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Importance of EHR Interoperability

August 13, 2021 - Parul Saini, Webmedy Team

In healthcare IT, it's really difficult to think of any huge buzzword other than interoperability. Interoperability influences healthcare quality for both - patients and physicians. The major purpose of healthcare interoperability is to enable the flow of health data seamlessly between care-provider and other healthcare systems participating in the care delivery of the patient for better decision making.

Healthcare professionals are moving towards technology now numerous providers and health care facilities use it. In 2017, according to the report of the National Coordinator of Health Information Technology, 86% of office-based doctors used EHRs. With EHRs being widely used, it is important to understand what EHR Interoperability is and how better EHR interoperability can be beneficial for your healthcare.

What is EHR Interoperability?

Let's understand what interoperability in healthcare implies. In simple terms, interoperability means a system that can be integrated with any other system to share information. In medical terms, EHR or EMR interoperability means the capability of medical devices and technologies to share, explain and showcase health data in an easily digestible form whenever and wherever a patient receives care. It refers to the ease with which medical records and health care information can be transferred from one provider or system to another.

According to the office of the National Coordinator for Health Information Technology (ONC), EHR must have four key areas of technology successfully integrated to be considered completely interoperable. These key areas are:

  • Application interaction with users
  • System communication
  • Information processing and management
  • Consumer device integration

Levels of EHR Interoperability

Typically, there are seven different levels of interoperability. Keep on reading to know these levels.

  • Level 0 - NO Interoperability

    Stand-alone systems which don't have interoperability. This involves systems that cannot share information and are restricted to individual system boundaries.

  • Level 1 - Technical Interoperability

    This level of interoperability uses a communication protocol for sharing data between systems. It deals with technical aspects of interoperability like communication protocols, interconnection services, and data exchange format.

  • Level 2 - Syntactic Interoperability

    This level implies the capability of two or more systems to share data and services through mutually interoperable protocols like High-Level Architecture (HLA).

  • Level 3 - Semantic Interoperability

    This interoperability specifies the ability of two or more systems to positively decode the information exchanged meaningfully and exactly to generate favorable results as defined by end-users. Semantic interoperability means that the actual meaning of shared information is understood by communicating systems.

  • Level 4 - Pragmatic Interoperability

    This level of interoperability is acquired when the interoperating systems know the methods and procedures that they are using.

  • Level 5 - Dynamic Interoperability

    Two or more systems are said to have dynamic interoperability when they understand the state changes taking place and are capable of taking advantage of those changes.

  • Level 6 - Conceptual Interoperability

    Conceptual interoperability is attained when assumptions and constraints of purposeful absorption of reality are aligned. However, interoperability in healthcare has different meanings such as -

    • Interoperability of massages (data) to be shared among healthcare applications.
    • Interoperability of electronic health record (EHR).
    • Interoperability of patients' health records.
    • Interoperability of other business processes.

How is Interoperability achieved in an EHR system?

Interoperable EHR systems utilize industry-standard protocols and APIs for information sharing. Some of these are:

  • Fast Healthcare interoperability Resources (FHIR): Protocols for exchanging health data at the clinic and administrative levels.
  • Health Relationship Trust (HEART): Profiles that allow patients to control access to their healthcare data.
  • Health Level 7 (HL7): Standard controlling the exchange of data through the v2 messaging system.

Importance of Interoperability

Computer systems can transfer information and use the data that they receive. In the healthcare industry, information needs to be distributed and recognized once it is collected. With interoperability, the increased transparency, portability, and accessibility may increase the ease with which health information can be accessed by healthcare professionals. Health records can be securely shared with patients and other clinicians and health care settings to enable coordinated patient care. Collaboration allows for better and more timely decision-making, particularly in critical situations. If interoperability is not part of the equation, patient health suffers. Physicians and other medical staff require having the information that they lack at the point of care. If they lack specific information, they consume more time getting the information. Interoperability leads to better health outcomes with more accurate information.

Key Benefits of EHR Interoperability

  • Different stakeholders - Physician practices, hospitals, urgent care centers, pharmacies, and specialized medical centers, collaborate using interoperable systems that allow different systems and applications to communicate with one another. Patient's medical records follow them throughout the health care system and different stakeholders involved in the care of the patient can seamlessly collaborate.
  • Enhanced performance.
  • The safer transformation of care.
  • Minimized cost - Increased efficiency by greater data sharing conserves time and effort for staff, pointing to higher cost savings. Interoperability in terms of healthcare does it simpler for medical services providers to give patient information.
  • Interoperability in terms of healthcare does it simpler for medical services providers to give patient information.
  • Standards set by the government and management aid promote better interaction between diverse systems.

Barriers to EHR Interoperability

  • Lack of Consistency

    Organizations like CHIME and HIMSS are putting their efforts into the development of national patient identifiers for the last two decades. The reason behind that is as the health data exchange is continuously evolving, the need for an accurate and consistent way to identify individual patient health data is becoming more demanding. Allocating a unique patient identifier to each individual in the country is one way to make sure that hospitals can share medical health records and patient health data effectively and more accurately, lack of this can lead to increased healthcare facilities costs.

  • Lack of communication between healthcare providers

    Presently, the healthcare technology provided by today's vendors makes it tough to copy and share information from one electronic health record (EHR) software to another. Mismatched formats and data fields mean that at first data needs to be manipulated and desolated before being introduced into another system. A few different standards development organizations (SDOs) define, create, update and manage health data standards via collective processes that include health IT users but there is not any common single standard. The lack of standards for gathering, communicating, sending, storing, and managing health data is a major obstacle to healthcare interoperability.

  • Vendors blocking the information

    Lack of shared data in healthcare is a headache. A major bottleneck to healthcare interoperability is the practice of data blocking - from the vendor's side. A study published this year highlighted that information blocking is still all over the place, and policies are ineffective to curb the practice. Though efforts to shut off information blocking are already undertaken by mandating some level of data sharing by government regulations, if efforts are successful, then slowing down information blocking will help to make sure that information follows across provider organizations, which in turn will improve efficiency and quality of care.

  • Difficulty with Analysis, Measurement, and Improvement of Interoperability

    As one of the sayings goes you can't improve what you can't measure. Hence, it's difficult to measure the costs of error rates that occur when healthcare systems do not communicate with each other in a useful way. Due to the lack of ability to measure, or trace outcomes, health systems and other healthcare providers can't boost their important processes and this results in a lack of initiative to improve interoperability. The challenge faced by healthcare providers and their vendors is the lack of a standard way to measure the influence of interoperability problems. Once the healthcare industry can control these issues across healthcare systems, they will be able to analyze problems and make changes, and can also measure how those changes can boost the quality of care and patient outcomes.


Interoperability means how efficiently various computers and software systems can interact among themselves, sending and translating all types of data. In the health care industry, EHR interoperability is essential for enhancing patient care and outcomes, improving the workplace environment for providers, and saving money for the health care organization at large. Interoperability makes sure that health data is shared correctly between providers and organizations, improving the effectiveness, minimizing unnecessary tests, and improving communication between referring doctors and specialists.

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