Interoperability is the ability of systems to exchange information and use the exchanged information effectively.
It can also be defined as an extent to which systems and devices can exchange and interpret data. In other words, for two systems to be interoperable, they must be able to exchange data and present data which can be easily interpreted by the user.
Interoperability as a concept was identified first by the Americans in the 80’s when they ended up building 20 different railroads across the country, making it impossible for the trains to move from one end to the next. To tackle this, a common standard was established for the railroad systems after which flexible travel could be achieved.
EHRs have taken inspirations from the railroad systems and today we see a rapid growth of EHR interoperability, in the interest of sharing electronic health information at a health system/ organization level.
Just like it is easy to carry conversations with like minded people, it is important for systems to have a likelihood to exchange and interpret information based on a common ground.The fundamental challenge would be to introduce and adopt a common set of standards across all healthcare settings.
HIEs (Health Information Exchanges) are playing a major role in establishing this kind of an environment and facilitating access to and retrieval of clinical data. An HIE aims to keep records, diagnosis, and treatment integrated between healthcare organizations to ensure patient data integrity. It also prevents clinical data loss and takes care of security concerns while facilitating this exchange.
So if this has such major implications, have adoptions of HIE and practice of interoperability enabled individuals and their healthcare providers access to health information ? Are we making better decisions using the information exchanged ?
Healthcare interoperability is in a mess and here’s why:
While in the mature markets, dominance of EHR vendors has caused defacto standardization, which have called for standardization at an industry level. Non-standardization has resulted in problems like poor security and loss patient data during the exchange process.
In a market place crowded with EHR systems, where hospitals are implementing, running and maintaining so many products it is all the more imperative for Interoperablity to be at the primary focus.
According to a survey by HIMSS Analytic, the average hospital in U.S. has 16 disparate EMR vendors in use at affiliated practices and only 2% of the Hospitals having a single vendor in use.
Out of these EMRs, a couple of them could be specialty EMRs such as ophthalmology, fertility or behavioral, which might not be displaced by core vendors in the market.
It is probably one of the biggest challenges posed to healthcare community. Standardization at a large scale would require more that just involvement from a few EHR vendors, a few organizations or a few regulatory pushes by governments. It is a cultural change that would take its own course of time before achieving a total view of the patient obtained from so many different data points. This is what government organizations like CMS and not-for profit societies like HIMSS are striving to achieve.
Just like the Internet has certainly impacted our life because of free flow of data, we can expect Interoperability to spur some real innovations in the field of healthcare, provided we pick all the right cards at the right time.
Sr. Business Analyst