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What is going on with healthcare interoperability?

Nick Semple, healthcare IT expert at PA Consulting, discusses healthcare interoperability.

Click here to read the full Electronic Health Reporter article. 

The article notes that the US Department of Health and Human Services (HHS) heard from stakeholders about several barriers to interoperable access to health information. Interoperability barriers include:

  • Technical barriers: These limit interoperability through—for example—a lack of standards development, data quality, and patient and health care provider data matching. Addressing these technical barriers by coordinating to establish the technological foundation for standardizing electronic health information and by promoting exchange of that information can considerably remove these barriers.
  • Financial barriers: These relate to the costs of developing, implementing, and optimizing health IT to meet frequently changing requirements of health care programs. The cost to adjust health IT to meet these requirements can impact innovation and the timeliness of technical upgrades. Specific barriers include the lack of sufficient incentives for sharing information between health care providers, the need for enhanced business models for secondary uses of data, and the current business models for health systems or health care providers that do not adequately focus on improving data quality.
  • Trust barriers: Legal and business incentives to keep data from moving present challenges. Health information networks and their participants often treat individuals’ electronic health information as an asset that can be restricted to obtain or maintain competitive advantage.

Nick says:Interoperability is happening but so far in a fragmented rather than a concerted, orchestrated way. While there are national and regional initiatives, there is still some way to go. The federal government’s vision for interoperability was ahead of the healthcare industry when the vision was established in the early 2000s. Through federal incentives to ensure greater adoption of electronic health records (EHR) and healthcare technology, hospitals and provider groups have made advances to set the stage for interoperability; i.e.: they have moved from a paper based to an electronic health record. However, lack of standardization and information ‘locked’ within a specific EHR has been a challenge. There also is increasing pressure on vendors and payers/providers to share information.”

He adds: “The main driver for interoperability has been the establishment of Health Information Exchanges (HIE) at the community, regional and state levels, as well as industry/vendor-led interoperability networks. There is now growing use of HIEs to facilitate interoperability. In 2018, the DirectTrust HIE saw an exchange of 274 million Direct message transactions between DirectTrust users in 2018, up from 168 million transactions in 2017.”

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