What is interoperability in healthcare? Definition and basics
When asking what is interoperability in healthcare, we can come up with lots of definitions but narrowing them down, we should state that interoperability implies abilities of systems and devices to exchange, interpret and share data in such a manner that it can be understood by end-users. Interoperability promotes the operational speed to a new level, removes paperwork and accelerates digitalization of industries including healthcare.
ONC’s Cures Act Final Rule announced the implementation of interoperability as a requirement in organizing work of CMS (Centers for Medicare & Medicaid Services). Taking this approach enables patients to be better informed in healthcare decision-making and, overall, facilitates work processes in hospitals and healthcare system institutions.
The interoperability definition in healthcare can be narrowed down to secure transfer and exchange of health-related data that, otherwise, can make a negative impact on patient experience. Indeed, lack of interoperability in healthcare might not only create an information deficit but decrease the number of positive health outcomes.
The reason why interoperability is important in healthcare
Legal acts enacted through recent years oblige healthcare providers to accelerate modernization of healthcare infrastructure by adopting EHR and strengthening the privacy of sensitive data transfer.
Furthermore, interoperability as a requirement of healthcare information systems is essential due to a host of factors listed below:
For enhancing patient experience, it is important to improve communication between healthcare professionals and patients. Interoperability provides it by simplifying and accelerating the process of sharing patient information while not compromising on privacy and keeping it secure.
Access to patient data and information of the treatment promotes effectiveness of delivery healthcare service at best.
Interoperability helps to build efficient infrastructure for transferred and exchanged data.
Fast and reliable exchange considerably reduces medical errors.
How interoperability in healthcare supports patients and medical professionals
The importance of interoperability in healthcare is linked to the benefits it brings to both healthcare professionals and patients. With interoperability in mind, it is also easy to create actionable business rules against interpreted data.
Aside from satisfying the growing demand for access to data in real time, interoperability assists in reducing redundant testing and diagnostic procedures and promotes continuity of care by automation of tracking individual patients and patient groups.
Thus, caregivers get an opportunity of better coordination of their professional efforts by having timely access to data.
Patients get distinct advantages of ‘activation’ of interoperability because the efficient data transfer greatly advances the level of healthcare service and provides unbroken communication lines within healthcare service delivery.
Furthermore, data accumulated in public domains can be applied for research purposes that considerably improve public and population health.
Overall, interoperability in custom healthcare solutions empowers healthcare providers and patients by bringing the following benefits:
Ensurance of data privacy
Optimization of work processes within healthcare organizations
Facilitation of data transfer and exchange
Enrichment of research for public good
Enhancement of patients' customer experience
The three levels of interoperability in healthcare
Foundational interoperability is the basic level of interoperability that implies secure communication and receiving data from one system (application) to the other.
Structural interoperability is the mid-level of interoperability that implies data exchange between IT systems and its interpretation on the data field level.
Semantic interoperability is the advanced level of interoperability that implies capability of the system to provide shared understanding of the exchanged data among users.
Multiple health IT systems communicate within healthcare organizations for the purpose of improving the service and creating the portrait of a patient as a ‘digital citizen’. Examples of communication points include patient admission, ordering lab tests, checking for availability of test results, etc.
Deploying interoperable channels help build a healthcare ecosystem that excludes delays in communication or mismanagement.
Prior to addressing the question of how to achieve interoperability in healthcare, it is important to regard different types of interoperability.
Specifically, interoperability is presented on three levels, foundational, structural, and semantic.
Patient data is generated by doctors’ offices as well as labs, devices, and research institutions. Acknowledgment of obtaining data and loading it to the systems is a crucial factor in ensuring delivery of healthcare service of high quality.
Hence, when we talk about the foundational level of interoperability, we mean the basic level defined by receiving capabilities of the systems. The example of foundational interoperability is the presentation of lab test results. The foundational features of the system allow for loading data and promotion to higher levels.
Structural interoperability as a mid-level of interoperability is based on the concept of unification implying that transferring data will keep the information throughout all episodes of healthcare interactions without any alterations.
The success of meeting the unification requirements is determined by the ability of the recipient system to interpret data. The examples of interoperability of structural level in healthcare are introduced by HL7 interfaces. Another example is the user data transfer from various connected devices (for instance, fitness trackers). To take a step further in advancing the process, patient portals get configurations that enable users to upload data for interpretation.
Semantic interoperability as an advanced level of interoperability implies sharing the data across the disparate systems by streamlining exchange and the codification of the data. The example of semantic interoperability is processing lab data and ensuring accuracy of its measurements according to the predefined industry standards.
Introducing the highest level, semantic interoperability also presents the goal of healthcare service. Achieving semantic interoperability enables healthcare providers to exchange patient data with all the authorized parties by deploying various EHR systems for ensuring safety, compliance, and efficiency. It eliminates duplicative testing, empowers patients with resources for mindful decision-making, and mitigates risks of delays or misinterpretation.
What you need to know about challenges of interoperability in healthcare
Most healthcare organizations still operate on foundational and structural interoperability because there are several challenges we need to recognize when we discuss achieving interoperability.
Mostly, challenges of interoperability in healthcare relate to the absence of standards. In particular, the issues are associated with a search for:
standardized ways of patient identification
unified health IT interoperability standards for the medical industry
enacting the measurement standards that would be recognized by all industry players
rules that would regulate information blocking by vendors
Basically, data can be transmitted in a big number of formats (for example, HL7, FHIR, CDA as well as completely customized formats). Sharing data between systems and integrating them especially when doing one-to-one integration might consume too much time and resources.
But the disadvantages of interoperability in healthcare or problems with interoperability in healthcare are outweighed by benefits it brings in terms of creating well-formed structured data for wide clinical use.
Reliable resolutions of associated challenges are achieved by making a plan of implementation that complies with existing interoperability norms in healthcare.
Facts about the implementation of interoperability in healthcare
Level-based complexities raise the question of how to improve interoperability in healthcare. Among the proven practices of implementation of interoperability in healthcare, there are tactics you need to regard as must-haves for achieving interoperability in a hospital environment and other healthcare provider organizations.
Firstly, it is advisable you outline clinical cases of data usage. It will determine what data is needed and what kind of structuring it involves.
Secondly, it is important to define what rules and protocols to follow and plan the actual implementation.
Thirdly, it is the stage of realizing the implementation plan that goes through the following phases:
Deployment in a corresponding environment
Value of interoperability in healthcare and its growing importance is determined by its multiple benefits ranging from safeguarding sensitive health-related data to optimizing the routine of healthcare professionals.
Poor usability and interoperability in healthcare information systems put unnecessary additional pressure on overburdened health systems and block workflows.
Addressing this issue by providing appropriate usability standards can considerably improve interoperability in healthcare, remove complexities associated with delivering efficient data exchange and make a positive impact on patient customer experience.