The game of Telephone is great fun for children but a terrible way to communicate vital health information. Yet in today’s healthcare systems, the multiple fragmented systems can lead to a Telephone-like mishmash of incomplete information. These systems are supposed to work together along the entire continuum of patient care, sharing data accurately and fully among multiple care providers.
This is healthcare interoperability in a nutshell. If it doesn’t happen, the quality of patient care suffers. Clearly, healthcare IT systems need to improve their ability to exchange, process and interpret shared data between many devices, applications and other systems. Further, the data needs to arrive in usable formats that healthcare providers can understand in order to improve patient care and healthcare productivity.
HIMSS describes interoperability as the extent to which systems and devices can exchange data and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and present that data so a user understands the data and can fully use it in their treatment and operations decisions.
HIMSS goes on to specify three stages of health information technology interoperability:
1. Foundational interoperability allows one IT system to receive a data exchange from another and does not require the receiving information technology system to interpret the data.
2. Structural interoperability defines the structure or format of the data exchange (i.e., the message format standards) where there is uniform movement of healthcare data from one system to another. Structural interoperability ensures that data exchanges between information technology systems can be interpreted at the data field level.
3. Semantic interoperability is the highest level, where two or more systems or elements can exchange and use information. Semantic interoperability takes advantage of both the data exchange structure and the codification of the data. This level of interoperability supports the electronic exchange of patient summary information among caregivers and other authorized parties via potentially disconnected electronic health record (EHR) systems and other systems to improve quality, safety, efficiency and efficacy of healthcare delivery.
For interoperability to achieve its greatest effect, it must also include data processing and interpretation, with the goal of delivering actionable information to the end user such as clinicians and the patients themselves.
Five Ways Interoperability Improves Healthcare
Improving patient care and safety is the prime directive and end goal of interoperability. Additional goals are improved care coordination and experiences for patients, lowered healthcare costs, and more robust public health data. How does it accomplish that? Here are the five key benefits of healthcare system interoperability through better information data exchange:
#1: Improved care coordination and patient experiences
Patients must often do administrative tasks like searching for documents, filling out multiple forms, re-explaining their symptoms or medical history and sorting out insurance (both before and, often, after receiving care). This means today’s patient experience is still surprisingly redundant and inefficient. Moreover, the multiple providers who may be providing care for a patient do not have their care coordinated. In fact, the Office of the National Coordinator for Health Information Technology revealed research that shows only 46 percent of hospitals had electronic access at the point of care to the patient information they required from outside providers or sources.
By using interoperability to streamline this process, healthcare facilities will be empowered to give patients faster and more accurate and coordinated treatment, and enhancing their overall experience.
#2: Greater patient safety
According to a study conducted by Johns Hopkins, 44 percent of medical error deaths were preventable. By creating and implementing advanced interoperability, with the aim to capture and interpret data across systems and applications, healthcare organizations can better prevent errors, because of missing or incomplete patient data, and pinpoint their errors’ causes if they do occur.
Even if they have excellent interoperability within their own enterprise, hospitals may be unable to communicate with external affiliates and systems. Lacking data on a patient’s vital signs and history – including allergies, medications or pre-existing conditions — healthcare organizations may be prone to fatal errors.
If care providers can exchange and examine data, they can analyze the exact cause of a medical error to detect the trends in the decision-making leading up to the error. Once a pattern has been identified, healthcare organizations can begin remediating these issues to prevent future errors.
#3: Stronger privacy and security for patients
Patient privacy and security should be a major consideration for any CIO or CISO who is actively looking to improve interoperability within their health system.
Interoperability can help enhance the privacy and security of patient data by requiring organizations to fully assess where their PHI resides and with whom it needs to be shared. When organizations enter data into systems that cannot communicate with one another, for example, it becomes difficult to track all systems that touch PHI, as required by the HIPAA Security Rule. It can be even tougher to track the users with access to an EHR or affiliated applications: In a study of 1 million FairWarning users, 26 percent of users were found to be poorly known or unknown to the care provider.
By promoting interoperability of HR systems such as Lawson or Peoplesoft with your HER, though, you can better identify users, track their access and more effectively manage access rights. When PHI is entered into secure, interoperable systems, organizations can gain a better idea of where their data is located and who has access to it, helping them secure patient data and protect privacy.
#4: Higher productivity and reduced healthcare costs
According to an estimate from the West Health Institute (WHI), which recently testified in front of the U.S. congress, system interoperability could save the U.S. healthcare system more than $30 billion a year. It can also improve care and hospital safety. Interoperability gives organizations the opportunity to save time with every patient encounter by getting the right data to the patient, the provider and affiliate at the right time, every time.
#5: More accurate public health data
Faster and more accurate collection and interpretation of public health data is possible when IT systems are able to interact. This can help organizations answer pressing questions for both patients and providers. The opioid crisis provides an excellent example of why more robust public health data is needed to understand the scope of that criris and continue ways to more effectively address and resolve the crisis. By facilitating the sharing and interpretation of such data, interoperability allows healthcare organizations to collectively educate one another on predicting and preventing outbreaks.
The Time Has Come
The National Hospital Association released a report, Sharing Data, Saving Lives: The Hospital Agenda for Interoperability. The title makes it clear that healthcare organizations understand the time has come to base healthcare on the best and most complete information possible – and that this is possible. Significantly better patient care and experiences are possible through the implementation of interoperability. These factors will create a more efficient and effective process for offering healthcare. With patient safety in the balance, the effort required to obtain interoperability will prove worthwhile.
About the author:
Shane Whitlatch is the general manager of Healthcare at FairWarning, where he is responsible for guiding the strategic vision and companywide direction for FairWarning’s healthcare business.