Healthcare interoperability is easier said than done.
Health system C-suites have spent the last several years building sophisticated IT platforms including their EHRs, business data analytics, communication services and more. Now, the next step to more coordinated care and better outcomes is interoperability, an expensive proposition for many institutions.
"The biggest threat in health IT and RCM at UTHealth Houston is the growing challenge of ensuring secure and compliant data interoperability, particularly in light of incidents like the recent Change Healthcare breach," said Babatope Fatuyi, MD, chief medical information officer at UTHealth Houston. "This breach underscores the risks of data breaches, privacy violations and operational disruptions that can arise from inconsistent data exchange practices."
Regulations on data sharing and exchange have evolved over the last few years and added complexity for health systems to stay compliant. Dr. Fatuyi said ensuring data exchange is secure, transparent and aligned with patient care needs can mitigate risks.
"The ongoing tension between major EHR systems and the vulnerabilities exposed by breaches, like the one at Change Healthcare, also threatens to fragment the interoperability landscape, particularly leading to silos that hinder seamless patient care," he said. "For UTHealth Houston, staying ahead of these challenges requires robust governance, proactive compliance strategies and a focus on maintaining trust and transparency in all data exchange."
According to a report from the Office of the National Coordinator for Health IT, released May 2024, less than half of hospitals routinely engaged in interoperable information exchange. Just 27% of hospitals reported "sometimes" using interoperable data exchange. But things are moving in the right direction; about 70% of the non-federal acute care hospitals have engaged in some type of interoperable information exchange in the last year.
Not all hospitals have the same ability to pursue interoperability. While 53% of system-affiliated hospitals routinely engaged in all four domains of interoperable data exchange (send, find, receive and integrate), 22% of independent hospitals met the same criteria. Hospitals with fewer resources, including rural and critical access hospitals, exchanged information interoperably at a lower rate than high-resourced hospitals, according to the report.
Melissa Cohen, chief innovation and transformation officer at Cayuga Health System in Ithaca, N.Y., sees interoperability as a pressing concern. With many healthcare providers still using fragmented IT systems, there are inefficiencies and potential errors in patient care and billing. But upgrading systems comes with its own set of financial and operational challenges.
"The push for greater interoperability, driven by regulations like the CMS Interoperability and Patient Access final rule, requires health systems to modernize their technologies, often involving significant financial and operational investments," said Ms. Cohen. "These fragmented systems create bottlenecks in patient information exchange and complicate the flow of the revenue cycle management data, further threatening the financial health of the organization."
Becoming fully interoperable is a huge undertaking, but it will be essential going forward. Amy Zolotow, director for operations at Timonium, Md.-based Mercy Personal Physicians said the "failure to embrace interoperability" is a prominent threat for healthcare providers.
"Without seamless data exchange, we risk siloed information that undermines patient care and inflates operational costs," said Ms. Zolotow. "This lack of integration not only integers efficiency but also stifles innovation. To truly drive transformation, we must prioritize systems that communicate and collaborate across the entire healthcare continuum."