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Healthcare | FHIR | Interoperability | IT Management

Healthcare Interoperability: Challenges and Benefits

May 26, 2023

The American Recovery and Reinvestment Act (ARRA) of 2009 provided hospitals and health professionals incentives to use electronic health record technology. Healthcare organizations quickly moved healthcare records to digital applications, providing an opportunity to use this data cohesively through healthcare interoperability.

ARRA has been the driving force behind the digitization of healthcare records in the recent past. The problem? Software vendors developed various applications for the healthcare industry. The result was data silos stored in disparate systems.

Healthcare interoperability is a step towards developing a digital ecosystem for the healthcare industry, where data can be exchanged and accessed securely without  boundaries.

What is Healthcare Interoperability?

Interoperability removes the barriers in information exchange introduced by differences in technology, architecture, and vendors.

Seamless access to healthcare data is critical. The inability to access healthcare records during an emergency can result in adverse outcomes.

Moreover, information blocking can result in penalties of up to $1 million per violation.

Keeping health data secure is just as important as the ability to share it. That’s why healthcare interoperability requires a careful approach. The combined use of APIs (Application Programming Interfaces) and information standards like FHIR and HL7 can help healthcare companies make the best use of electronic records while ensuring data integrity.

Healthcare interoperability allows clinicians to provide better care and coordinate with other clinicians. It provides clinicians and other healthcare providers with a standardized way to collect and report public health data.

Collectively, these factors can improve patient outcomes and safety, minimize the risk of error, and increase the efficiency of internal processes.

Levels of Healthcare Interoperability

The Healthcare Information and Management Systems Society (HIMSS) has defined four levels of healthcare interoperability. Each level represents a type of data exchange.

Foundational Interoperability

Foundational interoperability (or simple transport) is the most basic type of interoperability. A system transfers data to another system without interpreting or changing its format.

For example, you download a patient’s public health record and manually enter those details into your proprietary software.

Structural Interoperability

Structural interoperability (or structured transport) involves interpretation. Systems exchange data and, when needed, convert it to a standardized format for interpretation.

The information uses a standard syntax and organization, so it’s easier for the receiving system to detect and interpret specific fields.

FHIR and HL7 provide structural interoperability, allowing you to move information across systems seamlessly.

Semantic Interoperability

Exchanging and interpreting data with entirely different data structures requires semantic interoperability (or semantic transport).

Suppose you receive a scanned image of a patient’s medical report. The information in this image must be converted into text fields before it can be imported into your system.

Extracting the information from one system, structuring it so that another system understands the extracted information, and automatically filling out the right data in the right fields requires artificial intelligence (AI).

A combination of technologies like optical character recognition (OCR), robotic process automation (RPA), and AI can help achieve full semantic interoperability like so:

  • OCR extracts the information from the image: The information in the patient’s report like their name and blood group is extracted.
  • AI-based technologies like NLP and machine learning (ML) help interpret the extracted information: The information may not always be in a standard format. For example, the numbers in your blood report may be written as 10^9 or 109. NLP will help the system understand that both of these mean the same thing.
  • RPA populates the relevant data in the recipient system: Once the system interprets this information, RPA automatically adds this information to the recipient system.

Organizational Interoperability

Organizational interoperability is the highest level of interoperability.

It facilitates sharing and interpreting healthcare data securely, seamlessly, and in a timely fashion between organizations, entities, and individuals, with governance, policy, social, legal, and organizational considerations factored in.

Organizational interoperability is the goal. But most healthcare companies are still working on achieving foundational and structural interoperability.

Once organizations have achieved lower levels of interoperability, they’ll have a strong foundation for achieving organizational interoperability and other ways to improve health data exchange.

Navigating the journey from foundational to organizational interoperability is fraught with challenges, but these can be overcome with careful planning and strategizing. Read more here.

What is FHIR?

Fast Healthcare Interoperability Resources (FHIR) is a healthcare data standards framework developed by HL7 (Health Level 7). The FHIR provides a standard framework to make transferring healthcare data between systems easier.

FHIR consists of resources like health data formats and elements (such as conditions and medications) that you can exchange easily. It also provides standardization for APIs.

Modern healthcare benefits from FHIR in multiple ways. It facilitates exchanging information with legacy applications, but that’s not the only reason to use FHIR.

The Blue Button 2.0 API, which allows accessing healthcare information, is based on FHIR. The FHIR standards framework is a key component of the United States’ national interoperability roadmap.

If your healthcare business receives payments for Medicare or Medicaid, using FHIR for interoperability is critical.

Data from an Engineer Group survey commissioned by Change Healthcare suggests that only 24% of healthcare companies were using FHIR APIs at scale in 2021. However, the research suggests widespread adoption by 2024.

As more healthcare providers start using FHIR APIs, they’ll be able to use and provide patients with a richer set of functionalities.

4 Challenges with Healthcare Information Exchange

The current low rate of interoperability is a result of the challenges associated with healthcare information exchange. Below are four of the most pressing challenges that stand in the way of healthcare organizations achieving interoperability.

