Interoperability in healthcare is vital to streamlining services, preventing medical mistakes, and improving communications.
The sudden onset of Covid-19 has put the need for greater interoperability at the forefront.
But several barriers still exist. Recognizing these barriers and finding real solutions reduces their impact and facilitates the process towards true healthcare interoperability.
Interoperability has multiple levels corresponding to the number of devices or programs integrated into the system. The Healthcare Information and Management Systems Society, Inc. (HIMSS) has outlined three levels of basic interoperability and added a fourth in March 2019 to accommodate the needs of larger institutions.
This level creates the most basic form of interoperability. While most facilities will start at this stage, few will remain here aside from the smallest practices. Foundational interoperability only requires safe, secure, and reliable connectivity between a pair of systems. While the systems can exchange information, a user must still interpret the data. According to one study from 2019, 26% of facilities reported only having a foundational level of connectivity.
The second level is structural interoperability. This level differs from the first in the ability for the sharing systems to interpret received data as information fields. The syntax for translating the data is a hallmark of this step. Structural interoperability was the most popular of the first three levels, with 38% of study respondents reporting this stage in their facilities.
This is the ideal level for many small and medium-sized healthcare facilities. Information passes easily between systems and each system can completely interpret that information. Patient data passes easily through channels without the need for third parties. Additionally, all data shared electronically in this and in all other levels of interoperability only permits authorized users access to ensure HIPAA compliance. Before having a chance to integrate organizational interoperability, semantic was the second-most popular of the first three levels with 36% of healthcare facilities surveyed using it.
The most recent addition to the list is organizational interoperability. This level integrates technology and personnel infrastructures to facilitate the process of quickly, easily, and securely sharing information among authorized people, entities, organizations, and healthcare facilities. Large healthcare facilities with numerous staff will need to consider how to govern the changes, which policies to implement, how to train workers, and the legal implications of interoperability and data exchange.
With so many benefits to fully interoperable systems in healthcare, most people wonder why we haven’t got there yet. In fact, several difficult hurdles still exist.
First, many facilities have taken a staggered approach to adopting new technology. The result is a variety of programs that don’t communicate with each other. Many EHR vendors pose serious challenges for healthcare facilities aiming to integrate. With the average healthcare facility using 18 different vendors for their EHR, communications between software become increasingly difficult.
While EHRs provide the backbone of patient care, hospitals and other healthcare facilities can also use dozens or hundreds of additional applications in their operation. And integrating these with the myriad of EHR programs is no small feat.
For IT professionals looking at creating an interoperable system from these disparate programs, the situation feels unworkable.
Another issue stems from this, namely the amazing persistence of antiquated technology. Legacy hardware and software tend to not connect or be compatible with newer systems. A system still running Windows 95 simply doesn’t have the capabilities to properly submit secure data to another device using Windows 10.
Old computers running obsolete operating systems aren’t the only problem though. Retaining outdated and insecure devices and technology is another serious obstacle.
For instance, faxing still accounts for almost 75% of communications in healthcare. Facilities tend to use fax machines as a secure means of sending documents to other entities that don’t have compatible software. Medical offices use fax machines to submit claims and forms to insurance companies or to transfer referrals to other clinicians.
This use of fax gets around the lack of interoperability, but also poses more problems – potentially exposing patient data to unauthorized persons and wasting time sending, verifying receipt, and dealing with old and error-prone technology.
Interoperability may also be hindered by a lack of organization and/or miscommunication in a healthcare facility, something especially relevant to larger institutions. For instance, interoperability between departments becomes more difficult when each sector of a hospital has its own software and methods of record keeping. The lack of staff and resources necessary to organize and head the integration of interoperable systems in a facility needs addressing before making any significant upgrades.
While these barriers prevent the immediate creation of a fully interoperable system, they aren’t insurmountable. But failing to overcome these problems will leave the facility, staff, doctors, and patients vulnerable to all the inefficiencies and security risks posed by outdated technology and operations.
Too many facilities don't prioritize technological upgrades necessary to provide the type of care they want to give. IT needs to push for making interoperability a priority. Until purchasing aligns with the goals of technology, interoperability will remain difficult.
However, with more standardization and adherence to IHE HL7 (including flexible software APIs), the process of building a data collection and sharing system that works throughout the facility and with others is more possible now than ever.
Through integrating interoperable systems, healthcare services become more cost-effective, more efficient, less wasteful, and more accurate. The choice to build such a system is no longer a “nice-to-have” option but an absolute requirement for any healthcare facility determined to provide the best possible care.
One of the fastest and easiest ways to make a big difference in your organization’s interoperability is to switch to a cloud fax provider with a robust and easily-integrated API.
Doing so enables your team to securely fax documents directly from any of the existing systems they’re already using to manage critical documents and files.
Healthcare IT managers love how easy mFax is to implement and manage. Providers love the unparalleled security, network reliability, and ease of use.
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