Interoperability, are we getting anywhere?

2023 was another year for big announcements about interoperability. To name a few:

  1. ONC and The Sequoia Project Designate First TEFCA QHINs
  2. ONC finalized its Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) rule.
  3.  Proposed Rule: 21st Century Cures Act: Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking
  4. HHS-OIG: Information Blocking Final Rule released and posted its final rule implementing information blocking penalties to its website in June 2023.

But is this moving the needle? Are we closer to true, secure, and national interoperability? Here is what the experts say. And check out all our prediction posts looking to 2024.

Dr. Kel Pults, DHA, MSN, RN-BC, Chief Clinical Officer and VP of Government Strategy, MediQuant
LinkedIn: Kel Pults
X: @MediQuantLLC

To drive interoperability in 2024, we need to liberate disparate healthcare data trapped in legacy systems. An active discrete archive is a way forward, preserving data in an accessible and actionable format. It empowers end-users to access information seamlessly, not only at the point of care but also for research analytics, legal compliance, AR work-downs, and revenue retrieval. Opting for a discrete data archival system from the outset stands as the most efficient strategy for hospitals and health systems seeking interoperability. This approach also saves time and money by eliminating unnecessary (and often exorbitant) maintenance costs and licensing fees, simultaneously mitigating provider burnout by minimizing the need to navigate across disparate and sometimes redundant systems.

Kathryn Ayers Wickenhauser, MBA, CHPC, CHTS, Senior Director of Community Strategy, DirectTrust
LinkedIn: Kathryn Ayers Wickenhauser, MBA, CHPC, CHTS
X: @DirectTrustorg

News from ONC that TEFCA is now operational signifies a major milestone in federal efforts to connect providers nationwide and bridge gaps across the care continuum. This is especially challenging given the diversity among providers, facilities, and technologies. Looking to the year ahead, collaboration will be key in driving interoperability among these stakeholders. This should encompass not only educational opportunities but also the sharing of information regarding the technological capabilities at our fingertips. The challenge often lies not in innovation but in implementation. How effectively have we integrated our existing tools? In 2024, I anticipate a year of heightened collaboration, fostering the exchange of strategies and information for a collective and impactful approach to interoperability.

David Lareau, CEO of Medicomp Systems
LinkedIn: David Lareau
X: @MedicompSys

Interoperability will unleash oceans of data, but volume alone holds little value. The breakthrough will come when clinicians can instantly access customized views compiling the most essential information for each patient condition. Solutions that contextually filter, organize, and connect the dots within rising data volume to match clinical workflows will prove the difference-makers in tangible point-of-care impact.

Mo Weitnauer, Chief Product Officer, MRO
LinkedIn: Moliehi Weitnauer
X: @MROCorp

2023 was a year of significant strides in clinical data interoperability. Many CMS agencies were busy advancing policy agendas towards accelerating standards and offering incentives towards more interoperability, including connections between payers and providers. Also in 2023, we saw several players in healthcare take strides at adopting FHIR standards for clinical data connectivity. EHR vendors, data brokers, payers and providers all pushed their product roadmaps to adopt new standards in earnest.

In 2024, I expect to see regulators focus more on greater harmonization across the various rule-making bodies. As payers push for direct access to EHR data, savvy providers will not merely acquiesce to these demands. Instead, providers will continually seek to balance access, patient rights to the data, and downstream impacts of expanded data sharing on provider bottom lines.

I also expect a greater emphasis on the challenge of ensuring high quality data through the newly established interoperability connections. We may also hear more talk of their experimentation in the use of generative AI. However, I suspect these attempts will be limited to pilot projects, with minimal broad-based adoption taking place.

Don Rucker, MD, Chief Strategy Officer, 1upHealth
LinkedIn: Donald Rucker
X: @1up_health

There has long been a divide between how data flows in healthcare – clunky, slow, and incompatible – and how it flows in other spaces like financial and retail – moving seamlessly across a rich internet ecosystem of networks, sites and apps. Though healthcare’s shift to a more interoperable environment has been notoriously slow, the tides are turning thanks to the emergence of the digital economy, growing dissatisfaction in the public, and new federal regulations providing guidelines and timelines around the shift.

