Why healthcare interoperability moves at a snail’s pace

Vendors need to move beyond theoretical demonstrations of data exchange so that providers can have it work in practice.

Healthcare undoubtedly lags behind other industries when it comes to interoperability. Sadly, organizations remain stymied by systems that fail to communicate. Vendors’ sluggish efforts to make progress have only placed more distrust in the market.

There are concerted efforts underway, ranging from government officials emphasizing interoperability and information blocking, and industry standards such as HL7’s FHIR have come to the forefront. However, little has been done to motivate IT vendors to achieve better integration and data sharing. The industry will have to wait until April to see if the proposed health IT provisions within the 21st Century Cures Act will be enough to drive the final push toward true interoperability.

Having just returned from Cleveland following our annual participation in the IHE North American Connectathon—where vendors cooperatively demonstrate and test the latest industry standards for interoperability—it raises the question; “Why can’t this open collaboration successfully proliferate outside the confines of the event?”

Coordinated, accountable, patient-centered care relies on seamlessly orchestrated access to data. Despite that, providers continue to be challenged by fragmented technology and electronic medical record systems that lack communication, or that share and transmit information effectively. Disparate information trapped in silos across multiple systems and settings hinders data quality, resulting in suboptimal outcomes and avoidable costs of care. For organizations held prisoner by their legacy systems, data inefficiencies worsen as IT environments become increasingly more complex, and the growth and speed to which health information is generated magnifies.

As healthcare IT innovators, companies have a responsibility to develop solutions that allow bidirectional connectivity between systems to enable a coherent experience for clinicians and patients. This free flow of data across various providers and environments is the catalyst for comprehensive, coordinated care, enhanced clinical decision-making, healthier communities, and a better patient experience. As the Connectathon continues to encourage this open and interoperable exchange, a far greater level of industry involvement and incentive will be required to spur change.

While the intent of the IHE Connectathons are unquestionably valid, the massive size and short duration of the events allows only a superficial level of compliance testing. This unfortunately leads to a reality gap between what is tested vs. what systems are capable of doing in the field. To make more tangible progress, the event should be less about passing tests on paper and more about ensuring that products truly leverage the existing standards and IHE profiles.

To adequately ensure value in the market, applications that pass testing must go beyond simply demonstrating that a sequence of messages was sent, but rather prove that the interoperability concepts are truly integrated into the products being certified.

Despite demonstrating open and interoperable exchange, vendors seem to abandon interoperability standards when bringing integration into practice. For healthcare providers, integration projects are constant—and costly. Many organizations are struggling to remedy interface and integration deficiencies, such as resorting to ineffective screen scraping technology to manually transfer data to their local systems. Many, if not most, of the systems only act as a feed of identity data into the EMPI, specifically demographics and identifiers. This is because many systems have already been designed to produce this outbound communication for purposes other than the management of demographic data. When it comes to querying the EMPI for patient identity, this requires a fundamental paradigm shift for many vendors and a modest investment to enhance their software.

Access to comprehensive patient data is essential to drive informed clinical decision-making and delivering care quality and efficiency. Despite EHR improvements, few organizations have been able to overcome the barriers of information silos. And achieving a truly connected healthcare environment, even for the most technically advanced health systems, remains a goal rather than a reality.

With years of health IT standards in place that yield a centralized and uniform way of managing and exchanging data, the meager pace and progress of vendors to adopt them is disconcerting. As vendors continue to master additional standards, advances in system integration and interoperability stay stagnant.

As other verticals, such as banking and manufacturing, leverage standards-based exchange at a much faster pace, healthcare struggles to effectively accelerate increased adherence of standards adoption. The challenge to the industry is to engage in an open and frank dialogue to examine how vendors can be incentivized, so patients and physicians can benefit from real-time data exchange during every encounter along the healthcare journey.

For organizations to be successful in healthcare’s rapidly evolving transformation, the status quo of interoperability is no longer acceptable. An open IT infrastructure that provides a longitudinal view of patient data across the continuum is a critical component for value-based care and population health initiatives. Let’s support organizations and the communities they serve by removing the integration barriers that plague our industry’s IT systems, and facilitate access to comprehensive information at the point of care to drive better outcomes in quality, safety and delivery.

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