Today we can see a wide range of diverse software systems that somehow increase the level of medicine, health care quality, and accuracy. Nevertheless, the more systems appear, the more difficult it becomes to exchange vital health data between them. Thus, modern technologies like big data and AI cannot be used 100% percent on data running on healthcare medical software since not all systems can interact.
According to the Mobility Report, electronic data traffic is only growing and about 6.1 billion people prefer mobile health data to paper-based information exchange.
The solution to the lack of communication between medical software systems is applying interoperability, which is a lengthy task. As you may know, the healthcare industry demands full data security and follows laws and legal standards.
In this article, we are going to discuss how to embrace interoperability, while also taking into consideration all standards and pitfalls your medical organization might face.
What is health data interoperability?
Interoperability is a highly important and necessary extension of the process of implementing various technologies in the healthcare industry. So let’s take a deep dive into this vital topic.
Interoperability in healthcare is determined as the “capability to communicate, execute programs, or transfer data among various functional units in a manner that requires the user to have little or no knowledge of the unique characteristics of those units” (ISO, 2000).
It is a capacity to connect all internal software solutions that are applied in a particular healthcare organization to provide medical data exchange between these systems. Health data interoperability is considered to be an incredibly important undertaking since it is estimated to save the U.S. alone $30 billion per year when properly phased in, not to mention the time it will save all stakeholders. But rarely does something good come easily, and this is no exception as it is quite a challenging undertaking that demands knocking down barriers, while also following medical, privacy, and legal rules and standards for doing so, which we are going to discuss at more length further in this article.
This process enables secure health data to be shared and easily accessible from any location and organization, as long as it is sanctioned to do so. So what is the main point of interoperability of healthcare organizations’ systems? The benefits will be felt by all stakeholders. Starting with primary care physicians, who often must communicate and exchange information with specialists, hospitals, and other care settings, social service providers—and, of course, ending with the patients themselves.
These benefits include:
- easy access to patient data like electronic medical records (EMR), which may include information about diagnoses, conditions, and other important medical history contributed by primary care doctors, specialists, pharmacists, hospitals, emergency room, or urgent care doctors;
- fully secure medical data exchange between different healthcare software solutions like EHR, CDS, vaccine tracking systems, medical devices, and wearables, clinical and administrative systems, etc.;
- unification of healthcare systems, including converging on healthcare standards like HL7, CMS, ONS, and others, making their communication and information exchange more efficient: easier, and more accurate.
If we are unable to identify citizen-patients unequivocally, it will be very difficult to interoperate and guarantee the safety and quality of care.
Mario Chao, global CEO of ehCOS
We also recommend you watching the video by the link to learn why interoperability is important and needed today.
Types of health data exchange
Where interoperability is successfully implemented, health data is exchanged in one of the following ways:
#1 Directed exchange
This type of health information exchange implies sharing specific data from one provider directly with the other party who made a request. The data is exchanged in an encrypted form to ensure its security, privacy, and confidentiality. Directed data exchanges are usually used to collaborate on reports with the CMS or Center for Medicare and Medicaid Services and public healthcare organizations.
#2 Query-based exchange
Query-based health data exchange means that one of the providers requests patient data from the available clinical resources. Interoperability makes this possible, quickly executable, and clear. So in cases of emergency, a doctor or nurse doesn’t have to wait for an uncertain period of time to attain the necessary information.
#3 Consumer-mediated exchange
Consumer-mediated exchange allows patients to participate in their health care and gives them full access to their health dataю Thus, patients always have access to their private information that usually contains records of their medical and treatment history to show it to their providers if needed wherever they go, monitor their treatment course, and update their records to reflect additional treatment information and their current state of health.
Benefits of health data exchange
Health data interoperability aims to unify all healthcare software systems from different organizations and varying locations. Interoperability entails consolidating medical information by universalizing systems to convert and read their information clearly and understandably despite any difference in their features or formats. It eliminates any inconsistencies in receiving, entering, correcting, or updating health data.
