What Is Interoperability in Healthcare? - A Comprehensive Guide

In the healthcare sector, being able to access and share health-related information is essential. Data from multiple sources, such as electronic health records (EHRs), medical devices, and patient portals, can help streamline patient care coordination and minimize medical errors. This necessitates healthcare data interoperability.

Without interoperability, healthcare providers may not have access to their patient’s complete medical history, resulting in inaccurate diagnoses.

Let’s look into the details of healthcare interoperability, its benefits, challenges, standards, processes, and tools that will help with it.

What is Healthcare Data Interoperability?

Healthcare data interoperability is the ability of different healthcare applications, devices, and systems to exchange, access, integrate, and use data in a coordinated manner. This interoperability within and across organizational, regional, and national boundaries allows healthcare providers to easily share patient health information.

When the providers can access complete and up-to-date information, they can optimize the health of individuals and populations globally.

Why is Interoperability Important in Healthcare?

Data interoperability healthcare is essential for several reasons, from improving healthcare efficiency and the quality of care received to financial incentivization. Let’s look at some of the benefits:

Maximizes Efficiency

Interoperability in healthcare helps reduce administrative burden, allowing practitioners to minimize repetitive tasks and focus on patient care instead.

Access to complete patient records allows providers to avoid duplicate tests and procedures and make timely decisions about treatment plans. By minimizing errors and streamlining workflows, this efficiency also results in cost savings.

Improves Patient Care

With clinicians and practitioners being able to access data, including the patient’s relevant health information, it can lead to better diagnosis, treatment, and care coordination.

Gathering the right information at the right time helps avoid redundant tests and procedures and reduces miscommunication. This enables patients to receive care from independent practitioners, hospitals, or other healthcare clinics.

Reduces Errors

Medical errors can result in negative consequences on patient health. The healthcare system spends an estimated cost of $40 billion per year on medical errors. However, with data interoperability in healthcare, physicians can view disparate patient data and avoid manual re-entries of fields already existing in a patient’s medical history.

Enhances Patient Experience

When patients can access their medical histories at any time, they can take an active and informed approach to their health. Some benefits include:

• Not needing to repeatedly fill in papers at every medical facility.
• Seeking second opinions and alternative treatments.
• Accessing their diagnoses and test results.
• Download educational materials to help with disease management.

Reduces Costs

Healthcare interoperability results in better patient care, which, in turn, results in reduced hospital stays, complications, and unnecessary care, including redundant tests. Interoperability facilitates relieving clinical staff of mundane data entry tasks. It also helps lower administrative costs with the automation of prescription management and allows doctors to connect directly to pharmacy systems.

Challenges With Integrating Healthcare Data

While healthcare experts agree that better healthcare interoperability will improve overall healthcare and patient outcomes, there are some associated challenges. These challenges arise when attempting to make their data and systems more interoperable.

Some healthcare data interoperability challenges include:

• Legacy Systems Integration: Healthcare organizations with legacy systems must modernize their systems and meet interoperability requirements. A solution to this is to deploy a hybrid cloud to extract data from legacy systems, making it available to modern applications. With this, organizations can keep their data moving while updating their systems.
• ‍Budget Constraints: A considerable amount of financial and technical resources are required to build an interoperable system. Updating legacy systems, purchasing and maintaining new hardware/software, staff training, and integrating new systems with existing ones can add to the costs. Suitable solutions include funding from private sector partners or government agencies and cloud vendors offering pay-as-you-go options.
• ‍Data Privacy and Security: Patient health information is confidential and highly sensitive. Exchanging such data across healthcare organizations and systems increases the risks of cyberattacks, data theft, and hacking. Robust security measures, such as encryption, access-based controls, and authentication, can help safeguard the data. Compliance with regulations like GDPR and HIPAA will also secure data further.
• ‍Lack of Coordination: The lack of uniform systems, protocols, and standards for information exchange complicates coordinated data exchange between healthcare organizations. To resolve this, authorities must take a proactive approach to ensure the adoption of these standards. Solutions involve fostering open communication, encouraging partnerships, and providing training and education to healthcare organizations.

What Does CMS Say About Healthcare Data Interoperability?

The Centers for Medicare and Medicaid Services (CMS) and its federal partners continue to implement key federal government interoperability measures to:

• Advance the adoption of Fast Healthcare Interoperability Resources (FHIR) standards
• Enhance digital capabilities
• Promote interoperability
• Support enterprise transformation efforts

The CMS issued two rules pertaining to interoperability and burden reduction:

• CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F): This rule ensures patients have prior authorization processes to remain at the center of their care.‍
• CMS Interoperability and Patient Access Final Rule (CMS-9115-F): This mandate ensures that patients can access and use their health data through the third-party applications and technology platforms of their choice.

