Revolutionizing data usability: DUTR’s semantic interoperability push

Sponsored by The Sequoia Project and AHIMA, the Data Usability Taking Root initiative seeks to redefine health data interoperability, focusing on quality, usability and meaning.

This article is part of the August/September 2023 COVERstory.

Interoperability means more than just laying “the pipes” that connect healthcare organizations. To gain value from those connections, it requires ensuring that the data flowing through them can be easily used and can be used to impact care.

That highlights the importance of the usability of the data being shared. Most in the industry acknowledge that much work lies ahead to get maximum value from interoperability in healthcare.

This extensive project is now gaining traction from an initiative being jointly sponsored by The Sequoia Project and the American Health Information Management Association (AHIMA). The joint effort was announced this summer, with 11 other health and health IT organizations already pledging to support it.

Called Data Usability Taking Root (DUTR), the effort is aimed at making health data more useful by specifically implementing guidance intended to enable semantic interoperability of health information. Semantic interoperability refers to the ability of computer systems to exchange data with unambiguous meaning.

Semantic interoperability

That’s crucial in realizing value from interoperable systems because it focuses on transmitting the meaning of data, not merely the act of transmission itself. Semantic interoperability, while extremely difficult, can achieve vast benefits in improved patient care, reduced workloads on clinicians, and savings in both cost and complexity.

According to research by Wolters Kluwer, “fluent machine-to-machine communication depends on the ability of different HIT systems to map different terms to shared semantics, or meaning.” Semantic interoperability is key to actualizing initiatives such as quality improvement programs, population health management and data warehousing, as well as enabling health information exchanges, accountable care organizations and patient-centered medical homes.

Further, HIMSS has defined four levels of interoperability, with semantic interoperability seen as the third of four levels. HIMSS defines it as providing “for common underlying models and codification of the data, including the use of data elements with standardized definitions from publicly available value sets and coding vocabularies, providing shared understanding and meaning to the user.” Many of the components of TEFCA are reflected in HIMSS’ fourth level of interoperability, highlighting the importance of achieving semantic interoperability to capitalize on the fluidity of data exchange.

Participants in the Sequoia-AHIMA DUTR project are working toward codifying ways to build on existing work in semantic interoperability to “improve the usability of data received by end users within their workflows. Input from all relevant stakeholders is essential to developing credible implementation guides for specific use cases.”

Project participants

Achieving such high-value use of interoperability involves many factors, says Didi Davis, vice president of informatics, conformance and interoperability for The Sequoia Project. These include data provenance and traceability of change, data integrity and trust, data tagging and searchability, the effective use of codes, reducing the impact of duplicates and the effective use of narrative.

Sequoia’s board of directors “prioritized data quality as a definite need that we would take on,” Davis adds. The organization sees it “as a long-term priority that will take about a decade to complete.”

DUTR is working off an implementation guide developed by its Interoperability Matters Data Usability Workgroup. The guide “targets improvements necessary to enable semantic interoperability of health information and builds on existing work,” Sequoia notes on its website. “Input from all relevant stakeholders is essential to developing credible implementation guides for specific use cases and ensuring stakeholder participation.”

The workgroup’s implementation guide focuses on data quality and addresses high-level use cases that include provider-to-provider health information exchange, provider-to-public health agency information exchange and healthcare entity-to-consumer information exchange.

In a press release from early July, DUTR noted commitments from major organizations supporting its work, including Azuba, Civitas Networks for Health, Epic, Foothold Technology, HCA, Health Gorilla, the Electronic Health Record Association (EHRA), Kno2, MedAllies and the New York eHealth Collaborative. Sequoia and AHIMA hope other organizations will join in to support the work.

Joining in

Despite the immensity of the project, DUTR hopes to springboard action based on its implementation guide to “get some quick wins,” Davis says. To do that, it hopes to draw on participation, especially from technology partners that can integrate solutions into systems and further encourage their users to incorporate changes.

Epic is evaluating how it can further support the initiative, says Matt Doyle, Epic’s interoperability software development lead. In addition to aiding the creation of the first implementation guide, “we are in the process of evaluating all the recommendations to see which ones we are already meeting and which ones we can do research on. The No. 1 thing we can do is become practical, to figure out what’s possible now.”

Health information exchanges and health data utilities currently are filling the gaps for ensuring data quality, says Lisa Bari, CEO of Civitas Networks for Health, but it’s important for downstream users of data, such as smaller health organizations or public health agencies to be able to have technology and practices in place that makes higher data quality ubiquitous.

AHIMA’s role is important because its members wrestle daily with problems that originate from poor data quality, says Lauren Riplinger, chief public policy and impact officer for the organization. “Our members are in the background trying to figure out how that data needs to flow. If we can fix it on the front end, we can facilitate and improve that flow.”

DUTR will be working on a second implementation guide in the coming months, Davis and Riplinger say. The group is looking for more participation in the project and has a monthly meeting at 4 p.m. ET on the first Thursday of each month. To register, go here. The initiative also has a laboratory tiger team that is working on lab-focused data usability pain points to improve sending and receiving system guidance to improve usability. For more information on that effort, and to sign up to participate, click here.

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