An article last week on HealthITAnalytics discussed the development of interoperability in the healthcare industry.

Health Level Seven International (HL7), an organization that determines data communication protocols for health IT, recently wrote a letter to the Senate Committee on Health, Education, Labor, and Pensions (HELP), asking for proof that interoperability will be as effective as they expect it to be.

The idea of interoperability is intended to lower costs for provider computer networks, ultimately reducing healthcare costs for patients, by improving communication and coordination among health systems. Since 2009, electronic health records (EHRs) have become widely adopted; however, the lack of interoperability has become a hindrance to the industry. Health IT systems that don’t communicate together seamlessly cause organizations to spend more time and labor for routing information by “sneaker net”, for example. “Sneaker net” is the practice of burning a CD or DVD and then running it around an office space. There is now a greater push to advance interoperability.

While data exchange within organizations has become well established, recent developments in the health system now call for an enhanced ability to share information. According to the article, there is greater demand for improved care coordination and population health management. The industry is also transitioning from a fee-for-service payment model to a value-based reimbursement model, where physicians are now paid based on the value of the care they provide. These developments have increased the progress of interoperability standards, but it is still a long road ahead.

Some of the forces working against seamless interoperability in all computer systems apply to health IT systems just as well. Hardware and software manufacturers alike are always competing in the market place to add new features – sometimes these features are ahead of the standards to process the data that is generated. And sometimes standards are well set but are “adopted and extended” to provide a market differentiator to consumers. For example, some very large software vendors would strategize with their implementation of various web standards. This would allow them to claim compliance to standards and remain unique in their product offering to the market, thusly providing competitive advantage through compatibility lock-out. This is why specific browsers work differently when logged into different web mail versions provided by their respective developers.

HL7 CEO Charles Jaffe and Board of Directors Chair Stanley M. Huff write in their letter, “The national interoperability infrastructure, which supports data exchange across provider organizations and with patients, is not yet fully scalable.” They want that standards be thoroughly tested through demonstration and pilot programs before they are released.

The article goes on to mention that although everyone involved understands the significance of interoperability and it’s benefits, it is necessary to comprehend the potential return of implementing it, and what the plausibility is of that potential becoming absolute. HL7 feels that “the prescription of standards and guidelines for interoperability needs to be driven by sustainable business cases that present opportunities for efficiency and clear value to end users.”

In order for interoperability to be truly accepted, it is essential for the federal government to provide evidence of its ability to succeed and justify the effort that will be required for full implementation.

Authors: Apoorva Anupindi & James Metzger

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