Healthcare Data Interoperability Standards

Most healthcare data is scattered, unstructured, and inconsistent, complicating uniformity in the information exchange process. For effective healthcare data interoperability, organizations must adhere to established protocols and standards.

Some key healthcare interoperability standards include:

FHIR (Fast Healthcare Interoperability Resources)

FHIR is an open-source HL7 standard for exchanging healthcare information electronically. Released in 2014 as an alternative to HL7 v2, FHIR relies on RESTful web services and open web technologies to simplify data integration.

The FHIR standard is widely adopted by many major healthcare systems in the United States. This is mainly due to its ease of use and ability to integrate with existing systems and workflows.

With FHIR, you can organize data into resources like patients, medications, and conditions. It provides a standardized structure for how data is organized and interpreted by different applications or systems.

Some of the FHIR-supported use cases include clinical care, administrative, and financial transactions. Apart from EHR and similar systems, the merits of FHIR also extend to mobile devices and wearables.

DICOM (Digital Imaging and Communication in Medicine)

DICOM is the standard for the communication and management of medical imaging information and related data. Developed by the National Electrical Manufacturers Association, DICOM enables transferring medical images across systems. It also facilitates the development and expansion of communication systems and picture archiving.

With DICOM, you can integrate medical imaging devices from different vendors with a standardized image format. This allows health practitioners to access and share DICOM-compliant images regardless of the devices being used for image capturing.

HL7 (Health Level Seven)

HL7 is a set of international healthcare data exchange standards for the integration, sharing, and retrieval of electronic health information between disparate systems. This messaging protocol specifies data types, terminologies, and codes to ensure accurate and consistent information exchange.

With this standard, healthcare providers can access and share patient information securely and efficiently. HL7 can support a central patient care system as well as a distributed environment where data resides in departmental systems.

How Healthcare Data Interoperability Works

Healthcare data interoperability involves integrating and exchanging information across several healthcare information systems. Here’s how the process works:

• Gathering the Necessary Data: The process begins with the gathering of relevant healthcare data, including patient records and clinical results, among others. Common data sources include lab information systems, medical devices, and EHRs.‍
• Normalizing the Data: This step involves data conversion into a consistent format for different systems based on interoperability standards, such as HL7, DICOM, and FHIR.‍
• Integrating the Data: The consolidated data from the different systems is integrated into a single dataset.‍
• Exchanging the Data: This step involves data exchange by transmitting the normalized, integrated data across different healthcare systems. You can use APIs, Health Information Exchanges (HIEs), or direct system-to-system communications for this.‍
• Using the Exchanged Data: The exchanged data can be used for health monitoring, patient care, and supporting decisions.

Levels of Healthcare Interoperability

There are four different levels of interoperability in healthcare, as defined by the Healthcare Information and Management Systems Society (HIMSS). These levels describe the data exchange standards and schema allowing data sharing in the healthcare ecosystem regardless of the applications or vendors. Each level builds on the previous one.

While some of these levels are achievable with the existing healthcare IT systems and architecture, others require new technology and organizational process innovations.

Level 1: Foundational

Also known as simple transport, this is the most basic level of interoperability. It involves the secure transfer of data from one system or device to another. Systems at this level do not interpret the data or transform it into a particular format.

At the foundational level, providers can share data such as PDFs or emails. An example of such data is a PDF file of a patient’s lab test results. A nurse can download this PDF file from the lab’s results portal and manually enter the data into the patient’s health record.

Level 2: Structural

At the structural interoperability level, also known as structured transport, data is standardized. This involves defining the format, syntax, and organization of data exchange, including at the data field level for interpretation.

Standards, such as HL7 and FHIR, help ensure structural interoperability so records can be centralized, consistent, and easily moved between systems.

Level 3: Semantic

The semantic level of interoperability, also known as semantic transport, allows systems with varying data structures to exchange information. It establishes common underlying models and data codification, ensuring that different systems present meaningful and accurate concepts.

An example is medical imaging with specialized DICOM and non-DICOM formats for images. With semantic interoperability, systems can transfer and receive images in various formats, interpret them, and incorporate them into a new system.

Level 4: Organizational

Organizational interoperability includes governance, social, legal, policy, and organizational considerations. This ensures smooth, secure, and timely communication of data within as well as between individuals, entities, and organizations.

The organizational interoperability level ensures the smooth movement of integrated workflows, security, and consent between different groups.

An example is the Trusted Exchange Framework and Common Agreement from the US Office of the National Coordinator for Health Information. This agreement aims to establish universal policy guidelines and governance for interoperability, simplifying inter-organizational connectivity. Patients can also access their complete medical records from a single interface.

