CEOs begin push for a broader assessment of interoperability

The Healthcare Leadership Council is looking to create an assessment approach that measures the capabilities of data exchange and identifies areas for improvement.

Measuring interoperability in healthcare typically has meant determining how many hospitals and physicians’ offices can perform certain data exchange functions.

An organization representing a broad nationwide coalition of healthcare organization CEOs is looking to expand the breadth and depth of interoperability analysis, asserting that a new set of measurement criteria will provide more value to the industry.

The Healthcare Leadership Council has outlined a first set of proposed measures that would provide a different way to assess interoperability. The organization is in discussions with the Office of the National Coordinator for Health Information Technology to fine-tune assessment criteria.

The council unveiled a report offering an initial set of assessment criteria Wednesday at the HIMSS22 conference in Orlando, Fla.

This initiative is important because it has the potential to help the industry focus on what interoperability can actually accomplish. That’s critical as value-based healthcare takes hold and more health information needs to be shared among more entities that have an impact on the health of patients.

Areas of focus

The HLC’s efforts to expand measurements of interoperability focus on several areas, including patient-facing data exchange, electronic public health reporting and cross-network information exchange. These areas have proven to be somewhat difficult to gauge with current approaches.

Federal agencies made interoperability a condition for receiving “meaningful use” electronic health record implementation incentive payments, but information exchange requirements often were minimized because of slow industry progress on interoperability.

ONC has increased the emphasis on interoperability in recent years, but its chief measurement tools gauge providers’ abilities to enable patients to access, view, download or transmit their data. ONC supplements this with data from an American Hospital Association survey, the annual National Electronic Health Records Survey and the Health Information National Trends Survey, all conducted by private-sector organizations.

But it’s time for the country to get a more well-rounded view of interoperability and measure the actionable results of it - as well as progress achieved over time, said Mary Grealy, HLC’s president. A new approach is needed to demonstrate how “real people get benefits” from interoperability, she added.

A ‘holistic understanding’

The council’s report states that the healthcare sector needs a “holistic understanding” of the state of data exchange. ONC’s efforts to measure interoperability to date “provide a high-level overview,” but more depth is needed, the HLC said. Current surveys “may not fully capture the breadth of efforts to advance interoperability in the private sector and in public-private interoperability partnerships,” the council’s report notes.

Additional measurements “can provide new insights into a variety of dimensions of interoperability and create a more robust and clear picture of the current state of interoperable data exchange,” according to the report, written for HLC by researchers Julia Adler-Milstein and A. Jay Holgren of the University of California San Francisco.

The report calls for augmenting public-sector management – which primarily focuses on core clinical use cases – with data of growing importance to the industry, such as public health reporting, interoperability with payers and bidirectional interoperability with prescribers and pharmacies. The report’s authors contend there’s a growing need for measurement that looks at core capabilities, including:

  • Structure: the capability to electronically exchange structured data;
  • Flow: the actual flow of structured data; and
  • Use: the access of outside data by recipients for clinical care purposes.

Significant data exchange progress has been achieved in recent years, according to presenters at an event at HIMSS22 sponsored by Surescripts, one of HLC’s members.

Cris Ross, CIO at Mayo Clinic, noted at the event that 86% of the nation’s hospitals can exchange clinical data through one of two large data exchange groups, Carequality and CommonWell Health Alliance.

But the COVID-19 pandemic highlighted weaknesses in national information exchange, especially in the bidirectional sharing of data with public health agencies, Ross added. The stress of the pandemic, he said, shows “our healthcare system is really badly broken. …Interoperability is not the only tool, but it is a really important tool.”

Measuring progress

Just measuring transaction volume or using limited measurements of interoperability doesn’t go far enough, said Tom Skelton, Surescripts’ CEO. Increasing the scope of measurement “isn’t about proving that we’re close to an end, but showing that every day, progress is being made somewhere.”

Interoperability needs to be broad to support the healthcare’s mission, Ross said. “We’ve proven we can do interoperability for some [entities]. The question now is, how do we do it for all? Do a patient and care provider have the right information to make the right care decision? We’re not there yet.”

Pointing to the need for interoperability assessments to support data exchange improvements, Grealy stressed that you can’t improve what you can’t measure.

Refining measurements

HLC hopes to work with ONC to continue to refine potential measurement capabilities. The council plans to produce a second report on potential approaches to measurement, said Tina Grande, the council’s executive vice president for policy. Working with ONC as well as broad partnerships with diverse stakeholders will be essential to making sure the new research efforts measure the right factors and provide value, Skelton said. “The industry can’t do this alone. Progress is being made, and in partnership with the federal government, we’re looking to find ways to document it.”

Related content:

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Care coordination – data standoffs and how to resolve them

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