As it relates to healthcare technology, the concept of interoperability has been around for more than a decade, though the term has become a hot button issue in more recent years.

What is Interoperability?

The Healthcare Information and Management Systems Society (HIMSS) provides a thoughtful definition of interoperability: “In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Data exchange schema and standards should permit data to be shared across clinicians, lab, hospital, pharmacy, and patient regardless of the application or application vendor.”

Interoperability can apply to either billing (claims) data or clinical data. For the purposes of this discussion, we will focus on clinical data. It is generally agreed that achieving interoperability with clinical data systems, such as electronic health records (EHRs), is more difficult due to the complexities and variations of clinical data. It is important to note, however, that for effective population health management, the goal is to have the ability to share both clinical and billing data between organizations that care for shared patients.

Why is Interoperability in Healthcare a Challenge?

There are several reasons interoperability has been a challenge in healthcare. First, many of today’s electronic medical records systems were originally designed and created at a time when exchanging electronic data outside of a source system was not a strong market need. Hospitals and health systems were among the first organizations to use such systems, where adoption grew during the late 1990s and 2000s, and their most important goal was to facilitate care for patients inside the hospital. Although systems have evolved and modernized, sometimes their core technology remains and has limitations when it comes to sharing information with other systems.

Medical terminology and laboratory testing systems variation are also part of the interoperability challenges. Within each EHR or clinical system, data must stored and labeled. Each system, of which there are now hundreds available to hospitals and medical clinics to use, was developed by a different person or company. In many cases, a particular code used to specify a diagnosis, for example, could be labeled and stored more than a dozen different ways across available systems. Additionally, over time many hospitals customized their systems’ data fields which accounts for additional variation. Multiply that complexity times the number of potential diagnoses, medications, lab tests, or any other sort of clinical data, and you now have millions of data variations across systems. In order for data to be transferred from one system to another in an accurate and user-friendly way, the systems must be mapped and data must go through a sort of “translation” process to exchange data. Now multiply that times the number of EHRs and customized EHRs being used across the country and the variation accelerates even further. Add to that the need for absolute accuracy, since an error in system translation could result in harm to a patient, and it’s now easy to see the challenges of interoperability.

These reasons are just a couple of many that challenge health IT professionals to create interoperability between systems, and why much of the discussion happening today revolves around creating stricter standards for data storage, use, and exchange that are better defined and precise.

Recent Developments

There is industry-wide consensus that to achieve higher levels of quality in healthcare, and to contain escalating costs, interoperability between EHRs and other healthcare technology systems is essential. The Senate HELP committee has been holding hearings to find out if policy changes can support further advancements to healthcare interoperability, and the ONC recently released its first Interoperability Roadmap (PDF).

For the latest developments in interoperability, please visit our Healthcare Industry News page.

Our Expertise in Interoperability

Since 2010, our technical team has worked on interoperability projects with technology professionals at more than 40 EHR vendor companies and close to a dozen other technology systems vendors. Additionally, in collaboration with many of the leading EHR vendors, we have successfully connected nearly 30 unique systems to our HIE network. During this time we've developed a deep understanding of the processes and technologies that are required to acheive successful interoperability between systems so that physicians and other clinical professionals can use them to improve patient care. We also know that while most EHR systems claim to be fully interoperable, not all in fact are. As part of both our HIE and Regional Extension Center efforts, we have also learned which systems routinely charge integration (connection) fees to physician offices that wish to connect their EHR to an HIE.

One of our missions is to promote EHR use and interoperability among healthcare providers in Colorado, and as such, we share our knowledge and expertise with those who need it. If you are a Colorado based provider and have questions about interoperability, please contact us.