Interoperability: friend or foe?

This is part I of a 3-part article series. 

There’s no doubt about it: the healthcare industry is clamoring for interoperability, or at least in theory. Some say it will even rival the worldwide network of electronic banking.

Others, however, believe that beyond it being the healthcare industry’s most overused word, interoperability comes with great patient safety challenges, empty ONC promises, and a lot of provider frustration.

Is interoperability healthcare’s great accomplishment or its worst nightmare?

The intent of this movement is well established. According to HIMSS, “interoperability is defined as the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Data exchange schema and standards should permit data to be shared across clinicians, lab, hospital, pharmacy, and patient.  Its purpose is to ensure that health information flows securely and seamlessly from general practitioner, to specialist, to hospital, to patient.” Or, in short, the patient’s information follows the patient regardless of geographic, organizational, or vendor boundaries. 

Intent aside, the integration of interoperability industry-wide is somewhat challenged.

A recent report by HIMSS Analytics[1] found that while more than 90 percent of the hospitals surveyed by HIMSS use six or more types of devices that could be integrated with EHRs, such as defibrillators, electrocardiographs, vital sign monitors, ventilators and infusion pumps, only a third of hospitals actually

integrate medical devices with EHRs today.

Further, the report says, those that are investing in interoperability integrate fewer than three types of devices on average, a far cry from the six to twelve devices that may be present around an intensive care unit (ICU) bed. When not operational, the lack of interoperability, experts contend, creates great waste to the patient and the healthcare providers due to incomplete, stale information, with estimates as high as $30 billion in savings according to a West Institute analysis[2].

And last week, the American Medical Association and the American Hospital Association in remarks to the ONC urged the government to reconsider how it measures interoperability. On the positive side, a report by the National Health Information Exchange and Interoperability Landscape[3] found that 80 percent of healthcare providers said that electronic data exchanges increased their efficiency, while 89 percent said that they improved their patient’s quality of care. 

And while the data on the benefits of interoperability is limited, the horizon for fast-paced growth looks promising. The Centers for Medicare & Medicaid Services’ EHR incentive program, updated in October 2015 is spurring interest and development in Fast Health Interoperability Resources (FHIR) and other application programming interfaces (API). According to CMS, requiring 2015-certified EHR software to support these APIs will “enable the development of new functionalities to build bridges across systems and provide increased data access”, all which is believed to save precious time and money for healthcare providers.

The next article in this series will illustrate how interoperability works -- grabs relevant data from an EHR system, pulls images from ultrasound machines, attaches relevant additional notes following treatment, and assigns procedural and follow-up tasks to clinicians, shares data in a language that everyone can read, and offers great financial benefits to patients and providers.

About the author:  llan has spent more than 25 years in the enterprise application market. Before joining Jitterbit, he led market development for the Amazon.com Merchant platform and spent several years promoting, architecting and developing integration, database and groupware related technologies at Microsoft.