Improving Interoperability for Enhanced Continuum of Care
- Posted On August 19, 2020
- Posted By Vu Nguyen
The healthcare industry has been shifting for years to help patients access care in the appropriate setting. While this shift is good for patient quality and can mitigate stressors on the overall industry, it can also mean special attention needs to be paid to the continuum of care for patients who receive care across multiple settings. As this continuum becomes more complex and more nuanced, the interoperability of information technology becomes more important than ever.
What is Interoperability?
Interoperability in healthcare information technology (HIT) describes the sharing ability and accessibility of HIT data across systems in different care settings. With well-functioning interoperability, data can be shared efficiently and securely between health care settings such as primary care, specialty providers, acute care hospitals, long-term acute care, and nursing homes, as well as with ancillary healthcare services such as pharmacies and labs.
How Interoperability is Related to the Continuum of Care
Interoperability has significant and direct consequences for the continuum of care for patients. Poor or non-existent interoperability can lead to delays or errors in care. Conversely, optimized interoperability can mean more efficient healthcare delivery with better care coordination, reduced overhead costs in the delivery of care, and even better patient and provider satisfaction.
According to EHR Intelligence, “Interoperable systems between specialty and primary care providers ensures the specialty provider understands the patient’s current health conditions and can make informed medical decisions.”
The efficient access to HIT in interoperable systems means avoiding redundancies that can be dangerous, unneccesarily costly, and patient dissatisfiers. Better and more timely access to information across the continuum of care means more effective clinical decision-making is possible.
Three Stages of Interoperability
One of the major barriers to interoperability is lack of coordination between different health entities, which can often occur not because of deliberate resistance to cooperation, but because of IT or workflow challenges. Let’s take a look at the three stages of HIT interoperability. These stages each relate to separate data-exchange opportunities.
- Foundational Interoperability: True to its name, this is the cornerstone stage of interoperability, which is the ability of one information system to exchange data with another. This doesn’t necessarily mean that the system receiving the data is able to interpret it, even if they are able to read and store it.
- Structural Interoperability: The next stage is structural interoperability, in which data is able to not only be exchanged, but preserved in an interpretable format with consistent data fields between the sending and receiving systems. In order for this stage to be reached, the sending and receiving systems must be aligned to the same accepted data standard.
- Semantic Interoperability: The next and highest stage of interoperability is semantic, in which systems can exchange, use, and interpret data seamlessly.
Top Ways to Review and Improve Interoperability
To evaluate the current quality of your system interoperability, it’s important to consider the:
- Information transactions: what is the volume of HIT exchange through your system and what is the quality and usefulness of the information exchanged?
- Functionality: How well does the interoperable system work? Are there any problems that need to be addressed?
- Workflow: Does the system you have in place support the workflow of your staff and providers?
Improving Patient Data Access
One argument advocates that by giving patients more access to their own EMR through secure, private patient portals, patients are more engaged and informed about their own care and improves connection across providers and healthcare settings. The Interoperability and Patient Access final rule (CMS-9115-F) mandates standards and policies for patient data access that each healthcare organization should know.
Consolidated-Clinical Document Architecture (C-CDA)
This is the overall standard for the structure and coding of EMR and clinical documents for exchange—the key component for interoperability support of efficient and effective clinical decision-making for an improved continuum of care.
Application Program Interfaces (APIs)
One way to improve system interoperability is to use application programming interfaces, also known as APIs. APIs help disparate systems to communication and exchange data. An API may be designed simply to share information, or may be more complex and able to update individual records, or to aggregate data for reports. They can address gaps in interoperability, but aren’t necessarily the best ultimate solution as they often need to be custom built and many times an organization will need multiple APIs for interoperability with a larger network of healthcare provider and payor partners.
Use of Health Information Exchange (HIE)
A Health Information Exchange (HIE) is a secure network designed for improving interoperability which healthcare providers connect to in order to allow exchange of healthcare information across systems. These tools, which exist in all 50 states, are designed to provide real time access to patient information to be used for clinical decision-making.
Review and Develop Plan to Upgrade HIT
Healthcare Information Technology (HIT) is expensive and complex—but having the right HIT is crucial for interoperability. It’s important to review your technology for efficiency, security, and interoperability, and to put together short-term and long-term strategies to address areas deficient for interoperability. One way to evaluate your systems are to review them compared to the ONC Health IT Certification Program.
Take IT Steps Forward for Better Patient Care
Taking charge of a full forward-moving strategy for interoperability is important for patient care. Keeping your own data in a silo—or being unable to efficiently receive important data from a larger healthcare network can not only mean a less efficient continuum of care, but is now regulated by policy. In order to develop the right steps to take, consider qualified IT leadership or consultation.
We help clients develop interoperability solutions that can be scaled and customized to each organization’s needs. Learn more about the services we offer and contact us about how we can help you address your interoperability strategy.