3 Misperceptions About Healthcare Interoperability

April 06, 2020 - In early March, the ONC and CMS issued two final rules with the goal of giving patients unprecedented secure access to their health data and stopping the practice of information blocking. While achieving this won’t be easy, it may not be as difficult as some fear.

Why? Because in many cases, the technical aspects of healthcare interoperability have been solved, and the market offers mature solutions to enable interoperability across many platforms, applications, devices, and networks.

Here are three misperceptions about interoperability and insights behind each one.

Misperception #1: Healthcare Interoperability is hard

The challenge of sending and receiving information between disparate systems because of each product’s communication protocol idiosyncrasies is in large part a non-issue these days. The biggest interoperability barrier for most organizations is not a lack of solutions, but a lack of resources (time, money, and people) to help them get from their current circumstances to a place where information exchange is effortless.

The challenge now is changing the way organizations prioritize and think about interoperability. If hospitals and health systems can think of the long-term benefits of implementing an interoperability layer, they’ll be less likely to run into issues down the road. When organizations proactively address the true barriers to interoperability, the floor will open up for more interesting conversations about the critical issues impacting the disparity in interoperability access.

Misperception #2: Everyone Is Using FHIR

Fast Healthcare Interoperability Resource (FHIR), a relatively new healthcare data standard, has attracted a lot of hype recently because it will be useful in many areas of innovation emerging in the industry. But that doesn’t mean everyone is using it — yet. Nor will it be a silver bullet to solve all interoperability issues.

Two recent developments have industry leaders increasingly focused on FHIR. First, with FHIR Release 4, it is now normative, meaning it’s no longer a draft standard. Second, the CMS interoperability rule specifies the use of FHIR-based APIs to make certain health information available to patients.

That said, FHIR it is still a young standard. The health IT industry is still working out the most strategic places to implement FHIR. As new applications come to market and new use cases are tested and rolled-out, FHIR will surely gain real momentum in terms of actual implementations.

Misperception #3: Interoperability is an EHR Problem

In truth, the EHR is just one piece of the puzzle. As an industry, we have — for the most part — figured out how to overcome the technical hurdles of CCD compatibility, as well as other barriers to getting records in and out of different systems. The real challenges of interoperability are more about operational, political, and philosophical differences that are much thornier to deal with, which is ultimately what the industry needs to be focusing on.

While it’s true that EHRs are a key piece of the interoperability puzzle for hospitals and health systems, there are three distinct layers within the healthcare industry that highlight the less-technical barriers to interoperability.

The first interoperability layer is the organizational level of healthcare, which impacts the exchange of information within the existing systems. (e.g. medical records, administrative systems, billing systems, as well as medical and operational IT systems).

The challenges associated with these information sources are less of a technical barrier, and rather one of semantic and operational perspective.

The second layer is the community or regional level of healthcare, where the complexity of interoperability becomes even more elaborate. Here, the exchange of information extends between different organizations (e.g. data sharing among health systems and pharmacies, public health organizations, radiology and labs, payers and researchers).

At this level, there are  HIEs, national registries, NIH/CDC (collecting epidemiological data), alliances like GPOs and BPOs, payers, pharma, and research organizations — all of which have different purposes, motivations, perspectives, and platforms. With so many different entities each with their own priorities, permissions, and requirements, the interoperability challenges become complex not just technically, but politically and operationally as well.

Finally, the device level (Internet of Medical Things) can further complicate information exchange. The growing number of hardware platforms, operating systems, and communications protocols employed by the myriad of connected health and healthcare devices — from “smart” consumer products to personal fitness apps to sophisticated implantable medical devices — is staggering.

Accessing, aggregating, and normalizing this data into information that is useable at the point of care is difficult. As the industry continues to sort out this challenge at the micro-level, the impacts may be felt at the organizational and community levels as well.

An interoperability layer helps bridge the gaps created by these different technologies and platforms, allowing organizations to focus on the higher-level, operational, and political aspects of interoperability. These issues include transforming organizational behavior and shifting industry perception about its responsibility toward patients, clinicians, members, and other stakeholders.

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About Lyniate

Lyniate partners with healthcare organizations around the globe delivering cutting-edge solutions to address interoperability challenges. Our industry-leading products, Corepoint and Rhapsody, are used by thousands of customers to send hundreds of millions of messages every day. Lyniate is committed to delivering the best interoperability solutions for healthcare organizations, from specialty clinics to large networks, from payers to vendors, and everything in between. We’re building the future of interoperability.