Overview
Interoperability, the ability of Health Information Exchange (HIE) between various systems, devices and applications benefits both, providers and patients. Interoperability within an electronic healthcare record (EHR) creates enhanced patient care. In the current scenario, not every EHR allows quick and easy exchange of information. This creates gaps in sharing valuable patient information (past illness, medication) for the highest quality of care. The efficiency of healthcare systems declines without open communication with each other.
Thankfully, you can overcome this problem by embracing EHR systems that allow connectivity between healthcare systems. With interoperability, you can greatly improve the quality of care, boost the efficiency of your practice, and receive incentives through the CMS Promoting Interoperability Program.
What is EHR Interoperability?
EHR interoperability refers to the digital health record systems’ ability to openly communicate with each other, allowing providers to access and exchange patient healthcare information. The systems must process the data and present the information in an easily accessible manner to qualify as truly interoperable.
The Office of the National Coordinator (ONS) diligently works alongside standards development organizations (SDOs) to develop consistent interoperability standards amongst various healthcare systems. They have created a number of helpful guidelines that ensure the systems can speak to each other and present the data in a user-friendly manner.
Unfortunately, despite the creation of these standards, the vast majority of EHR systems in use today do not allow practices to share patient records with ease. Instead, they must exchange information through fax and other archaic methods — or cycle through more than a dozen standalone systems. At the average hospital, for example, providers have to tap into 16 distinct EHR systems to retrieve information and update their patients’ records.
Interoperability would change all that by allowing everyone in the healthcare industry to openly communicate with each other in operating their clinics and caring for their patients. The system would also give patients better access to their health data.
Here are the 3 Main Levels of Interoperability
Level One: Foundational Interoperability
At this level, the interoperability permits one information system to exchange data with another authorized information system. It tackles the establishment of inter-connectivity requirements.
These are needed for one system to share (and receive) data from another. A good example of foundational interoperability would be sending lab results from one facility to another.The information will make it from the sending facility to the receiving facility securely. However, it’ll need manual data entry and interpretation and, this is where the second level comes in.
Level Two: Structural Interoperability
On level two, the structural interoperability tackles the format of the data exchange. It deals with the standards that govern the format of sent messages as they travel from one system to another.
The objective of this intermediary stage is to ensure that the messages are clear from the clinical and operational perspectives. In addition, this level has to confirm that the data was sent securely and wasn’t corrupted (on purpose or not) on its way from point A to point B. When we address data, we’re talking about information at the level of data fields in the form of a patient records database. For example, there is the case of transmitting a patient’s discharge medication list.
The receiving machine will recognize the individual data elements like the medication name, the route, the dosage, and the frequency. Furthermore, e-prescribing wouldn’t have been possible to achieve without structural interoperability. The structure will ensure that the pharmacy’s computer system will accurately reflect the information sent from the prescriber’s system.
Level Three: Semantic Interoperability
At the third level, we encounter the highest level of connection. Multiple systems can exchange and use information with ease at this level. In addition, the computer systems would have a robust understanding of vocabulary and common usage of medical terminology. The structure of the data exchange as well as how the data is codified allows medical providers to share patient data regardless of the EHR software used.
This presents a tremendous amount of communication capabilities. In addition, it provides cooperation amongst healthcare providers, researchers, and scientists. Any health-based profession that requires large amounts of data to conduct studies will be able to use a treasure trove of data. This data is the key to addressing emerging diseases or other public health concerns.
A great example of semantic interoperability is understanding that a frequency field ‘bid’ would be equivalent to ‘twice daily’ and to ‘am/pm.’ For immunization registries and other clinical-based units, a high level of semantic interoperability would hyper boost the system’s recognition. It will allow the system to understand that a levothyroxine prescription for 100 mg, one tablet qam would be equal to 50 mg/two tablets qam.
Methods of Interoperability
This brings us to the methodologies used to achieve interoperability between medical software.
It’s deeply connected to the second level of interoperability, which is all about structure. In order to start applying interoperability on the ground level, the HL7 committee created a framework through which health information can be exchanged. The framework is built on compiling a collection of messaging formats and related clinical standards, each fitting its own areas like radiology. This way we get a loose definition of the ideal representation of health information.
For instance, health organizations that make use of applications leveraging the HL7 messaging standard can —in theory— communicate with one another regardless of the actual computing language in use. Meanwhile, trying to tackle the challenges present in the HL7 messaging protocol, the HL7 organization has introduced Fast Healthcare Interoperability Resources (FHIR).
FHIR was developed to enable health IT developers to easily build new applications for EHRs and to speed up data transfers from one application to another.
