The healthcare industry has done a remarkable job of replacing traditional paper charts with electronic health records (EHRs). Information that used to be sharable only by the most rudimentary means — it’s been said that fax machines lasted so long only because of healthcare — is now captured and stored electronically in a readily transmittable form.
That’s powerful stuff. Think of all the ways we as individuals move information electronically through email, online destinations, and the applications we access as part of daily life that would have been impossible less than two decades ago. That convenience is coming fast to health information, and the race is on to put that information to beneficial use through interoperability.
“EHR interoperability” can take many forms. It can refer to the ability of dissimilar EHRs to exchange health records, its most commonly understood meaning. It can also refer to the ability for EHRs to interact with dissimilar devices and with applications that are well beyond the realm of the health record itself. Interoperability is all of these things and more, coming together to advance care in ways that were unimaginable in the days of paper charting.
Interoperability among EHRs
In the first phase of electronification, health data was captured and stored in individual EHRs operating as providers’ personal information silos. The next task is to enable those EHRs to exchange patient data efficiently and securely with each other.
Meaningful use Stage 2 is a driving force in this aspect of interoperability. Stage 2’s consolidated clinical document architecture (C-CDA) requires EHRs to exchange diagnoses, allergies and medications in real time, a great first step (and another good reason to upgrade to a Stage 2-certified EHR). More complete information exchange is still needed, and the industry is making great progress in this arena, largely thanks to such cooperative initiatives as the CommonWell Health Alliance and Healtheway Carequality program. We should ultimately see all clinical data necessary for quality care shared among EHR systems, so it won’t matter whether a person is receiving care near home or while traveling across the country — his or her pertinent information will be available at the point of clinical decision-making in any location.
Interoperability with dissimilar devices and applications
Delivering patient data from one EHR to another is one piece of the interoperability puzzle; clinical information is often needed for decision-making beyond the reach of EHR-connected computers. Mobile devices are leading the way in putting patient data in the hands of providers wherever it’s needed via apps on tablets and smartphones. Patients also need remote access to health data, a role filled by the patient portal, which is fast growing in importance for patient engagement. As portals and EHR-to-EHR interoperability advance further, healthcare consumers will be able to manage information across multiple providers from a central location, just as today it’s possible to go online and personally manage finances by moving assets across accounts and institutions.
Interoperability with patient populations
The exchange of electronic health records with other EHRs, mobile devices and portals is all about individual care, which of course is tremendously important. Equally important is patient engagement for purposes of population health management, which occurs outside the walls of care facilities and patient appointments. Shifting payer models increasingly hold physicians accountable for outcomes, and tools that leverage EHR data are beginning to assist in that regard. We’re nearing an era in which each time a patient with a chronic condition makes an appointment, the provider will know whether or not that patient is overdue for a screening test, a foot exam or any other measure needed to fulfill a recommended preventive care program…and can administer that care at the same time.
These are just some of the ways interoperability is beginning to transform healthcare, and innovation is accelerating. In the not-too-distant future, “health IT interoperability” will largely be taken for granted, with information flowing in beneficial ways we can only dream of now — and as we are all consumers of healthcare, we’ll all benefit tremendously from breakthroughs to come.
About the Author: Tee Green is the CEO of Greenway Health™, where he is a co-founder. He is strongly committed to Greenway’s mission to improve population health through creation of a smarter, sustainable healthcare system.