The Hidden Impact of Healthcare’s Lack of Interoperability

Summary

A lack of interoperability in healthcare prevents professionals from accessing up-to-date and accurate patient information, significantly hindering their ability to deliver excellent patient care.

As healthcare providers focus on centralizing patient care, they are constantly challenged by a need for greater interoperability of existing systems.

Electronic Medical Records (EMRs), Electronic Health Records (EHRs), patient portals, insurance forms, and other systems have become a complex web of data, with significant gaps between each component.

This lack of interconnectivity impacts the quality of care provided, along with its cost efficiency. This is critical for large and multi-locational providers, where seamless system integration is even more crucial.

This article examines the challenges of healthcare interoperability and presents solutions for creating a more interconnected and efficient healthcare system.

Understanding interoperability
and its challenges

In the past few years, notable progress has been made in enhancing interoperability among healthcare systems, driven by advances in technology, regulatory requirements and industry initiatives.

The 21st Century Cures Act of 2016, enforced by the Office of the National Coordinator for Health Information Technology (ONC), has been pivotal in this progress. The act requires healthcare providers and payers to adopt standardized APIs for seamless data exchange and bans information-blocking practices.

A 2022 ONC report highlighted that nearly 70% of U.S. hospitals now use FHIR-based APIs (Fast Healthcare Interoperability Resources) for health information exchange.

Source: HealthIT.gov (2022)

Despite these advancements, true interoperability remains a challenge. The healthcare ecosystem's complexity, with numerous stakeholders and legacy systems—along with data silos and inconsistency in the adoption of technology and proper data management—complicates integration.

Industry collaborations like the CommonWell Health Alliance and the Carequality Interoperability Framework promote cooperation, paving the way for a more connected healthcare system.

Additionally, ongoing efforts in standardization, technological innovation, and regulatory compliance are crucial to overcoming these barriers and realizing full healthcare interoperability.

Levels of interoperability

According to HIMSS guidelines, a healthcare system's interoperability can be classified into four levels, depending on its ability to send, receive, find, and integrate across the healthcare network:

Foundational interoperability: This enables data sharing between one software system to another. However, interpreting and organizing the data requires additional software tools

Structural interoperability: The format for data exchange is better defined, ensuring that the clinical and operational purpose of healthcare data is shared uniformly between systems. Also known as syntactic or technical interoperability, it allows data interpretation at the field level

Semantic interoperability: This standardizes the way data is handled and utilized across players. Information can be broken down and shared, allowing two systems to automatically recognize terminology, medication symbols, and other details without human intervention

Organization interoperability: This enables different healthcare organizations to communicate, exchange data, and collaborate effectively. It aligns policies, procedures, and objectives across entities for secure and efficient data sharing. Achieving this requires governance structures, legal frameworks, data agreements, and coordination mechanisms among providers, payers, and legislative stakeholders

Implementing semantic and organizational interoperability is challenging but significantly benefits providers and payers.

How to overcome healthcare
interoperability challenges

Many healthcare experts and leaders acknowledge that enhanced interoperability could significantly improve healthcare delivery and provide tangible benefits to providers and payers.

Below is an examination of the challenges faced by healthcare organizations striving to improve interoperability and the best strategies to overcome them.

1. Lack of coordination

Interoperability necessitates coordinated efforts among organizations, regulators, and legislative leaders. Regulators must establish clear, consistent standards, while healthcare organizations need to develop dedicated strategies and prioritize interoperability in their planning processes. Effective collaboration between internal teams and external partners is essential for enabling seamless data exchange.

This includes harmonizing workflows, data formats, and communication protocols. Such coordination is necessary for a cohesive and efficient system as it eliminates duplicated efforts, wasted resources, and slow progress. A unified approach is necessary to achieve a coherent healthcare system where patient data can be stored, shared, accessed, and organized seamlessly.

2. Budgetary constraints

Financial and technical limitations frequently hinder organizations from developing fully interoperable healthcare systems. However, government grants aimed at updating health record systems and pay-as-you-go models offered by cloud vendors are cost-effective and predictable solutions.

This enables organizations to manage expenditures while incrementally bolstering their interoperability capabilities. Such initiatives are crucial for healthcare providers to align with evolving interoperability standards.

3. Disparate technologies

Implementing interoperability in healthcare requires navigating diverse technologies across different providers. Regulatory requirements based on care types and locations further complicate efforts, leading to highly customized and isolated data systems. In this case, hybrid cloud platforms provide a flexible solution by integrating both internal and external systems, accommodating necessary customizations while improving connectivity.

4. Legacy systems

Legacy systems often lack compatibility with modern technologies and standards, hindering modernization attempts and seamless data integration. Adopting a hybrid cloud approach can also alleviate these challenges by extracting data from legacy systems, making it accessible for modern applications, and facilitating ongoing system updates.

5. Maintaining data security during data transfer

Ensuring data security during transfers is critical in healthcare. Sensitive patient information must be protected from unauthorized access and breaches. Implementing robust encryption protocols, secure authentication methods, and regular security audits are essential to ensure adherence to global privacy legislation.

Utilizing secure, private networks for data exchange and employing blockchain technology can further enhance security by creating immutable records and audit trails. By prioritizing these security measures, healthcare organizations can foster trust and effectively protect patient data.

