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Efficient healthcare requires widespread and effective communication among primary care providers for sensitive personal health information in order to properly and successfully perform their functions. Along with the need to make this information readily available, there is a need to protect information from unpermitted access. This is where the concept of interoperability of healthcare data is challenged to meet the demands of the data users.
Information sharing is one of the primary areas that the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) identified to improve healthcare outcomes. This is a continuation of similar objectives from Meaningful Use. The concept of interoperability has evolved from merely enabling information sharing between separate data systems, to the current expectation in the healthcare environment that transferring patient data from location to location will take place in a HIPAA-compliant manner with minimal user effort. If the current expectations are met, the results may also include more accurate data entry and less administrative burden on medical practices, thereby achieving the grand goal of entirely improving healthcare for all stakeholders.
Ideally, interoperable systems are designed and connected so that crucial data is instantly available to those who need it. These secure data transfers eliminate the need to enter duplicate data during the course of any medical engagement, which increases productivity by streamlining workflow. Many details like the uniform configuration of data schemes for the documents and records that Electronic Health Records (EHR) systems produce are key components in creating seamlessly interoperable networks of healthcare records.
The benefits of interoperability are numerous and include reduced administrative burden, cost savings, and improved healthcare outcomes. For example, in medical billing, the data flowing between the EHR and a Revenue Cycle Management (RCM) service allows for automated claims “scrubbing”, which is an automated computer process to flag common manual errors in ICD-10 codes that could lead to claims denial. After scrubbing, there is an automated transfer of the correct and accurate data from point of care to submission for payment by the insurance payer. This process results in lower administrative costs than if the claims had been submitted for a claim without scrubbing and then denied, which requires a full review and recoding to correct the error.
What Makes a Network Interoperable?
According to HealthIT.gov, there are four particular areas of EHR systems that should be addressed when developing an interoperable network:
- How applications interact with users (such as e-prescribing)
- How systems communicate with each other (such as messaging standards)
- How information is processed and managed (such as health information exchange)
- How consumer devices integrate with other systems and applications (such as tablet PCs)
When considering how users interact with applications, it’s important to ask the following: how is the operator using the system? What are the functions in use? Another example of a common EHR software function would include e-prescribing, which involves the EHR communicating directly with the pharmacy. This functionality can include accessing the information on brand name vs. generic drugs as information is passed from pharmacy databases into the order screen of the EHR in real-time. Although there are still many points to be addressed regarding EHR interoperability, this is an example of an interoperable function that didn’t exist only a few years ago and is taken for granted today.
Inter-system communication involves the different ways in which the systems correspond to one another. How is the data exchanged between the two systems? For systems to be interoperable, they should be able to exchange data and also make the data intelligible to the end-user.
On the patient side, does the system work with mobile devices such as tablets? The ability to communicate with the patient via text or email, or the ability to schedule patient appointments in the EHR saves valuable time and effort in the administration of the medical practice. Having integrated mobile technology can also help practices to implement telemedicine, which would allow them to give the care to even more patients (i.e., those with limited mobility).
Although similar systems are equipped to handle similar tasks, they do so in a plethora of different ways, on unique device operating systems and across screens of varying sizes and resolutions. Therefore, when a medical provider identifies a new system that they want to be connected to an existing system, the task of figuring out where the bits and bytes of data will go begins for EHR developers. The EHR vendor has a long effort ahead to deliver a complete system where the interoperability of all the parts behind the scene creates a presentation that meets market expectations.
How To Maintain Forward Progress with Your EHR Provider
Whether by a specific request or as driven by market forces, physicians and developers collaborate to decide how best to construct an interoperable network that will allow clear and efficient communication to benefit patients. For example, at the specific request of the MBTA, PrognoCIS EHR added a diagnostic device called the Health o meter to automate the collection of standard vital signs. This data acquisition automatically passed through the blood pressure cuff into the EHR face sheet and leads to shorter collection time and greater accuracy of medical data.
Along with the integration of machine interfaces, correspondence among different EHR systems will allow patient care to be considerably more prompt and efficient. Health Information Exchanges (HIEs) can provide exactly that because they establish standards for sending and retrieving electronic data among different EHRs, which gives the medical provider faster and more efficient access to health information.
Further Steps Being Taken To Improve Interoperability
Advances on the technical side of interoperability will continue, but the key driver for the success of meeting market expectations regarding interoperability will be in the healthy communication of ideas and needs between the medical community and EHR system developers. Knowing how to identify a deficiency or new interface need and communicating it to your EHR Software provider will greatly assist continued forward progress in the healthcare community. If you have product feedback ideas for PrognoCIS EHR, or To request connection to a specific HIE or hardware device, please visit our contact us page and start the conversation.