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Healthcare industry shows importance of data interoperability
Data interoperability facilitates the quick and easy exchange of information between different systems or applications. Its use in healthcare shows the importance of data exchange.
Data interoperability helps ensure that data is easily communicated between multiple parties. No industry illustrates the importance of data sharing better than healthcare, where delays can be the difference between life and death.
Data interoperability refers to the basic exchange between two or more computerized systems that can communicate with each other readily. It enables users to interpret shared data for critical decision-making.
Disparate computer and software systems that contain a wide range of structured and unstructured data fill the healthcare industry. Sources of data include clinics, medical practices, hospitals, electronic health records, laboratories, pharmacies, digital and social media, as well as wearable and medical devices. It is critical to share health information between the different applications, databases and systems.
In response to a lack of cohesive coordination of relevant data with common data language and standards, the Centers for Medicare and Medicaid Services (CMS) published the Interoperability and Patient Access Final Rule, which gives patients access to their health information. This helps promote seamless healthcare data exchange between payers, providers and patients. Data exchange can improve health outcomes, reduce costs, and enable better quality of care and experience.
Introduction to healthcare data interoperability
Data interoperability in healthcare follows four levels and specific standards set forth by the US government through the CMS.
The levels define how data becomes "interoperable" between three key stakeholders in the healthcare ecosystem -- the payer, provider and patient:
- Foundational. Access data. Transfers data from one system or application to another.
- Structural. Receive data. Defines the format, syntax and organization of data exchange.
- Semantic. Exchange data. Provides common underlying models and codification of data.
- Organizational. Assists with the nontechnical aspects of the organizational process and workflow. Aspects include governance, policy, social, legal and organizational considerations to secure seamless and timely communications and use between organizations, entities and individuals.
Standards
The goal of data interoperability in healthcare is to facilitate the access and retrieval of data in a timely, safe and efficient manner with equitable access for patient-centered care. Various networks, such as the Health Information Exchange (HIE), help accomplish this goal. A set of standards provides a common language that supports interoperability between systems and devices. Standards sanction the sharing of data, content, privacy and security of health information exchange. Standards development organizations perform rigorous real-world testing of these standards to ensure continuous improvement.
The following five aspects of healthcare data have standards that relate to interoperability:
- Vocabulary/terminology. This includes the ability to represent concepts unambiguously, by following, for example, the Current Procedural Terminology code.
- Content. Relates to the data content within the exchange of information. Health Level Seven International (HL7) is the standard that facilitates the exchange of clinical data between systems.
- Transport. Addresses the format of messages exchanged between computer systems, document architecture, clinical templates, user interface and patient data linkage. For example, Fast Healthcare Interoperability Resources (FHIR).
- Privacy and security. Defines a set of administrative, physical and technical actions to protect the confidentiality, availability and integrity of health information. The most well-known ruleset is the Health Insurance Portability and Accountability Act (HIPAA).
- Identifier. Uniquely identifies patients or providers, such as a medical record number.
Why healthcare data interoperability is important
Interoperability is more than a standard computer-based interaction. It facilitates faster conversations between providers and patients and increases patient interaction and engagement, which can lead to better outcomes.
Easier access to electronic health records enables better care coordination, treatment planning and continuity of care. Having a full picture of a patient's health, history and past encounters helps avoid duplicate testing, reduces adverse events and promotes appropriate follow-up care with care management teams.
Another benefit is cost reduction due to sharing useful information in a timely manner, which improves business and administrative processes by eliminating time-consuming tasks. For example, sharing a patient's lab or blood test with the provider early on might prevent an emergency room trip, which saves the time and cost of doing more tests at the hospital. It also saves staff time and effort, improving efficiency and leading to more cost savings.
One of the core standards is privacy and security. Patients should feel their experience within the system is safe and beneficial. Interoperability allows for overall improvement in patient safety and care.
Barriers to healthcare data interoperability
Several barriers remain to healthcare interoperability becoming a nationwide success. Technical barriers might limit data quality and data matching. Financial barriers include the development, implementation and optimization of health IT.
Some other barriers that account for hesitation around the full adoption and implementation of healthcare data interoperability include administrative prerequisites, documentation and reporting, usability of IT and trust. However, the Office of the National Coordinator for Health Information Technology (ONC), vendors, patients and providers see the benefits of healthcare data interoperability and must be in compliance with the Patient Access Final protocol so acceptance of healthcare data interoperability has received a warmer response than in previous years.
Real-life examples of healthcare data interoperability
Data interoperability has a variety of applications in healthcare today:
- Identification and patient preference. A provider can identify a patient's visit, receive lab results and access information about a patient's preferences. Data might include advanced directives, empowering patients to make decisions about their care.
- Medication adherence. Using a patient's past and current medication usage, providers can examine medication adherence and reconcile differences in medication records to produce an accurate picture of a patient's medication list. The list enables providers to ascertain appropriate potential medications for future encounters.
- Provider alerts. The HIE network alerts providers when a patient presents an emergency room (ER) visit to ensure they receive follow-up care. The goal is to avoid re-admissions to the ER or urgent care.
- Holistic care. Healthcare interoperability eliminates duplicative efforts. A physician can query a network or external health system for the appropriate patient data from other sources, such as from another hospital or behavioral health data. They can then select certain patient documents or resources, such as diagnosis, treatment plan documentation, medication and allergy lists, to access during a patient visit and deliver better care for the patient.
- Population health and value-based care. At an individual level, an interoperable system allows access to longitudinal health data, closing information gaps. A key consideration in healthcare is to manage the overall health of the population while incorporating nonclinical data into patient records. Nonclinical data includes an individual's social determinants of health, such as food security status, housing stability and access to reliable transportation. Health systems use nonclinical data to proactively identify a health risk within a targeted population and intervene. With the advent of value-based care, providers and payers can move from traditional fee-for-service to fee-for-value payment models to reduce costs, risk and improve quality.
Throughout the United States, health systems, providers, clinics, payers, patients and vendors clearly see the benefit of sharing information. Data interoperability makes it easier to share patient information within the ecosystem, enabling healthcare professionals to deliver better care at reduced costs.
Sue Tripathi is a thought leader in data, AI, technology and transformation with experience covering 19 industries as a writer, speaker and presenter. She is currently a partner at IBM.