Benefits of securing healthcare
interoperability

Patients frequently interact with a range of healthcare providers, such as primary care, specialists, and hospitals—each using their own Electronic Health Record (EHR) system.

Healthcare interoperability ensures that vital patient data, such as medical history and test results, transfers between these systems smoothly, empowering providers with comprehensive information for decision making.

Therefore, interoperability provides significant benefits to providers, payers, and patients alike.

Source: Appinventiv (2024)

Benefits to payers

Reduced cost: Interoperability in healthcare reduces costs by enabling seamless data exchange and improving efficiency, reducing redundancies. This minimizes administrative burdens and enhances care coordination, which leads to better patient outcomes by optimizing resources
Improved patient experience: Interoperability provides healthcare professionals with comprehensive patient data, leading to accurate diagnoses and personalized treatments. It reduces medical errors minimizing the need for patients to repetitively share their medical history, resulting in a smoother experience
Enhanced data protection: Interoperability enhances patient data privacy and security by minimizing human error with automation, reducing manual entry and handling while ensuring strict access protocols. Encryption and user authentication ensure that only authorized personnel can access patient records, thereby reducing the risk of data breaches

Benefits to providers

Seamless data exchange: Interoperability ensures seamless data transmission between healthcare professionals, insurance companies, and government programs. It allows instant access to vital information, such as diagnostic test reports, expediting patient care
Higher staff productivity: Interoperable systems boost productivity by reducing redundant data entry and streamlining digital records. This shift allows healthcare professionals to save time, allowing a greater focus on patient care. Additionally, advanced clinical decision support tools provide real-time recommendations and alerts, enabling informed treatment decisions
Reduced physician burnout: Interoperable systems mitigate physician burnout by automating administrative tasks to reduce their workload. A 2023 survey by Beckers Hospital Review highlights that physicians spend up to 15.5 hours a week on paperwork and administrative tasks. Returning this time enables a greater focus on patient care
Improved organizational trust: Interoperability bridges the gap between healthcare systems and research networks. Standardized data formats ensure consistency and facilitate meaningful analysis of health trends. This collaborative approach fosters community engagement, promoting goodwill and trust
Enhanced population health: Interoperability enables early disease detection and allows prompt, targeted interventions. Additionally, it helps mitigate healthcare disparities by revealing unequal resource distribution and access to care, which can guide strategies to improve overall healthcare equity and community health outcomes

Demand generation: The fuel for
interoperability strategies

Effective demand generation strategies are essential to fuel healthcare interoperability initiatives and bolster the alignment required to build external networks and foster continuous engagement.

Demand generation strategies include targeted marketing, educational programs, stakeholder engagement, and contributing to cultivating an innovative culture with effective change management practices. These efforts are crucial for promoting interoperability across healthcare networks and ensuring the sustainable adoption of interoperable solutions.

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1. Targeted display campaigns

Promoting interoperable technologies and standards through targeted display campaigns focused on large providers, legislative agencies, and healthcare influencers helps raise awareness and adoption. Highlighting the benefits of interoperability, including improved patient care, better internal efficiencies, and lower burnout rates, encourage investment in interoperable solutions by other healthcare players. By addressing specific pain points and demonstrating tangible outcomes, these campaigns are pivotal in shaping perceptions and driving the adoption of interoperable systems.

2. Education and training programs

Education programs help spread awareness and implement interoperability strategies, establishing your organization as a leader in the industry. Training sessions that emphasize the impact on patient outcomes and operational effectiveness help overcome resistance to change. Education also cultivates a shared understanding of interoperability standards and practices, ensuring alignment across diverse stakeholders and promoting a unified approach to data exchange.

3. Stakeholder engagement and collaboration

Demand generation facilitates stakeholder engagement by encouraging active participation in interoperability initiatives. It involves creating platforms for dialogue and collaboration among healthcare providers, regulators, technology vendors, and patient advocates. Stakeholders can collectively drive interoperability goals forward by aligning interests and addressing concerns through open communication channels.

4. Culture of innovation and change management

Change management strategies ensure smooth transitions to interoperable systems by addressing organizational resistance and encouraging buy-in from key stakeholders. By celebrating successes, sharing best practices, and encouraging feedback loops, healthcare organizations can sustain momentum in their interoperability journey and effectively navigate future challenges.

Key takeaways

A lack of interoperability in healthcare hinders access to accurate exchange and access of patient information across the healthcare network. This affects care quality and cost
Improving healthcare interoperability can reduce costs, improve patient care and experience, and protect patient data. For healthcare providers, it translates to higher productivity, lower burnout, and organizational trust
Enhanced interoperability requires clear objectives, system analysis, adoption of standards like FHIR, and usage of APIs for seamless data exchange
Effective demand generation strategies fuel healthcare interoperability strategies with targeted display, education programs, and stakeholder engagement for successful implementation and adoption

Engage key stakeholders with qualified demand generation for healthcare

INFUSE Health experts understand the main interoperability challenges of healthcare organizations, and offer demand generation support to raise awareness and address stakeholder pain points effectively.

Contact an INFUSE Health expert to bolster your interoperability efforts and more