The Benefits of Interoperability
Interoperability should be looked at as a philosophy instead of communication and data technology to truly unlock its potential. Multiple groups of stakeholders need to believe in the system in order for it to work. Thus, if medical software vendors aren’t willing to share what can be considered proprietary system information, then the process of data sharing won’t function in unison.
Moreover, medical practices must be willing to share patient details. These details should be shared over networks for access by different databases. However, it’s essential to keep in mind the importance of confidentiality. Security protocols for both patients and medical practitioners are in place for a reason. Furthermore, on the technical side of the aisle, there are numerous benefits that can be measured.
Transitions of Care with Safety in Mind
Patients with chronic conditions tend to deal with multiple health service providers at once. And, they can face multiple issues regarding their continuity of care process. With interoperability in the picture, safer transitions of care can be put in place for better patient outcomes across the board.
For instance, there are many common cases of patients falling ill on vacation. They’re in no shape to provide their emergency health providers with any sort of medical history. This can make all the difference in the world regarding the path of treatment the doctor decides on.
Higher Efficiency Levels
Interoperability was created for the sole purpose of boosting efficiency levels. It provides essential data to the authorized individuals in charge at the click of a button. This simplifies the process for medical practitioners when they need to get to the heart of the matter.
Lowering Costs Across the Board
This applies to both patients and medical practitioners. By having interoperability in place, useful information can be shared in a timely manner. This can prevent unneeded blood tests and other procedures from taking place. Here’s an example. A patient’s data was taken through a blood test earlier this week at their doctor’s office. This data is now used today during a trip to the emergency room. This type of information can not only save time and money but also people’s lives.
EHR Interoperability Is the Future
We’re moving towards a more interconnected state. As such, our technologies will mirror our need for efficient data-sharing platforms. With all that you’ve learned about EHR interoperability, that barely covered the tip of the iceberg. Thus, make sure to check out our industry blog to know all about specialty EHR and much more!
How Can Practices Benefit From EHR Integration?
With industry wide EHR interoperability, all clinics, hospitals and other healthcare facilities could access and update their patients’ full medical records. Sections of the patients’ records would no longer remain veiled behind the standalone systems. They can easily exchange health information data from within the clinical workflow and at the point of care.
Through EHR integration, healthcare providers would no longer have to go the extra mile in retrieving or updating these records. With just a few clicks of a button, each patient’s records would quickly populate and display the vital information needed to make wise healthcare decisions. This information could be then shared with other healthcare providers, labs and pharmacies. The accessibility of patient data by various providers through Interoperability greatly helps the movement of patients between different healthcare facilities.
Healthcare systems can together provide a holistic view of patient data, promoting value-based care. In fact, studies show that interoperability has the power to cut hospitals’ costs by eliminating redundancies and readmission through improved communication. Eventually, it helps achieve improved care coordination, patient safety, and positive patient outcome.
Interoperability creates incentives for healthcare practices through the Promoting Interoperability Program offered by the Centers for Medicare & Medicaid Services (CMS). As you use interoperability to benefit your patients, your clinic will receive payments from CMS for as long as you adhere to the program guidelines.
PrognoCIS Integrations
To promote the continuity of patient care and equip providers with the right data and information, PrognoCIS has integrated with various different healthcare platforms, a few are listed below.
- FHIR API Documentation
- PrognoCIS Developers Terms of use for API published
- Clinical Integrations – Labs, Radiology, E-prescriptions, Pharmacy
- Immunization Registries – Around 25 States
- Qualified Clinical Data Registries – NIPM, RISE, and more
- Device Integrations – Midmark, Labdaq, and more
- Patient Engagement Integration – Patient Portal, Appointment Reminders
How is Interoperability Achieved in an EHR system?
Leaders in the health tech industry have introduced EHR systems with interoperability at the forefront of their design. With their progressive software, your practice can seamlessly send and retrieve health data as needed to care for your patients.
The data moves between the systems while abiding by the guidelines created by SDOs, such as:
- Fast Healthcare Interoperability Resources (FHIR): Protocols for exchanging care data at the clinic and administrative levels
- Health Level 7 (HL7): Standard controlling the exchange of data through the v2 messaging system
- Health Relationship Trust (HEART): Profiles that allow patients to control access to their healthcare data
By following these guidelines, effective interoperable EHR systems achieve all of their amazing feats behind the scenes. They accomplish this goal through the use of application programming interfaces, or APIs. With these APIs, the system creates a portal of information unique to each patient and accessible by all the healthcare providers who attend to that patient. They can easily exchange health information data from within the clinical workflow and at the point of care.
Learn how PrognoCIS helps achieve interoperability solutions for success in clinical, financial, and patient outcomes. You can easily get started in improving the interoperability of your practice with PrognoCIS EHR software.