Tools to Help With Healthcare Data Interoperability

Healthcare organizations that are looking to enhance data interoperability can look into utilizing any of the following tools:

Blockchain Technology

Blockchain offers a decentralized solution to share large amounts of sensitive healthcare data securely. The use of cryptographic techniques ensures data integrity and privacy. Blockchain helps keep EHR information safe from unauthorized parties when it moves from one system to another. It is also useful for tracking medical records, managing patient consent, and preventing fraud.

Application Programming Interfaces (APIs)

APIs can help achieve healthcare data interoperability, mainly because they facilitate the secure exchange of data between different applications and software. With APIs, it’s easier for healthcare providers to attain software interoperability internally and at cross-organizational levels.

You can use APIs to connect EHR to other systems, allowing real-time data sharing and integration. APIs also enable EHR vendors to stay updated with changes in guidelines and policies.

Health Information Exchange (HIEs)

HIEs are specialized networks that rely on interoperable systems for secure and easy sharing of electronic health information. These HIE services simplify moving clinical data among diverse health information systems while maintaining its meaning.

HIEs provide a platform for accessing patient data across various systems. This helps improve care coordination and reduce duplication of services.

Cloud-Based Solutions

Cloud platforms offer cost-effective and scalable solutions for data storage and sharing. These solutions allow healthcare providers to access patient information from anywhere. With interoperability and data sharing, it promotes remote collaboration and care.

From reducing costs and resource consumption to enhancing security, scalability, and flexibility, cloud-based solutions offer many benefits.

Integrating Data for Healthcare Data Interoperability Using Airbyte

To facilitate healthcare interoperability, you can use Airbyte to gather patient records or data from multiple sources and put them into a common platform. Airbyte is an efficient data integration platform that allows you to extract data from varied sources, transform it, and load it into desired destinations.

With over 550 configurable connectors, you can set up a data transfer pipeline in just a few minutes. However, if you’re unable to find the required connector, you can utilize Airbyte’s Connector Development Kit to develop one.

Airbyte also supports healthcare application integration to consolidate your healthcare data from various apps into a central data store. This makes it easier for patients as well as physicians to access health data.

Here are some other note-worthy features of Airbyte:

• Advanced Security: Airbyte offers security measures, including role-based access control, encryption of data at rest and in transit, secure API practices, and authentication integration. This helps maintain confidentiality, safeguard healthcare data from unauthorized access, and ensure secure data transfer.
• Change Data Capture (CDC): Airbyte’s CDC functionality allows you to identify changes made to your source files and replicate them into the target system. With this, you can keep track of health data updates and ensure data consistency.

With these features and more, Airbyte can also help you unify data for AI-powered healthcare workflow automation.

How to Ensure Compliance With Healthcare Data Interoperability

Ensuring compliance with healthcare data interoperability allows various healthcare systems to work together smoothly. This can enhance data exchange and also patient care.

Here are some ways to ensure compliance with healthcare data interoperability:

• Use an Electronic Data Interchange (EDI): EDI is a data-sharing platform that facilitates the sharing of data by different computer systems. By using an EDI, providers can easily share information, while patients can receive better care.‍
• Standardize Medical Coding: With standardized coding systems, you can ensure all providers are using the same terminology when documenting patient care. Working with a professional coding company can help centralize your coding workflow.‍
• Prioritize Privacy and Security: Ensure quality, privacy, and security of healthcare information. Compliance with HIPAA will safeguard patient data during the sharing process.‍
• Establish a Designated Record Set (DRS): Organizing a DRS that includes healthcare information in all formats will help set guidelines for how information sharing must happen between different providers. With a DRS, providers will have all the information needed to provide the best possible care.‍
• Manage IT Integration: When building a data ecosystem, you must involve a data layer that provides APIs and is compliant with the most common healthcare IT interoperability standards.‍
• Ensure Anonymity: Protect patient privacy by anonymizing patient information, ensuring that no unauthorized third party can view it. This involves external vendors helping you develop and maintain applications, researchers, and anyone not directly involved in a particular patient’s case.‍
• Create a Reliable Patient Consent Process: Establish a transparent consent protocol with policies allowing patients to restrict data transmission and access. However, to encourage patients to provide consent, you can explain how their information will help in the development of innovative treatments for saving lives.‍
• Move Your Data to the Cloud: With cloud-based EHRs, healthcare organizations can improve data interoperability. The added benefits of disaster recovery, backups, encryption, and protection against cyberattacks contribute to compliance and interoperability.

Conclusion

Healthcare data interoperability involves the secure exchange of patient data between different systems and applications. It contributes to improved healthcare, reduced errors, and cost reduction, among other benefits. However, there are the associated challenges of budget constraints, privacy, security, and lack of coordination.

Adopting the different standards, such as FHIR, HL7, and DICOM, and utilizing appropriate tools will help improve healthcare interoperability. This will ensure healthcare providers can access relevant information to provide their patients with the required care.