Even as the healthcare information technology (IT) field has made strides to facilitate cooperation between EHRs (electronic health records), it’s become abundantly clear that we still have a way to go to achieve anything approaching complete and total interoperability.
All attempts at interoperability must inherently begin by recognizing the starting point that makes everything so tricky: EHRs consist of a series of disparate systems built in silos that are suddenly being asked to work together for the good of the patient.
That’s a tall order, although not an impossible one. Right now, much of the focus is on application programming interfaces (APIs), not surprising given the fast healthcare interoperability resources (FHIR) standards developed and proposed by Health Level 7 (HL7).
We’re only at the very beginning of this journey, which is somewhat disappointing given the work that’s already been put in. A recent study revealed that just shy of 30% of hospitals were able to meet the four key metrics necessary for true interoperability: data integration, reception, distribution and finding. Even more alarming? These 2017 numbers were up from just 24.5% three years earlier, which means that only one in 20 hospitals attained interoperability in that time.
As these numbers make abundantly clear, many hospitals remain out in the cold when it comes to the successful sharing of patient health information. While some of our nation’s leading providers have embraced interoperability and embarked on exciting pilot projects and unprecedented methods of communications, others remain woefully underequipped for the challenges that lie ahead.
Let’s get one thing straight: This isn’t necessarily the fault of providers. Until relatively recently, facilities have not been properly incentivized to make interoperability a priority. It’s only now, in an era of value-based care where every aspect of an organization is being scrutinized like never before, that administrators are starting to rethink whether the systems they have in place act as a hindrance to overall care.
We as healthcare IT providers are hardly blameless. For decades, the focus was on the creation of walled gardens, closed platforms that didn’t play well with others. Hospitals didn’t have the choice to invest in an EHR that communicated openly with other EHRs; they simply sought the best system possible for them and their patients.
Restricted somewhat due to Health Insurance Portability and Accountability Act (HIPAA) regulations, competition and the very nature of the current system, healthcare as a whole finds itself in quite a predicament. While tech developers in other industries continue to come up with apps, software and hardware that create entirely new sectors of business, healthcare struggles to garner the widespread adoption necessary to simply ensure that providers are able to successfully communicate with one another.
Is it any wonder, then, that companies like Apple and Amazon are swooping in with new approaches that put patient data in the hands of the patients themselves? We shouldn’t be surprised at the popularity that these notions have engendered within the population. Consumers have become tethered to their smartphones, using them as conduits for handling the vast majority of their personal and professional affairs. It makes sense that they would want the same kind of access to their patient data.
We in healthcare IT need to recognize the call for interoperability and answer it with innovative ideas. Forget thinking outside the box; we need to nuke the box into the Stone Age and move on to the next big thing.
The good news is that when I look around our field, I see so many professionals more than up to the task. Today’s tech leaders aren’t content with ensuring hospitals are able to communicate with one another. At my company, and at so many others -- including heavy hitters like Cerner (an Ensocare partner), Epic and the VA, but also lesser-known startups that are just breaking through -- the focus is on deep-dive, predictive analytics set to usher in a new era of data-based care. It's also on wide-ranging tools that tap into every aspect of the clinical experience and deploy insightful, immediate diagnostic suggestions to physicians on robust, multi-function care delivery systems that create a patient experience unlike any we’ve seen before.
The state of interoperability right now isn’t fantastic, but it’s changing quickly. At the Health Information and Management Systems Society's 2018 conference (HIMSS18), I watched as our industry’s best and brightest took the stage to share some of the most exciting tech developments I’ve ever seen, and I’ve been in this business awhile. There’s a willingness to cooperate and a willingness to engage in these problems that is unlike anything I’ve witnessed before.
We’re definitely “getting there” when it comes to interoperability. We have a long way to go, but I have no doubt that the combination of entrepreneurial spirit, impactful clinical application and unprecedented teamwork will lead us into a bold new era of healthcare IT innovation.
