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and higher quality care.
What Is EHR Interoperability?
Interoperability as a single concept means the ability of different information systems (devices, applications, or otherwise) to access and cooperatively use data together in harmony. Why is it important? The main function of interoperability is to provide seamless portability of information across organizations and practices.
EHR is the first stepping stone in the process of interoperability. Moreover, health data exchange architectures, application interfaces, and standards allow data to be accessible and sharable in a secure manner across a variety of care systems and departments. As interoperability operates in the form of a process, it has multiple levels as set by the HIMSS board in 2013.
Here are the 3 Main Levels of 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.
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.
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.
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.
- 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