What is Healthcare Interoperability?
Healthcare interoperability refers to the ability of two or more healthcare systems to share information with each other so that they can interpret and use it. The “systems” can be medical devices, computer software, mobile apps, and more. The term was made popular during the American Recovery and Reinvestment Act (ARRA) in 2009, which was the first attempt by the US government to outline expectations for health information technology (HIT) to electronically exchange data.
Why is healthcare interoperability important?
Imagine if pharmacists and doctors were unable to share critical patient information between their offices to make a timely treatment decision – that’s one of the many reasons healthcare interoperability is important. Potentially life-threatening scenarios aside, healthcare interoperability has also worked wonders in terms of making the industry more consumer-friendly and convenient. Take blood sugar monitors for example – diabetes patients can simply prick their fingers and have their blood compared against the device’s database. No need to go to the doctor’s office or pay for expensive treatments. The convenience that healthcare interoperability allows can also be illustrated by the recent COVID-19 pandemic. Due to evolutions in healthcare systems, inflicted patients were able to share physical symptoms and parameters via the cloud to reduce the spread.
What are the benefits of healthcare interoperability?
While the benefits of healthcare interoperability are too immense to fit in one article, we will mention some of the most notable ones revolving around efficiency, accuracy, privacy, and more. Some key benefits of healthcare interoperability are that it:
- Increases the organization’s operating efficiency
- Reduces redundancy in data entry and management
- Prevents costly mistakes: medication errors, etc.
- Promotes consumer involvement
- Speeds up and simplifies research
- Improves digital medicine by facilitating big data analysis
- Adds financial incentives through Meaningful Use
Healthcare Interoperability Standards
There are five types of standards associated with healthcare interoperability:
- Terminology standards
- Content standards
- Transport standards
- Identifier standards
- Privacy and security standards
Terminology standards in interoperability are exactly what they sound like: guidelines surrounding the vocabulary, codes, and classifications that can be used through the process of connecting two systems. Content standards differ because they deal with the data inside of the document during the information exchange – not the ways in which the terminology is used. Transport standards refer to how the message or document is formatted during the exchange. For example, Digital Imaging and Communications in Medicine (DICOM) allows for the transfer of medical images to be passed between systems. Identifier standards simply revolve around how a patient or medical staff personnel can be identified within the system. Privacy standards aim to protect an individual’s (or organization’s) right to determine whether, what, when, by whom and for what purpose their personal health information is collected, accessed, used or disclosed. Security standards define a set of administrative, physical and technical actions to protect the confidentiality, availability and integrity of health information.
Healthcare Interoperability Levels
Healthcare interoperability is broken down into 4 levels: foundational, structural, semantic, and organizational. These levels are differentiated by their function and purpose – whether to connect the systems, organize the data, interpret the data, or the processes for how interoperability is used with other distinctions in the organization.
The foundational level of interoperability establishes the connection between two healthcare systems. Without it, healthcare systems would not be able to communicate with each other in the first place. Foundational interoperability allows it all to take place, but further levels of interoperability are required to process, gather insights, and ultimately gain value out of the connection.
Structural interoperability is the level that determines how the data will be shared from one system to another. It defines the format that must be used in order for the two systems to make use of each other’s data. Once the structural requirements have been defined, the systems can understand the data being shared, and the user can, too.
The semantic level of interoperability is where healthcare-specific concepts are exchanged and interpreted between systems. It ensures that medical terminology, naming conventions, etc. can be shared and used in a way that works. For example, common resources at the semantic level are HGNC and SNOMED. HGNC is the nomenclature for genes and SNOMED is a general-purpose language with over three hundred thousand medical concepts.
The organizational level is how healthcare interoperability is used at the highest level – through business processes, workflows, and standard operating procedures. Inputs from legal, social, and organizational components are required to ensure proper integration across the whole ecosystem.
Healthcare Interoperability Challenges
As with most technological advancements, there is a cost that comes with adapting to healthcare interoperability. And while we know the benefits far outweigh the alternatives, investing in the necessary people, tools, and education to make it work is not always feasible. Healthcare technology is expensive, and outdated or struggling organizations may not be able to afford to get started. Improving interoperability requires strong coordination between different organizations, regulators, and leaders as well as coordination within organizations. Regulators provide standards and rules for healthcare organizations to follow but organizations that want to be proactive about interoperability should consider creating a dedicated interoperability strategy and make interoperability planning a priority.
This tends to go hand-in-hand with budget constraints, as organizations with outdated technology may have to invest even more to bring their tech stack up to speed. For example – they will have to modernize their technology before connecting their data. Once they have new systems in place, they will still have to invest it properly aligning with the standards of healthcare interoperability – so it can feel like a double whammy. Not all organizations have the financial or technical resources they need to invest in the technical resources needed to build a truly interoperable system. There may be some government grants available to update health records systems, so organizations should check to see if they’re eligible. Many cloud vendors also offer pay-as-you-go payment models that could make technical expenses more affordable and predictable.
Organization & coordination
It takes a village to build and adopt a modern way of managing your healthcare systems. Leadership, faculty, and patients must all work together to meet the requirements of regulatory agencies, act in accordance with the law, and ensure that all parties are comfortable handling their sensitive healthcare data.
Wide range of needs
There is a large volume of healthcare organizations that provide different medical services and require different data-sharing protocols. Organizations may use different internal and external systems than their counterparts based on their specific needs and the volume of patients they serve. This can lead to increased complexity when adopting a more integrated approach.
Healthcare Interoperability Resources
Health Information Exchange (HIE) Health information exchange, or HIE, allows us to move clinical information between two or more healthcare systems in a way that retains the meaning and use of the information. In doing so, HIE makes it faster, safer, simple, and more effective to transfer this information between entities. Fast Healthcare Interoperability Resources (FHIR) Fast Healthcare Interoperability Resources (FHIR) was created by Health Level Seven International (HL7) and is a “standard describing data formats and elements and an application programming interface for exchanging electronic health records.” Simply put, FHIR was created to make it easier to transfer healthcare data between systems. FHIR organizes and structures data and provides guidelines for how they should be organized and interpreted by other computer systems and applications. See the whole list of interoperability standards and resources here.