The Future of Clinical Interoperability

January 17, 2023

Shared and effective care relies on interoperability. When you ask yourself what interoperability is, it is basically exchanging electronic information between two devices and systems seamlessly with minimal effort from the user. 

In healthcare, interoperability is also known as healthcare data. It consists of the technologies used in patient care to enable the sharing of data to deliver personalized care and effective population health management.

What is Interoperability?

It is the capability of different information systems, devices and applications (systems) to access, exchange, integrate and cooperatively use data and information in a coordinated manner, with other organizations, territorial and national boundaries, to give appropriate and easy portability of information and optimize the health of people and populations globally.

Health data exchange structures, application interfaces and standards enable data to be accessed and distributed properly and securely over the entire care division, with all relevant perspectives and with relevant stakeholders.

Interoperability in healthcare

Interoperability refers to secure access, integration and utilization of electronic health data so that it can be used to optimize health outcomes for individuals and populations. It will take time for all types of health IT to be fully interoperable.

Achieve Interoperability with 5 elements

1. Adoption and Optimization

2. Standards

3. Financial and Clinical Incentives  

4. Privacy and Security

5. Rules of Engagement

Healthcare Interoperability Challenges

Most would acknowledge that the aspirational goal i.e.., the ideal for healthcare is an open and safe ecosystem where individual patients can enter their data easily through smart apps, and clinicians can access additional information from external systems easily.

In healthcare, a lack of interoperability compromises patient safety, contributes to clinician burnout, and wastes billions of dollars every year. The United States health system loses over $30 billion every year because of a lack of healthcare data interoperability, according to one study. 

Typically the lack of healthcare interoperability hinders development, which may be the most significant problem. Most hospitals and systems are unable to share data because they have very different ways of storing the information, lack common standards for how to store it, and/or lack technical skills. 

This, in turn, discourages innovators from venturing into healthcare and sparking change because they are unable to work with these systems. This means that there is no competition and little innovation in the healthcare space. 

In spite of the fact that interoperability standards have been established and providers have been helped understand what interoperability means, the healthcare system still faces new challenges caused by the COVID-19 pandemic. 

Let’s explore Interoperability Challenges

Disjointed coordination

Promoting interoperability needs great coordination within different organizations, regulators and directors. Regulators give standards and rules for healthcare organizations to follow but organizations that want to be proactive about interoperability should build a dedicated interoperability strategy by making interoperability planning a priority.

Limited budgets

Few organizations may face budget and technical issues, as they have to invest more to create an interoperable system. There can take the help of government grants available to modernize health records systems, so organizations should check for their eligibility. 

Diverse technology needs

Different organizations that provide different types of care are required to follow different rules and regulations. It also depends on what kind of care they provide and where they're located, so many organizations have highly customized data. 

CMS Interoperability

ONC's interoperability rules and CMS policies such as the CMS Interoperability & Patient Access Rule and the 21st Century Cures Act represent great strides towards improving health care.

By introducing consistency, HL7 v2 addresses differences that existed between proprietary systems. Interfaces can now communicate globally using the Internet as the mainstay of backend communications.

However, these are only the first steps in the direction of increasing the interoperability of healthcare data. A comprehensive, complete profile of the patient will enable better conclusions about which patients need to be treated, how to do it, and when they will be treated, thus improving outcomes.  

Efforts that define interoperability as a bidirectional exchange of data are experiencing the greatest success today in the health interoperability ecosystem. There are still a number of hurdles to overcome regarding clinical data exchange standards, and provider connectivity is a constant concern.

The mission to integrate healthcare data remains challenging for most healthcare providers and payers due to the increasing pressure from regulators to improve outcomes, quality, and control costs.

The issue of ensuring data accuracy, completeness, and defining interoperability standards remains a challenge for payers and providers alike.

The meaning of interoperability is seriously hampered by the varying performance measurements and coding and reporting requirements. Although scaling data sharing has its challenges, the benefits outweigh them significantly. 

Data that is accurate and complete is what payers seek. When care providers and payers use appropriate data interoperability tools, they are better equipped with the right information at the right time. Interoperability in healthcare is seen as a priority by health systems, payers, providers, and hospitals alike.

Interoperability and Patient Access final rule

  • Patient Access API (applicable January 1, 2021, enforced July 1, 2021)
  • Provider Directory API (applicable January 1, 2021, enforced July 1, 2021)
  • Payer-to-Payer Data Exchange (applicable January 1, 2022)

Healthcare interoperability benefits

1. Better care coordination

With access to electronic data, clinicians can easily access a patient’s important health information. This will lead to fewer repeat tests, prevent inadvertent medication interactions and reduce miscommunications.

2. Higher performance

When data is available easily, it can be analyzed more quickly. Interoperability helps organizations to study data trends, past performance and produce data-driven improvements for patients.

3. Better experiences

Data interoperability can decrease the number of unnecessary administrative work for organizations, building a more satisfying experience.

What is the Future?

Utilizing the latest AI in healthcare like NLP technology and medical machine learning we will be able to organize claims intelligently, diagnose accurately, code with computer assistance, and gain insights into patients.

As the evolution to value-based healthcare continues, the real-time exchange of data between payers and providers will not only improve the quality of care but will also increase efficiency in delivery. 

With the advancement of technology, interoperability will continue to evolve and improve in healthcare. It is essential that clinical data flows among networks freely so that the healthcare industry can progress.

The technology and software applications used by healthcare organizations need to provide efficient and secure communication and exchange of patient data using the most up-to-date healthcare interoperability guidelines

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