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Interoperability in healthcare and its Challenges

January 14, 2020 - by 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.

Do you know what interoperability implies in healthcare?

Interoperability is 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. Healthcare systems should be able to carefully and actively create and brings meaningful clinical knowledge, decisions, and actions.

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

  • Level 0 or we can say NO Interoperability

    Stand-alone systems which don't have interoperability. This involves systems that cannot share information and restricted to individual system boundaries.
  • Level 1 or 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 or 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 or 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 or Pragmatic Interoperability

    Two or more systems are said to have dynamic interoperability when they understand the state changes taking place and they are capable of taking advantage of those changes.
  • Level 5 or Dynamic Interoperability

    Two or more systems are said to have dynamic interoperability when they understand the state changes taking place and they are capable of taking advantage of those changes.
  • Level 6 or Conceptual Interoperability

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

Obstacles related to interoperability

Here are some of the obstacles related to true interoperability:

  • Lack of consistency

    Organizations like CHIME and HIMSS are putting their efforts into the development of national patient identifiers from 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.

Encouraging Steps Towards Interoperability

The government's action for encouraging interoperability is a significant boost for healthcare interoperability. The good news is that tremendous progress towards interoperability is being made by some standard bodies like Health Level Seven (HL7) and Fast Healthcare Interoperability Resources (FHIR) standards group. EHR practice management platforms are already adopting these standards to lead efforts to move towards true interoperability.

Shortly, we'll probably see the confluence towards some standards, reduction in cost, gathering of patient information and capability to analyze and use collected data. With some efforts, interoperability can and will be attained - but needs a good deal of effort like all other things.

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