Are You Ready for Interoperability?

Healthcare providers are asking for data interoperability. They understand its vast potential, and how it could help improve access, lower cost, streamline processes and enhance patient care and outcomes. But do you know what you are getting from interoperability, or how it will impact your patient care?

In the first article of my blog series and during my appearance at the annual HIMSS conference in March, I focused on addressing health care access and the tools to accomplish it. One of those tools could be interoperability. I say “could,” because with the recent health care industry experience with increasing EHR use, the desired outcomes have not yet been fully realized.

It is fascinating that many other industries during the same period have gone digital with successful transformation of service and performance. Why the difference?

Interoperability needs a clearer, more focused definition, as well as a strong business case – not just at the Veterans Administration, but across healthcare. Interoperability is not an outcome, but a tool that delivers either significant positive or negative impacts. Perhaps both, depending on your organization’s preparation, and how well providers help define the business cases being addressed, and how they are addressed.

As it relates to data exchange, interoperability is well described. The definition as related to clinical and process improvement is not as well defined. We need “meaningful interoperability” defined as the data exchanged from multiple entities and, likely with significant duplication, is presented at the time it is needed -- in a way it can be understood and effectively leveraged to provide safer, more effective, and lower-cost care and more efficient staff processes.

There are multiple use cases to include scheduled clinical care, unscheduled emergency room, care, population health, and business billing needs, to mention a few.

The mistake often made is thinking interoperability’s value will be based on innovative technology. Assuming you could simply flip a switch tomorrow and have instant interoperability, what would happen? All the data would be available but likely not synched or “de-duplicated,” as there are numerous locations and ways data is captured.

Meaningful interoperability involves communication and processes -- the communication between systems, how the receiving system processes data, how all that data is made available for system and human use. It will impact all your current work processes.

Achieving meaningful interoperability won’t be solved by one technology or simply adopting a standard. Establishing the business case and outcomes desired needs to start now, especially what impacts you and your service’s ability to deliver effective health care.

Over time, healthcare can be a succession of doctor visits, examinations, blood tests and other medical procedures. Medical procedures also mean a series of payments, billing cycles, and insurance claims. Each element in the process collects data, which over time has relative value based upon the current need in the health care process. Ideally, that data would be collected and shared in a universally understood language.

Having multiple sources of data collected in different formats creates a curation headache as well as data presentation issues. Moving toward standard terminologies is an important step forward -- but it is not the only areas of concern, and it will not happen overnight.

So, back to flipping that perfect interoperability switch:

• How are you doing with medication reconciliation now, just looking at medication and allergies?

• Is your process automated?

• Does it handle multiple sources of data?

• After reconciliation occurs, is the data easily stored as current data in the EHR?

• What happens at a patient appointment in a different clinic one hour later?

In my next post, I’ll be talking about some of the solutions that Accenture can offer to help start making interoperability a reality.