Interoperability has become a key issue in the health industry. HIMSS, arguably the largest health IT organization states: “Patient-data mismatches remain a significant and growing problem. According to industry estimates, between 8 and 14 percent of medical records include erroneous information tied to an incorrect patient identity. The result is increased costs estimated at hundreds of millions of dollars per year to correct information. These errors can result in serious risks to patient safety.”

The goal of true interoperability cannot be done by one group or organization. It requires a concerted effort by everyone involved in healthcare, from providers to electronic health record (EHR) companies and health IT organizations. Interoperability is not only good for patients but also providers.

We’ve been keeping tabs on major strides towards interoperability from both the government to health IT organizations. Here are recent updates on the most promising innovations in interoperability: HL7 FHIR, the National Patient Identifier, and MACRA.

HL7 FHIR, the Future of Health Information Exchange Standards

Electronic health information technology has been gaining ground as the focus the health industry, and HL7 FHIR is at the top of the list. It’s web and modular based approach to data exchange seems very promising to the future of health information exchange.

FHIR is seeing a lot of support by many in the health industry; at HIMSS 2016, the Office of the National Coordinator for Health Information Technology (ONC) announced two interoperability challenges focused on promoting the FHIR app economy. Prizes totaling $675,000 are aimed to spur the development of FHIR applications for both consumer and provider use.  FHIR is a key part in the ONC’s new strategy to ” foster private sector innovation to help make health information available in user-friendly formats to enable consumers and providers to easily and securely access and share electronic health information.”

HL7 FHIR is in its third iteration (May 2016), Healthcare IT News reports. It features some new capabilities, such as support for the Clinical Quality Language for clinical decision support as well as further development of work on genomic data, workflow, eClaims, provider directories and CCDA profiles. Read about our breakdown of HL7 FHIR here.

The National Patient Identifier

The sleeping giant of interoperability, the National Patient Identifier, is being poked and prodded by the health industry. Though it’s been banned from federal funding since 1996 due to concerns over privacy, many argue that the NPI may be the holy grail of interoperable health solutions. An NPI could substantially boost interoperability by allowing patient records to be searchable on a national scale versus a localized system.

CHIME, a leading health IT organization, is in the judging stages of its National Patient ID challenge,  a contest aimed at developers to create an NPI. With a grand prize of $1,000,000, their goal is to “ensure 100% accuracy of every patient’s health info to reduce preventable medical errors and eliminate unnecessary hospital costs/resources.” Patient data mismatches are a growing problem, which causes millions in financial loss and may risk patient safety.

Other organizations such as the American Health Information Management Association (AHIMA) are banding together to petition the removal of a 16-year federal budget ban that prevents the HHS from developing unique patient identifiers. “AHIMA is confident the technology exists to solve this problem while ensuring that patient privacy is protected,” Lynne Thomas Gordon, CEO of AHIMA said in a Journal of AHIMA report. “But it will require public-private collaboration and open discussion.”

Read about the history of the NPI here.

MACRA to Overhaul Medicaid

The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) has seen its fair share of controversy since its creation. The government has seen this and responded with MACRA, new legislation set to overhaul Medicaid. It has two key components: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

Recently, the Centers for Medicare & Medicaid Services (CMS) has incorporated a new program into MIPS, the Advancing Care Information (ACI) to replace Meaningful Use. The ACI promises to be “more patient-centric, practice-driven and focused on connectivity”, and specifically focuses on revamping the Meaningful Use’s interaction with EHRs. It promises to:

  • Improved interoperability and the ability of physicians and patients to easily move and receive information from other physician’s systems;
  • Increased flexibility in the Meaningful Use program; and
  • User-friendly technology designed around how a physician works and interacts with patients.
Advancing Care Information

Advancing Care Information as part of MIPS

Read more about our breakdown of MACRA here, and Advancing Care Information here.

Interoperability for All

It is clear that interoperability is a central issue in healthcare. Understanding and utilizing new avenues of healthcare innovation that promote interoperability is vital for a health care infrastructure both safe and efficient.

As the Center for Medical Interoperability notes, “As healthcare professionals, and as an industry, we can no longer accept the status quo. It is possible to have real-time, two-way, low-cost, standards-based connectivity that enables improved decision-making and assures safety at lower cost. The technical capability exists. However, a byproduct of our fragmented national healthcare system is that vendors lack incentives to make their technologies work in a plug-and-play manner.”

Health organizations spend millions of dollars developing technology exclusive to their organization. Adopting an open-source mentality such as HL7’s is essential for creating a healthy environment that promotes patient safety and security. Interoperability must be a goal everyone in the industry should strive for. Not only would it create a safer environment, it would reduce costs for everyone across the board.

Check back for weekly updates on interoperability and how it will affect the healthcare industry, from providers to EHR software.



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