The latest release of the CMS Interoperability and Prior Authorization Rule will further support value-based data-sharing this year by enhancing provider and patient access to data and by improving processes around prior authorization, all via moving to FHIR-based APIs. Because these new rules pertain to population-level APIs from business to business, they are expected to see greater adoption compared to previous rules requiring actions from individual patients. With industry-wide support and compliance with the latest data sharing requirements, there will be far less standing in the way of healthcare’s long-overdue entrance into the modern digital space.

John Blair, MD, CEO, MedAllies
LinkedIn: A. John Blair, III, MD
X: @MedAllies

Though many have lamented healthcare’s slow progression towards achieving interoperability, the industry is poised to take real steps next year as TEFCA advances. The Trusted Exchange Framework and Common Agreement is a set of regulations backed by the federal government that seek to establish the technical standards to enable healthcare stakeholders to securely share clinical information across networks. TEFCA will drive healthcare interoperability forward by creating consistent policies and procedures that will make healthcare data more accurate, complete, accessible, and useful for clinical decisions that benefit patient care.

Katie Devlin, DHSc, MS, CPHIMS, Vice President, Interoperability, Cotiviti
LinkedIn: Katie Devlin
X: @Cotiviti

The year ahead holds a lot of promise and possibility for clinical data exchange. With the first round of QHINs onboarding this year and the forthcoming Common Agreement 2.0 supporting FHIR-based exchange, TEFCA is finally coming to life. Unfortunately, though, there is still ambiguity on the timelines for supporting Exchange Purposes outside of treatment and individual access, making it difficult for payers and other healthcare stakeholders to build effective interoperability strategies.

Another area of interoperability where we’ve seen significant progress is with the enforcement of information blocking provisions. Earlier this year, OIG published a final rule that could fine certified health IT developers and health information exchanges (HIEs) up to $1 million for each violation committed. This was a step in the right direction. However, this rule didn’t address providers and hospitals. So, this past October, HHS proposed another rule to establish disincentives for providers who commit information blocking. Finalizing this rule would be a much-needed step towards nationwide interoperability.

Mark Gingrich, Chief Information Officer, Surescripts
LinkedIn: Mark Gingrich
X: @Surescripts

Raising the Bar for Data Quality and Healthcare Interoperability Standards
Advancing healthcare interoperability in 2024 will require that all stakeholders commit to raising the bar for data quality. Higher quality data that follows a standard, simple structure can lead to better decisions by both clinicians and machines, ultimately helping patients get the appropriate level of care they need. Electronic prescribing standards are a great example of what data accuracy means for patient safety and to building the trust of clinicians who rely upon it to inform patient care. In 2024, we will look to e-prescribing standards as an example to follow as we work toward a comprehensive standard for sharing all clinical patient information and intelligence.

Sandra Johnson, Senior Vice President, Client Services, CliniComp
LinkedIn: Sandra Johnson
X: @CliniCompIntl

In the realm of health information technology, 2024 heralds a new era of interoperability where seamless data exchange becomes the norm rather than the exception. As stakeholders increasingly prioritize collaboration and standardization, we anticipate significant strides toward achieving true interoperability. Our collective efforts aim to break down silos, empowering healthcare providers with comprehensive, real-time patient data, ultimately enhancing care coordination and delivering better outcomes across the healthcare continuum.

Prof. Assaf Ben-Meir, CO-founder and Chief Medical Officer, Fairtility
LinkedIn: Assaf Ben-Meir
X: @fairtility

We are in a world where data is king. Different systems and devices continuously collect data, yet the inclination to share that data is similar to a gold digger wanting to share the location of a new gold field – it just doesn’t happen unless you pay for it, in gold. The urge to protect data within a system is what has made interoperability such a challenge. But, in healthcare, there is a higher purpose to the integration – improving and even saving lives.