Inconsistent Data

Healthcare organizations generate data from multiple, disparate sources. These sources typically store data in the database in various formats and data types that are incompatible with each other.

When systems exchange incompatible data types, the recipient system can’t interpret the information. For example, medical records may contain the patient’s medical history and treatment plan. The recipient system must interpret this information to be able to use it.

Maintaining Client Data Confidentiality

Ensuring the confidentiality of patient health records is critical to maintaining a good reputation and, more importantly, complying with HIPAA (Health Insurance Portability and Accountability Act).

Electronic health records (EHR)  need a secure mechanism to validate requests for patient information.

Many providers use systems that may or may not be compatible with EHR products, which can potentially result in a breach of regulations like HIPAA.

Once the ONC’s Cures Act Final Rule comes into force, healthcare providers will need to comply with its new training and certification requirements too.

Personal health information (PHI) breaches can be a recipe for losing reputation and heavy penalties.

Conflict of Interest

Not all businesses want to share patient data because you’ll often need to share information with a direct competitor.

For example, if you’re a hospital, you’ll understandably be reluctant to share patient data with urgent care clinics.

Regulations are the best solution to this challenge. The Cures Act has various information-blocking provisions that will compel healthcare providers to provide information when appropriate.

Cost of Hiring an Interoperability Specialist

Achieving interoperability is expensive because it requires specialists that dedicate their time to maintain interoperability.

Of course, this person needs the right qualifications and experience handling interoperability-related tasks.

If you make some rough calculations, you’ll see just how expensive hiring this specialist can be. The cost makes providers, especially smaller healthcare businesses, rethink the feasibility of interoperability.

The solution to this problem is simpler than the previous ones. Instead of hiring a person, you can invest in an automated interoperability system that takes care of most tasks.

An automation system costs significantly less than hiring a specialist in the long term.

5 Benefits of Healthcare Interoperability

The benefits of healthcare interoperability far outweigh the cost of addressing the challenges. Here are the five benefits healthcare interoperability offers.

Improves Patient Outcomes and Experience

Healthcare interoperability isn’t just a regulatory burden. It’s an asset you can build to improve patient outcomes and experience.

As life expectancy rises, interoperability will prepare you for value-based patient care. Real-time access to a patient’s medical history allows you to get a deeper insight into the patient’s condition and minimize medical errors.

Data access also reduces duplication of efforts. Since you’ll have the information about diagnosis, tests, and results, you can directly start working on developing a treatment plan or running other tests.

You’ll know about the patient’s allergies and health plan before starting treatment so that you can provide appropriate advice.

These factors collectively improve the patient’s experience and allow you to provide better care.

Reduces Cost of Care

Interoperability reduces the cost of care in multiple ways:

  • Streamlines care delivery: Better coordination among healthcare providers streamlines care delivery. You won’t have to repeat tests, and you’ll have the information about the previous diagnosis and treatment.
  • Minimizes errors: Interoperability reduces the cost of care by minimizing medical errors.
  • Increased productivity: Your administrative staff won’t have to reenter the same data over and over once you’ve achieved interoperability. Your team saves time on manual data entry when you use technologies like intelligent document processing (IDP) to convert physical documents into digital files.

Collectively, these factors can help reduce the cost of care by a good margin. You can transfer these savings to your patients to offer them more value at a lower cost.

Keeps Patient Data Secure

Patients trust that their data is safe with healthcare providers. Compromising this data’s integrity can result in a loss of reputation. Ensuring data integrity is also a compliance requirement.

Hundreds of electronic medical records are compromised daily. As many as 54,396 individuals were affected just by a single breach at the NewYork-Presbyterian Hospital on March 20, 2023.

Your systems need to be HIPAA-compliant. The best interoperability partners are experienced in creating compliant interoperability solutions, which is reassuring when implementing a complex technological solution with legal implications.

Contributes to Research

The data you collect during regular business, like diagnosing, testing, and treating patients can be an asset for public health researchers.

Interoperability allows researchers to request data from your systems for studies in various medical fronts like epidemiology and pathology.

This helps build a good reputation. You can add the fact that you share data with scientists to contribute to society and build goodwill for your healthcare business.

Minimizes Burnout

Digital transformation generally makes processes faster and easier. But the situation with EHR adoption is a little different.

The administrative load on physicians has increased significantly because of compliance requirements and disparate solutions used by clinicians.

That’s where interoperability helps. It allows you to automate mundane labor-intensive tasks like data entry.

With less time spent on time-consuming and repetitive tasks, your administrative staff won’t reel under the pressure of EHR compliance requirements. Addressing burnout also reduces the probability of human error.

Start Your Interoperability Journey with Blanc Labs

Achieving structural interoperability offers various benefits. Selecting a partner with extensive experience managing APIs is critical to reaping the full benefits of structural interoperability and frictionless implementation.

Blanc Labs are experts at building standards-based interoperability solutions that enable healthcare organizations to improve patient outcomes, enhance efficiency and achieve seamless integration within the health ecosystem.

Book a discovery session with Blanc Labs to learn how we can help your healthcare business achieve interoperability.