Healthcare Interoperability: Four Levels of Interoperability

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Healthcare data creates a paradox: it needs to be kept private and secure due to its sensitive nature, which makes it challenging to share. However, not having secure access to this data when necessary can have serious, even fatal consequences.

Without data interoperability healthcare providers can’t have a complete understanding of patient’s or the population’s health needs.

What is healthcare interoperability, the four types of interoperability in healthcare, current challenges it faces, and the benefits of data interoperability healthcare providers can get - in today’s blog.

What is Interoperability in Healthcare?

So, what is interoperability in healthcare?

Healthcare Information and Management System Society (HIMSS) defines healthcare interoperability as “the ability of various information systems, devices, and applications to access, exchange, integrate, and use data together in a coordinated way. This coordination occurs within and across regional, national, and organizational boundaries to ensure the timely and seamless transfer of information, ultimately optimizing the health of individuals and populations worldwide”.

In very simple words, data interoperability in healthcare means that different medical systems and gadgets can talk to each other and share information without any hassle. This makes it easier for healthcare professionals and hospitals to get the right patient info when they need it, leading to better care and improving patient outcomes.

Let’s see it in the example.

Imagine a patient visiting your clinic after recently undergoing diagnostic imaging at a specialized facility. With interoperable systems in place, accessing the patient’s imaging results becomes seamless. This enables you to quickly review the images during the consultation, facilitating a more informed discussion about the patient's condition and treatment plan. Subsequently, the imaging results are effortlessly shared with other healthcare providers within your clinic for further assessment or treatment care coordination.

Now, suppose the patient requires a specific medication that was prescribed during a recent hospitalization. With interoperable systems, retrieving the patient's medication history from the hospital's electronic medical records becomes straightforward. This ensures that you have access to vital information about the patient's past medications, enabling you to make informed decisions about their current treatment regimen.

Following the consultation, the patient's treatment plan may involve a combination of medications and therapies. Interoperable systems streamline the coordination of care by enabling seamless communication between different medical professionals involved in the patient's treatment. This ensures that everyone has access to the latest information, promoting continuity of care and patient safety.

Describing the Four Types of Interoperability in Healthcare

Data interoperability in healthcare is a complex concept. HIMSS describes four types of interoperability in healthcare.

Foundational Interoperability

Foundational interoperability represents the most basic level of data exchange between two health systems, enabling them to securely send and receive information without processing it. As described by HIMSS, this level of health data interoperability establishes the necessary interconnectivity for communication, allowing one system to acknowledge receipt of data from another.

An example is sharing a PDF containing a patient’s hospital stay summary and discharge medication list; the receiving system can store this PDF, and clinicians can read it to guide care. However, the receiving system cannot automatically process or analyze the data, requiring manual input by providers into the patient’s electronic health record. While foundational interoperability is crucial for health information seamless exchange, it falls short of allowing providers to meaningfully use the health data exchanged.

Structural Interoperability

Structural interoperability focuses on how data is formatted and organized for exchange. This means systems can not only send data to each other but also understand and process it. For example, a pharmacy system can use the same format as a provider’s system to process medication lists.

An example of this is ePrescribing, where both the provider’s and pharmacy’s systems use the same standards to ensure prescriptions are accurately processed. HL7 FHIR is a widely adopted standard for this level of interoperability, used by many major EHR vendors. It helps ensure that exchanged data maintains its meaning by assigning standardized identifiers to each piece of data, making it easier for different systems to share and understand health information.

Semantic Interoperability

Semantic interoperability ensures that various healthcare systems communicate effectively by using the same codes and standardized terminology, such as SNOMED CT, ICD, and LOINC. This means that when they exchange data, it's clear and consistent across the board. For example, if one system mentions "headache," the other system understands exactly what it means.

This level of interoperability allows healthcare providers to easily share patient information, like summaries, between different EHR systems. Ultimately, it streamlines communication, reduces errors, and saves time and resources for centers for medicare. It's akin to speaking the same language, ensuring seamless data exchange and enhanced patient care.

Organizational Interoperability

Organizational interoperability involves all the practical steps needed to make semantic interoperability work in a healthcare setting. This includes governance, policies, legal issues, and management processes. According to HIMSS, it covers everything required to ensure secure and smooth communication and data use within and between healthcare organizations.

