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Healthcare interoperability: Are we there yet?

In 2015, the Office of the National Coordinator (ONC) revealed its much anticipated healthcare interoperability roadmap report – delivering a promising framework of free flowing patient data and improved patient care. The roadmap pinpointed three, six, and 10-year milestones with an ultimate goal to build a fully interoperable learning health system by 2024. But despite overwhelming support from healthcare professionals in favor of its progression, interoperability is showing very few signs of becoming a reality anytime soon.

According to the Healthcare Information and Management Systems Society (HIMSS), interoperability describes the “extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.” For the healthcare industry specifically, interoperability relates to several distinct systems capable of exchanging and sharing data from a range of vital sources, including laboratories, clinics, pharmacies, hospitals, and medical practices.

The benefits of healthcare interoperability are well recognized – a recent National Health Information Exchange and Interoperability Landscape report revealed that 80% of providers saw increased efficiency and 89% saw improved quality of care when using electronic data exchanges.

Yet in spite of these benefits, there’s been little progress to date; according to a recent Health Affairs report, just 29.7% hospitals have engaged with finding, sending, receiving, and integrating patient data from outside providers which is a slight increase of 5% from 2014.

So why has the industry been so short of achieving interoperability? What is the big holdup? According to Charles Jaffe CEO of HL7 ,the reason interoperability hasn’t progressed is due to a lack of business case. Other reasons cited by the industry have included – obstacles of a technological, financial and logistical nature, fear of new procedures, lack of standardization, data gaps in EHR systems.

  • Financial strains Interoperability between all existing systems is expected to take years to achieve, requiring significant investment. Funding for interoperability projects needs to be earmarked in budgets for a number of years.
  • Lack of standardized technology structure – Not every electronic health record can understand and interpret the data structure of other electronic health records.
  • Policies – Vendor intentions to integrate technologies are often hindered by issues relating to policies such as HIPAA and information blocking – stemming from actual restrictions or misinterpretation of the rules.
  • Workflow complexities – Patient consent and processes will need adapting and concerns about cybersecurity risks and patient confidentiality must be addressed and resolved.

Although interoperability implementation thus far has been slow, industry-wide initiatives to overcome these challenges are gaining momentum, so we expect the landscape will continue to show progress, albeit slowly.