7 considerations for healthcare interoperability

Interoperability remains one of the biggest digital challenges in healthcare. But digital health technologies, technology standardization, and interoperability are the fundamental enablers for delivering connected health services. And for delivering better patient care, which is the whole point.

But how do you accomplish interoperability? Here are seven things to consider:

1. Know where you are going before you draw the map

There should be a shared understanding among stakeholders regarding what the process of achieving healthcare interoperability involves and what a successful outcome should look like. Each stakeholder – whether an end user or a vendor – should be aware of the consequences of their specific needs and uses of the system on other parties.

For example, in an enthusiastic rush to get a ‘perfect’ departmental healthcare software system, decision makers can overlook the impact on the IT organization – they presume IT has the bandwidth to support. Most importantly, both groups must be prepared to work together for the benefit of the patient.

The management of stakeholder expectations is one of the major considerations, but often overlooked when everyone focuses on the technology. It’s something we talk about in the article From ‘Digitization Without Direction’ to Digital Journey: Discovering the Path to Success.

2. Interoperability comes with costs, but it has benefits

It is essential to create willingness within the vendor community to work together and share information. As the customer, you have the right to expect cooperation from your vendors. Cross-enterprise interoperability and collaboration may also be stymied by a lack of funding during an austerity cycle, especially where no strategic budget is available.

Interoperability is rarely plug and play – it always requires testing. And testing requires work cycles. But the result is worth it. It allows providers to get information more quickly and make decisions faster. Transitions of care become smoother and safer. And costs go down.

For example, duplicate tests – defined as tests repeated within 12 hours – were found to be not medically indicated in 20 percent of the cases, according to a study published in the Journal of Medical Informatics. The study went on to suggest that incomplete electronic record transfer among incompatible electronic medical record can also lead to duplicate testing behaviors. This is both costly and risky.

3. Technical challenges or implementation problems

Technology itself is not the major challenge to healthcare interoperability. The technology, standards and protocols exist today. But implementation can be a problem, particularly if it is under-resourced. A key to getting it right is having subject matter experts available that understand the needs of the impacted department(s).

Everyone involved needs to understand that ‘go-live’ is really the beginning of the journey, not the end of the project. But if you know what you want the project to look like in the end and clearly communicate that to all parties involved – your internal project governance and vendors – the end-result will be more satisfaction than frustration.

4. Warning: common roadblocks

Interoperability roadblocks are usually human, but increasingly, they’re becoming budget issues. Interoperability projects cost money and the fragmented nature of health systems actively conspire against collaborative working models.

By definition, interoperability means you are trying to bring disparate systems together. The more you understand about each of those systems, the easier it will be achieve an acceptable result.

With the right roadmap and buy-in, you can achieve success. Concentrate on stakeholder engagement. When users, vendors, and executives cooperate and collaborate to build a shared understanding of a successful project, they vastly improve their chances of achieving it.

5. A universal healthcare technology standard: pipe dream or possible?

Is an interoperability standard purely for the healthcare sector desirable? Sustainable?

Yes. But again, we are dealing many different technologies, so we need to be mindful of the challenges. The health of an individual involves multiple agencies including health, social care, housing, planning and education. The patient has the right to expect that healthcare systems will be able to collaborate around consistent, timely, accurate information.

So, in fact, interoperability must go beyond the healthcare sector. And we need to change the emphasis to ensure healthcare providers treat patients as individuals, not as ICD-10 codes.

6. The road to standardization in digital solutions

Technology providers need to accept the need to work together and actively participate in ensuring interoperability between their systems. Healthcare organizations can encourage this through their procurement process by writing interoperability requirements into their contracts.

Globalization came to healthcare 80 years ago with the first commercial transatlantic flight – and healthcare organizations still have not caught up. While standards are in place, individual country standards need to be subject to international standards.

It’s time.

7. Information blocking

Information blocking is now illegal. Under the 21st Century Cures Act (Cures Act), the Health and Human Services (HHS) Secretary mandated to have regulations by December 13, 2017, that prohibit “information blocking” as a condition to Electronic Health Record (EHR) certification.

But the perception is that it is rampant. Despite all of the major EHR vendors committing to promote their core values of transparency and cooperation, an October 2017 healthsystemCIO.com survey resulted in most health system technology leaders stating they had experienced information blocking – but not necessarily on purpose.

More than half indicated they had experienced information blocking, but felt it was incidental to loose standards and technical issues or the expense associated with the complexity of information sharing. Whether real or imagined, the perception is that it is there. And it undermines healthcare interoperability.

What are your thoughts on the challenges and benefits of interoperability?