For example, health data utilities are statewide entities that combine and share health data for various purposes like treatment and public health. These HDUs require broad stakeholder participation, strong governance, and high standards for data privacy and security. They often use existing infrastructure to facilitate data exchange and are typically non-profits or state agencies.

Four levels of data interoperability in healthcare

The Importance of Interoperability in Healthcare

Accessing and securely sharing health data has always been challenging. The adoption of EHRs has seen substantial growth nationwide, yet many healthcare institutions still struggle to seamlessly integrate data from external sources into patient records, highlighting the urgent need for a more integrated data ecosystem.

According to the Office of the National Coordinator for Health Information Technology, the comprehensive integration of health data is imperative to unlock the full potential of EHRs.

True interoperability solutions not only empower healthcare providers to gain comprehensive insights into patient health but also enable stakeholders across the healthcare industry to optimize their operations.

By fostering greater collaboration and data exchange, health plans can refine their service offerings, government agencies can identify and address population health trends, and life science organizations can accelerate research efforts.

Of course, achieving organizational and semantic levels poses significant challenges, yet the benefits are great.

Benefits of interoperability in healthcare

Benefits of healthcare interoperability for each group:

Patients
Interoperable systems streamline a patient experience by consolidating health info and treatment plans. This means no more repeating medical history to every new doctor.

Physicians
Interoperable health information systems give doctors comprehensive access to patient data. This speeds up diagnoses, reduces unnecessary lab tests, and lowers stress for healthcare providers.

Administrative Staff
Interoperable systems automate clinical documents exchanges, reducing the risk of costly medical errors. Staff can avoid the manual process of coordination of information, simplifying tasks like appointment scheduling and billing.

Pharmacies
Interoperability includes Rx transfers, allowing pharmacies to receive e-prescriptions and manage medication distribution more efficiently.

Insurers
By supporting early diagnosis, interoperable systems help insurers cut down on costs related to adverse events. They also save on expenses from redundant lab tests and procedures.

Interoperability Challenges in Healthcare

# Overwhelming Number of Standards

Achieving interoperability requires collaboration, and healthcare data standards are meant to facilitate this. However, ensuring that your clinic aligns with other healthcare facilities becomes challenging when health standards vary so much. Instead of simplifying processes, the multitude of international health standards complicates them.

For instance, adopting various message formats, FHIR, and EHR interoperability standards is difficult because they each impose different rules for information exchange. This leads to a fragmented implementation process for clinics.

# High Loads of Data are Difficult to Handle

When transferring health data between systems, it's crucial to manage it effectively to avoid overload, which is no simple task.

Achieving all types of interoperability in healthcare involves handling EHR/EMR information, IoT data, internal hospital systems, and more. Failing to manage these simultaneously can disrupt operations. To prevent this, investing in data integration tools and healthcare analytics solutions is essential.

# Scarcity of Skills and Resources

Interoperabilable solutions are effective only if clinicians, insurers, and government agencies collaborate. However, many medical facilities don't have the financial resources to implement the required changes. Although interoperability can lead to significant long-term savings, the initial investments are often too high for many clinics.

Additionally, the lack of training impedes seamless interoperability. Stakeholders must invest in training their staff across all levels to optimize workflows and ensure proper use of interoperable systems, which requires both time and resources.

# Unclear Data Exchange Practices

Some providers exploit the need for interoperability by charging fees to access health data like patients' EHRs, a practice known as information blocking, which significantly hinders healthcare interoperability.

Additionally, insurance companies that withhold health data from providers create another barrier. Ideally, providers could review patients' previous treatments by examining their claims, but insurers often resist sharing this information, complicating the process.

Control Your Medical Data with Four Levels of Interoperability

If achieving interoperability seems challenging for your health organizations, inVerita has the tools and expertise to help you succeed.

Having vast experience in building healthcare software solutions, we understand the specific needs of small- and medium-sized clinics to deliver high-quality care.

Our primary focus is optimizing the workflows of your doctors and staff to achieve enhanced patient care, which is why we consider healthcare interoperability a crucial component of high-quality service.

Whether you need a remote patient monitoring tool, EHR/EMR software, or a telemedicine platform, we prioritize interoperability in our development process. Our software solutions integrate seamlessly with your existing health systems, ensuring simplified data sharing and compliance with standards like FHIR.

Just drop us a line and we will arrange a free consultation to discuss the scope of your product.

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