Healthcare has made a remarkable leap in digitization – whether through AI, big data and ML in diagnostics and treatment, BD analytics and drug discovery, or whether through telemedicine and remote monitoring, and various platforms between patients and their clinical teams. While these steps ushered healthcare into a digital era, their true potential lies in interoperability.

Integrating diverse systems—BD analytics, predictive tools, medical devices, patient portals, EMRs, and more—facilitates real-time information flow. Applying AI atop these interconnected systems propels us beyond basic digitization to healthcare digitalization. This entails extracting real-time insights on efficiency, treatment progress, and preferences of both patients and clinicians. Decision support based on a patient’s complete health profile becomes instantly available.

This evolution is starting to take place in reproductive care, where AI integrates with Time Lapse Incubators, electronic witnessing systems, patient EMRs and clinic systems. The result is a seamless flow of information, fostering AI-driven insights that enhance clinical decision-making and operational efficiency in real time. Present digitalization informs current treatments, and as this digitalization takes hold, it will pave the way for a future with predictive insights guiding treatment decision making.

Lyle Berkowitz, MD, CEO, KeyCare
LinkedIn: Lyle Berkowitz, MD
X: @KeyCareInc

One often overlooked aspect of interoperability is the capability of health systems’ virtual care partners to access patient records from the originating health system. When virtual partners use the same electronic health record vendor as the health systems they partner with, patients obtain a continuous care experience because virtual clinicians can view patients’ complete medical records and medication histories, and share them back with the patient’s PCP. For patients, this capability can impact both convenience and quality by allowing their virtual care providers to know their history when making decisions and to share visit information with the patient’s home health system.

Bill Charnetski, Executive Vice President, Health System Solutions and Government Affairs, PointClickCare
LinkedIn: William Charnetski
X: @PointClickCare

HIT incentives and staying consistent with federal interoperability standards will be key in solving the nation-wide staffing crisis
In 2024, organizations will fully realize HIT’s potential in helping to solve the ongoing staffing crisis in healthcare. By improving productivity and enabling organizations with funding to invest in improved solutions to enhance interoperability, caregivers will be able to perform their jobs more efficiently. Making the clinical workspace an inviting place to be with improved access to technology that allows clinical staff to do their job more seamlessly will lead to improved outcomes and happier staff across the board. As technology adoption increases across the nation, it will be more important than ever for states to model interoperability standards with federal strategies and standards. Alignment with the federal infrastructure will strengthen the impact of HIT investments on clinical staff and high-need patients.

Jonathan Shoemaker, CEO, ABOUT
X: @ABOUT_est2005

In recent years, the demand for care has increased exponentially, placing an unprecedented strain on provider resources and exposing the implications of the independent, transactional care delivery model. As technology innovation continues to drive digital transformation and interoperability in 2024 and beyond, providers will need to implement technology and best practices that enable proactivity in guiding patients to the optimal care setting rather than just dealing with them when they arrive at a facility. When the boundaries to care are no longer limited to a specific location, healthcare becomes more ubiquitous, and providers can ensure prompt access to care at every stage of the patient journey.

Angie Franks, Chief Executive Officer, Kalderos
LinkedIn: Angie Franks
X: @KalderosInc

As an industry, vendors holding data hostage as a strategy continue to impede innovation and impact patient care. People want to share information for the betterment of patients, but a lack of transparency and interoperability is hurting that effort. We need to get medications to patients that need them at prices they can afford – with discounts applied at the point of sale. In 2024, I expect a wider push for greater transparency and disruption of the status quo.

Brian Drozdowicz, SVP & GM, Acute and Payer Markets, PointClickCare
LinkedIn: Brian Drozdowicz
X: @PointClickCare

Interoperability Models: Out with the Old, In with the New
Traditionally, we think about interoperability as HIEs (health information exchanges), but in 2024 I expect to see new models emerge. The traditional HIE subscriber model continues to become more complex, with challenges in achieving clinical outcomes and maintaining sustainable funding. That said, the industry as a whole needs to find new ways to share data where the economics and the values are balanced. In particular, one emerging model is the Trusted Exchange Framework and Common Agreement (TEFCA) which advances the principles and benefits established by the Cures Act by establishing a secure technical infrastructure for healthcare networks. I anticipate this will be something every major payer and provider will be focused on and for good reason, as it also has an impact on the ability to advance value-based care. The evolution of interoperability is happening now, and payers and providers need to be on top of TEFCA and HIE updates to provide continued clinical value.

