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Why Aren’t All Healthcare Systems Interoperable?

Interoperability refers to the ability of a system to work with another system. In healthcare, interoperability more specifically refers to the ability of multiple systems to share and interpret data – usually, electronic medical records. But many physicians, lab directors, and even patients wonder, when everything else is digital and seamless, why does effortless, total healthcare interoperability seem unattainable?  In this article, we’ll look at a few of the reasons behind the industry’s slow crawl toward absolute interoperability.

Policymakers Pushed for EMRs – But Failed to Truly Champion Interoperability

One of the challenges of true interoperability is that it requires all parties – practices, diagnostic centers, labs – to embrace specific rules and guidelines. So there’s more to it than just great software. It requires high standards listed out in tedious handbooks. And since health data include so much private, protected information, policymakers are very involved in big-picture regulation and implementation.

Why, then, didn’t legislators push for total interoperability from the very start, when medical records started shifting to electronic data? After all, that would have harmonized so many practices with each other, and with their diagnostic labs and imaging centers. The answer isn’t great: It was just never really the top priority.

In 2009, when policymakers wrote legislation on health information (HITECH), the bill had two main points. The first, it required an accreditation program to ensure that EMRs all shared competencies. The second was “Meaningful Use.” What does “Meaningful Use” mean? According to HealthIT, it refers to appropriate use of EMRs to ensure better patient care, engagement, and privacy. The goal: “Meaningful Use” would lead to better clinical outcomes, improve public health, increased transparency and efficiency, and better, more robust research data.

At first, this legislation listed health information exchange as a requirement of its EMR certification program. But it postponed the vital requirement until “Meaningful Use” was implemented – it never pushed for true interoperability. This allowed practices, racing to move to EMRs, to seek out software solutions that did not truly address interoperability.

Many believe that internetwork communication would be completely different now had true interoperability been a legislated, top-priority goal from the very start.

Some Vendors and Providers Have Reason to Avoid Interoperability, Too

True interoperability would be a great asset for patients. Too great, some worry.

If a patient could switch to another physician with the click of a button, might his current practice too easily lose him as a patient? If a vendor made truly interoperable software, what would stop a client from moving all its data to another vendor’s system? These are tough questions on the quest to true interoperability.

The Veteran’s Association utilizes a single system to manage its EMRs, affording its vast network genuine interoperability. But many believe it’s way too late for policymakers to mandate such a change for the entire healthcare industry – after all, they had their chance to champion true interoperability, and they failed to pull it off.

Pulling Off True Interoperability Would Be a Ton of Work – And Worth It!

What would it take to achieve nationwide interoperability? It wouldn’t be easy – but it would truly push the healthcare industry into an era of actual “Meaningful Use.”

First, all EMRs would need to be compiled and codified in the same way. While early legislation pushed for some commonalities, this would be a more stringent requirement for true uniformity.

Second, all systems would require data liquidity. That means the communication between systems would be fluid and seamless, even if the EMRs weren’t perfectly aligned. Information could be shared between systems, even if they weren’t in perfect sync.

Third, the technology and interoperability must be aimed at boosting engagement with patients and other physicians and lab directors to improve patient outcomes.

Says HealthIT: “EHR Interoperability enables better workflows and reduced ambiguity, and allows data transfer among EHR systems and health care stakeholders. Ultimately, an interoperable environment improves the delivery of health care by making the right data available at the right time to the right people.”

Sound too good to be true? It isn’t! Great software vendors are working hard to develop stronger, smarter systems that push their clients toward better outcomes every day. Some physicians, vendors, and legislators may be hesitant to embrace total interoperability, but if we all work toward a common goal of improved communication, patient health improves. And that’s always the objective.

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