Health IT Interoperability

April 8, 2013

As health IT progresses, there has been a shift in focus from simply ensuring that healthcare organizations have electronic medical records systems implemented to a demand that EMRs are high performers and able to seamlessly relay and utilize information across all settings.  To be more concise, EMR systems must demonstrate interoperability.  In a broad sense, interoperability is the ability of one system to work with another system.  When looking to healthcare, Healthcare IT News gives a succinct definition by stating that, “…interoperability is looked upon as the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.” Interoperability stresses the importance of making data available to the appropriate people when they need it and it is at the center of H.I.T. today.

Components of Interoperability
Interoperability may be able to be defined relatively easily, but H.I.T. professionals know that achieving it is an extremely complicated and ongoing process.  Many argue that the key to interoperability lies in standards.  Healthit.gov notes that when creating an interoperable H.I.T. environment, standards are critical in four areas of EMR technology.  These areas include how applications interact with users, how systems communicate with each other, how information is processes and managed, and how consumer devices integrate with other systems and applications.  The establishment of standards in these areas should drive not only the design of EMR systems but the use of the systems, as well.  Doug Fridsma, MD, chief science officer and director, Office of Science & Technology within the ONC says that, “…to get to health information interoperability, we need more than just transport standards:  We must also use standards for vocabularies and terminologies (to help standardize the meaning of the words that we use), standards for structure (so computers know how to break a message into the appropriate information chunks), and potentially other kinds of standards.

One important thing to address in the concept of interoperability is how it differs from health information exchange, another widely addressed H.I.T. issue.  While health information exchange falls under the umbrella of interoperability, the two terms cannot be used interchangeably.  Think of health information exchange as the transmission of health information among facilities.  However, interoperability goes one step further and includes both the transmission of health information as well as the ability to use the information that has been transmitted.

Achieving Interoperability
We have noted that interoperability is a complicated concept with no concrete end.  It will continue to evolve as EMR systems and healthcare changes.  Depending on who is asked, some believe interoperability is right around the corner while others think it will be years before real progress has been made.  In addition, as interoperability is segmented, a divide in advancements can be observed.  For example, Healthcare IT News notes in an article that, “While the overarching focus of the interoperability movement has been on sharing patient data externally between different providers, interoperability within a facility has also been a significant movement that is gaining steam.”  The latter type of interoperability can include the exchange of health information between a patient’s EMR and medical devices.

When asked about the hurdles to interoperability, Farzad Mostashari, MD, chief of the ONC told Healthcare IT News that, “Most vendors really do see it now as part of their self-interest to be as interoperable as possible, but we still hear a lot of complaints from providers that their vendors are putting up what they believe are artificial roadblocks to them being able to share information, to participate in health information exchange.”  He goes on to mention that the responsibility of interoperability must be shared between vendors and providers and that the cost and complexity of interfaces must be reduced through standards and implementation guides.  In addition, he says that vendors must strive to meet Stage 2 of meaningful use to keep interoperability moving forward.

While there are certainly obstacles to interoperability, there are many positive developments, too.  Most recently, big news was made when major vendors, Allscripts, athenahealth, Cerner, Greenway, McKesson, and RelayHealth announced a collaboration to form the CommonWell Health Alliance, with the goal of working together to push interoperability.  This collaboration is unprecedented and seeks to ease access to data across systems and settings as well as help establish a national infrastructure with common platforms and policies.  They also aim to lower costs and improve quality and have invited all software companies to join them.

Interoperability is something that is sure to surround H.I.T. perhaps as much as meaningful use.  However, with government mandates, a push for standards, and cooperation amongst private vendors, there is much to be gained in healthcare through this initiative.

Excite Health Partners
Excite Health Partners is committed to interoperability and is pleased to offer EMR services to support it.  Contact us online or call 877-803-5804 for more information.