients must be able to easily identify what the data is and for which patient, and have the information intelligently filtered and matched with each patients’ specific issues.
3) Networking across networks is required: Both the private sector and the state and federal governments are actively working to improve interoperability and have numerous complementary rules in place that are driving us towards a common vision. For example, we have numerous local, state and even national health information exchanges, as well as numerous private networks. One goal of the 21st Century Cures Act is to have these various networks talk with one another and freely share data, possibly using open APIs. At the same time, the ONC is working to advance interoperability by eliminating issues associated with information blocking.
4) Incentives are needed to achieve the next level: The various rules and regulations have established a floor for interoperability requirements – and most providers and vendors are only doing the minimum because of competing priorities and a lack of financial incentives and penalties for delivering more than the basics. To move beyond the current floor, we need to consider new incentive programs that promote interoperability improvements.
5) Data security remains a priority: An ongoing concern is the need to keep clinical data secure. Industry leaders must continue to evaluate new technologies, such as blockchain, to ensure they actually mitigate privacy and security concerns, instead of creating a different set of problems. Adding to the technical challenges is the need to comply with constantly-changing state laws and regulations for patient privacy. A consensus national standard for patient privacy and the control of patient data would eliminate a good deal of friction between healthcare systems and smooth the way for increase data sharing.
6) Innovation and interoperability are linked: The use of artificial intelligence techniques and algorithms will become increasingly useful in terms of filtering and presenting data that will help with clinical decision-making. This becomes important as you consider ways to more efficiently manage incoming data and make it useful for recipients and physicians in particular. We need to spend more time innovating and making our current systems smarter than they are today.
Our progress towards achieving full interoperability at times seems slow. However, the reality is that we are continuing to move forward. Rather than feeling discouraged that we have yet to hit the ball out of the park, we should acknowledge that each time we hit a single or a double, we are inching one step closer to our interoperability goals.
By David Lareau, CEO of Medicomp Systems