And now, interoperability can bring the following benefits to healthcare organizations and it can impact the work of the healthcare internal systems in the following ways:
- guaranteed health data security among all participants;
- automatic and flexible health data exchange between different internal systems that are connected and interoperable;
- easily and quickly accessible and managed health data regardless of participant location, which is vital in cases of emergency;
- online access to patient data by all engaged healthcare organization is also convenient as it reduces paperwork, is more accurate and reliable, and also gives the providers more time to spend treating the patient, all of which can help prevents doctor errors that can be fatal, helps make treatment more impactful and helps improve health outcomes in general;
- patients also have access to their health information anytime they need it, so the customer experience improves;
- more efficient data gathering and exchange with public research organization can be a boon for medical advancement, for example, vaccine tracking data is useful for investigating vaccine efficacy and impact on human health;
- lowering costs associated with exchanging information between different healthcare providers.
Interoperability standards in healthcare
Electronic health data exchange requires the highest level of security and law-obedience. Internal healthcare software systems usually follow rules and regulations covering patient health information exchange. Systems` interoperability complicates this process as standards and laws differ from state to state.
HIPAA Privacy Rule
HIPAA, which is the acronym for the “Health Insurance Portability and Accountability Act” represents a national standard for the protection of the exchange of health-related information. This policy covers a certain list of entities. This rule regulates what and whom health information can be exchanged with, what data should remain private, etc.
In turn, covered healthcare entities are obliged to follow privacy regulation guidelines as per the protected health information or PHI, namely about:
- patient document information such as their social security numbers
- the individual’s past, present or future physical or mental health or conditions;
- details about the provided health care to the individual;
- the past, present or future payments for the provided health care to the individual.
The HL7 FHIR (Fast Healthcare Interoperability Resources) is a healthcare standard that determines the legal ways of securely exchanging health information between different health software systems used by different organizations, including private and public health organizations. The health information remains private and is only accessible by certain healthcare providers and entities. HL7 requirements are evidently applicable to closing in on the process of standardization and launching common interoperability. Implementing the FHIR standard has become pretty widespread and hence easy for development teams as they are supported by such vendors as Apple, Google, Microsoft, Cerner, and other EHR systems providers.
Here is a brief overview of HL7 standards, so we advise you to check it out.
CMS and ONS regulations
CMS or Center for Medicare & Medicaid Services manages and controls the various healthcare entities, making sure that they conform to and abide by HIPAA standards. It is an HHS department whose mission and function is to uphold medical standards. Its main duties are to collect and analyze data to report back on the operations of healthcare programs’, assuring their effectiveness, validating their existence, and, consequently highlighting areas of improvement in the healthcare system based on this data.
ONS regulation powers the use of FHIR for exchanging health data between several software systems. ONC’s standardized set of health data classes and constituent data elements for nationwide, interoperable health information exchange.
Digital tools for health data access
Digital healthcare tools are tasked to take healthcare systems to a higher level. There are different types of medical software systems that help manage clinical workflow, record and hold accurate health data, etc. To make these systems more profitable and efficient, they should interact with one another seamlessly to the point of interoperability.
CDSS or Clinical Decision Support System is a web-based application that seeks to support decision-making in a healthcare organization. This is majorly important because any medical error can bear tragic consequences. This type of medical software interacts with other electronic systems such as the EHR. CDSS analyzes health data recorders in EHR systems to push notifications for healthcare organizations and patients, control medications, and manage clinical workflow.
EHR or Electronic Health Records are internal medical systems that gather and record patient health data digitally. It includes the entire medical history, allergies, treatment, patient statistics, etc. This information can be securely shared with other vendors if needed. EHR is a single database for a particular medical facility.EHR systems can communicate with other medical software, thus, the main function and aim still is to build a broadly connected health system for all.
Vaccine tracking systems
Vaccine tracking systems are now considered to be one of the requisitioned types of software for healthcare establishments. You may understand why. The number of people getting vaccines against the novel coronavirus – Covid-19 grows by the day. Here comes a question – how to arrange the vial supply chain? The vaccine tracking system is a software system that legitimizes the process of ordering, allocating, delivering, administering, and tracking side effects of the vaccines to make sure they are safe and effective.
Unfortunately, there is no single universal vaccine tracking software for all countries yet, so these tracking systems only cover particular geographical areas, at least for now. Vaccination data tracking will also go a step further, offering vaccination cards to encourage people who travel to get vaccinated, and also lessen the strain on covid testing capacity, as well as reduce the risk of travel.
