Providers must demand interoperability as part of strategy in buying IT

Procurers of healthcare technologies have not marshaled their purchasing power, finds National Academy of Medicine.


Healthcare interoperability can only be achieved on a large scale through the strategic acquisition of health information technology solutions and devices.

That’s the contention of a new National Academy of Medicine report that cites the “suboptimal” nature of healthcare technology purchasing as a major barrier to the interoperable exchange of electronic health information.

“When it comes to procuring digital services for health and healthcare systems, interoperability is simply not yet an effectively structured component of either the supply or the demand equations, nor of the links between the two,” finds the NAM report. “In contrast to many other industries, the purchasers of healthcare technology have not fully leveraged their individual or collective purchasing power to require interoperability from the health technology marketplace.”

As a result, NAM contends that most electronic health records, medical devices and other IT systems are not interoperable.

“Hospitals and other healthcare providers purchase systems and equipment from a variety of different manufacturers, and frequently, each comes with its own proprietary interface technology,” according to NAM. “As a result, most healthcare providers spend time and money setting up each technology in a different way instead of being able to rely on a consistent means of connectivity. Healthcare providers also purchase technology that will work for their system, without considering the systems that interact with their own or the systems that their patients are connected with.”

The good news, contends the report’s authors, is that with better procurement practices—supported by shared interoperability platforms and architecture—healthcare systems can accelerate progress in achieving high-quality, connected and patient-centered care.

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Ultimately, the report says the goal is for healthcare systems to “move away from serial purchases of individual software and hardware with proprietary interfaces toward purchasing certified technologies that will interoperate with others through a vendor-neutral open platform.”

The NAM report identified five action priorities for healthcare organizations and other stakeholders to institute to achieve system-wide interoperability:

· Commit—Declare interoperability to be a priority and form an organization-wide interoperability steering group or related capacity to champion the IT acquisition strategy.

· Identify—Charge this group with identifying the set of interoperability goals, requirements and model use cases for the procurement process to support organizational priorities and patient outcome goals.

· Collaborate—Create a sector-wide strategy and partner with other stakeholders to align on common contracting requirements and specifications to move toward the next generation of interoperable health IT.

· Specify—Use the collaboratively developed specifications to state clear functional interoperability requirements in existing and future proposals, purchases and contracts.

· Assess—Establish and monitor short-term and long-term metrics for the progress and contributions of interoperability to system-wide learning and improvement of health outcomes.

“In moving ahead, the fundamental responsibility lies within the cooperation among healthcare system leaders as they guide progress within their own institutions, establish the organizational priority, marshal the expertise, and shape relevant acquisition strategies and interoperability requirements for purchases of digital technology,” states the report. “This cooperation requires solid and active commitment to collaboration that yields a multi-institutional strategy to develop and align on common contracting requirements to move toward the next generation of interoperable health systems.”

“To ensure that healthcare dollars are spent in pursuit of healthcare delivery systems reaching desired levels of care quality, safety and efficiency, interoperability must be a top priority,” said Victor Dzau, president of the National Academy of Medicine, in a written statement. “Only then will the healthcare industry begin to create truly integrated care systems that continuously provide better experiences for clinicians and patients while achieving better health and healthcare at a lower cost.

“The time is now to realize the true potential of health information technology, and all healthcare organizations have an obligation to see this through so that future generations will lead better, healthier lives,” Dzau concluded.

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