The federal government put into action a decade-long plan that includes incremental improvements that result in the establishment of a nationwide learning health system, according to EHRintelligence.com. This plan was put into effect several years ago, with the primary goal being to improve healthcare interoperability. How is this level of integration supposed to be established? What are the challenges that stand in the way of such a valuable healthcare system? These are two questions that this article will outline.
What Are Interoperable Electronic Health Records (EHRs)?
To fully understand healthcare interoperability, you first need to understand that it is a process that occurs at three different levels. According to the Healthcare Information and Management Systems Society (HIMSS), the first level, which is foundational to the entire structure, involves “data exchange from one information technology system to be received by another and does not require the ability for the receiving information technology system to interpret the data.”
The second level “defines the structure or format of data exchange (i.e., the message format standards) where there is a uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data are preserved and unaltered.”
And the third level “takes advantage of both the structuring of the data exchange and the codification of the data including vocabulary so that the receiving information technology systems can interpret the data.”
In addition to these definitions from the HIMSS, it is pertinent to understand two terms, both of which are essential in acquiring an in-depth understanding of healthcare interoperability. The first term is interface, which is a platform or system used to enable two systems to communicate with one another. Simply put, an interface is a translator and acts as the go-between in exchanging information from one system to another to ensure both systems recognize and properly understand all data being exchanged between one another.
The other time is application programming interface, commonly referred to as an API. An API streamlines the interaction that takes place between systems. Smartphone users, whether they realize it or not, utilize APIs every day. Application developers for Apple and Android work with APIs so that their developed applications will work well on both operating systems.
What Does EHR Interoperability Lead To?
There are several advantages to be gained by the establishment of EHR interoperability, including:
- More efficiency
- Time savings
- Reduced risk of malpractice
- Increased care coordination
- Better research
- Fewer unnecessary tests
What Are the Challenges?
It is hoped by the government that healthcare interoperability will be a common capability among healthcare providers by the year 2024. Unfortunately, though, for now, less than 50 percent of patients report that their providers actually share their records. In fact, only 39 percent of patients state that their records are directly shared between one provider to the next. And an amazing 25 percent of the patients say they have to hand deliver their records to ensure they are properly being shared among their providers.
This lack of sharing records has come about due to several factors. First, we are seeing resistance from some vendors. There are entities out there that want healthcare data to be exchanged only if money is involved. Some vendors are even requiring exchange fees of up to $50,000 to share data. There is also a lack of incentive to entice healthcare providers to exchange data. If more incentives were offered, we would surely see more providers jump on the EHR interoperability bandwagon.
Communication is key to healthcare interoperability. Both patients and physicians must be educated on the numerous reasons to hop aboard the bandwagon. More importantly, physicians need to be enticed with incentives as well as be informed of compliance requirements they must meet relating to governmental interoperability demands.
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