CPOE or Computerized Order Entry is a software system that manages doctor’s orders of medications, lab tests, diagnostic studies, nursery orders, etc. This type of software shares order information with third-party vendors like pharmacies and laboratories. Due to CPOE, all information is properly checked, like the accuracy of medications, their barcodes, expiration dates, etc.
AI is the future of the healthcare system
Integrating AI technology into interoperable medical software systems can improve the healthcare system even more and boost its digitalization outcomes even further and onwards to greater efficiencies. Among the top benefits that adding modern technologies such as AI or blockchain, (although the latter is still under investigation and study and yet to be proven) can bring the following benefits:
- accurate and easy to understand algorithms due to data analytics;
- validation of analysis results;
- create new research hypotheses;
- effectively processing lots of data from different medical software systems and drawing conclusions.
What organizations need to embrace interoperability?
Interoperable organizations are those that have already adopted health software systems that we described in the previous point. So, what organizations should seriously think about and consider opening interoperability between each other?
First of all, it’s healthcare organizations like:
- public hospitals;
- private clinics;
- vaccine providers;
- public health departments;
- healthcare vendors, etc.
These are the regular docks through which health information flows. However, there are many other areas where an active exchange of health data may be required, that is why healthcare organizations need to embrace complete interoperability.
What other organizations can request private health data and what for?
The answer is pretty obvious. The next and main sphere are insurance companies. Data health access gives the ability to predict and calculate risk for the particular customer and make an offer of insurance accordingly and that would also try to correspond to the needs of the customer.
Besides, healthcare internal systems sometimes have to additionally exchange health data with third-party vendors as software solutions may not contain all necessary functions to automatically give access and display vital pieces of information. An example of this need today are Covid vaccine distributors, who are responsible for certain areas. Healthcare organizations place orders for the supply of vaccine vials and can give access to health data about vaccinated people, their recovery process, and other patient data as relevant to vaccination. Thus, vaccine distributors and hence manufacturers can analyze and report on vaccine impact and effectiveness.
To sum up, any industry that deals with data exchange require the application of system interoperability, really, to boost the efficiency of its workflows.
How to start implementing interoperability?
To apply interoperability in your organization, it is important that all your systems can interact with one another, but in accordance with all medical requirements and guidelines. By unifying all internal systems, you get a so-called single database that includes all your tools, while also giving you the ability and flexibility to exchange all health data. Due to our vast experience in developing custom solutions for healthcare organizations, we know how to approach you to at least interoperability in your medical facility, and possibly beyond. Here is a general list of the steps to take to get you well on your way to creating interoperability:
- Determine the standards and policies that are used in your current internal systems to find out if they correspond to official medical rules like HIPAA, ONS, FHIR, etc.
- Define what beneficial features interoperability can bring to your workflows and organization in general.
- Analyze your existing tools to figure out if their technologies are updated and can be implemented with the potential of further development into a more effective solution.
- Learn the official medical software standards that we listed in this article about privacy, legality, rules of health data exchange, and others.
- Figure out what gaps should be filled to achieve full-scale interoperability for your organization.
This list can go on for a while. All these questions and tiny details will be discussed and addressed with the development team you are going to choose to make your systems interoperable. Business Analysts usually help determine the main objectives, possible risks, and pitfalls, they are aware of the latest medical standards and will tell you ways to shape your organization’s systems around them. We also would like to briefly mention a reminder about what criteria you should pay attention to when looking for a reliable development team:
- their experience on the market;
- experience in your particular industry, take a look at their portfolio of real projects for that;
- availability of developers and other specialists geared and suitable for your exact project;
- transparent documentation;
- awareness of medical laws and standards that cover your organization’s segment or industry;
- offering maintenance services of your systems after integration.
All in all
Enabling health data interoperability can make processes more efficient, and hence take the quality of treatment and other medical services to a higher level. This process is vital but also quite complex. Unifying all medical software systems under one functional umbrella is not only challenging from a technical standpoint but the fact that each system has to correspond to and align with updated medical standards like HL7, ONS, HIPAA, presents an added difficulty.
Interoperability is an inevitable process for all healthcare organizations to keep up with modern technologies and ramp up the coverage of the healthcare system as a whole. If you want to know if your systems can be connected and if they correspond to all critical standards, then contact us and we will conduct deep research and analysis in the area of your current software to determine how to correctly introduce interoperability in your healthcare entity.