Buff Colchagoff, CEO, RosettaHealth
LinkedIn: Buff Colchagoff
X: @rosettahealth

The Commoditization of Health IT Connectivity
We know of many ways that health IT connectivity and interoperability have progressed over the past 15 years — from the National Networks like eHealth Exchange, Carequality and Commonwell to FHIR to widespread ADT notifications. 2024 is the year where the 3rd phase of adoption will really start taking off. The first phase was a large organization that could afford to spend millions on interoperability. The second phase was large vendors (mainly EHRs) that included these connections in their products. The third phase is where small vendors and small organizations leverage these services en mass. The cost, availability of tools and amount of data limited adoption by this 3rd tier — but no more. Cost of access, availability of tools and sheer amount of data is now there for small organizations to adopt and innovate. Should be a very innovative 2024!

Piotr Orzechowski, MSc, CEO, Infermedica
LinkedIn: Piotr Orzechowski
X: @Infermedica

While we’ve made great strides in healthcare interoperability, it’s important to acknowledge that there’s still much work to be done. Achieving a seamless exchange of health data is a complex task, facing hurdles like standardization, data quality, security concerns, and accessibility. The potential of interoperability to impact patient care, drive innovation, and enhance medical research is clear, so addressing these challenges is essential towards achieving a truly patient-centric and efficient healthcare ecosystem.

Anshu Jindal, Co-Founder and COO, Darena Solutions
LinkedIn: Anshu Jindal
X: @DarenaSolutions

2024 will be a defining year where the impact of health IT regulations, the burgeoning health apps, AI integration, and increased patient awareness will converge to propel health data interoperability forward collectively. It’s vital to view compliance with the evolving data standards and regulations as stepping stones for progress, not final objectives. Acknowledging that interoperability is an ongoing journey, not a final destination, we must continue our efforts to make data exchange progressively easy and valuable.

George Dealy, VP of Healthcare Applications, Dimensional Insight
LinkedIn: George Dealy
X: @DI_tweet

As healthcare organizations rely increasingly on various forms of analytics to drive more objective, data-driven decision-making, we are surprised at how many hospitals that we work with don’t have standards-based (as in FHIR) interoperability configured in their EHRs. More seamless interoperability would certainly reduce the time and complexity involved in integrating data across EHRs for purposes of analytics and decision support, in general, to minimize the time from insight to action.

Trevor Bidle, Chief Information Security Officer, US Signal
LinkedIn: Trevor Bidle, CISM, CISA
X: @ussignalcom

The Integration Imperative in Patient Care: The expansion of telehealth, personal medical devices, and the explosion of available data lead by the integration of health record systems is creating an interconnected ecosystem of care. The ability to seamlessly integrate and utilize this data is transformative. By focusing on interoperability and data analytics, CIOs can drive resource efficiency, reduce costs, and unlock new revenue streams through predictive care models. This isn’t just about technology; it’s about using data not as a mere collection of information, but as the lifeblood of a more responsive and proactive healthcare system.

Leslie Orne, President and CEO, Trinity Life Sciences
LinkedIn: Leslie Orne

AI holds great promise in optimizing a variety of pharmaceutical launch strategies – helping to speed the delivery of medicines to patients across the globe. Bolstering interoperability can help increase AI adoption in healthcare. Current technologies in the life sciences industry have the potential to work together to revolutionize the way we develop, commercialize and manage medicines globally. More specifically, AI and machine learning (ML) technologies are enabling our industry to improve its knowledge by analyzing millions of data points and interpreting them for us. This holds great value in pharmaceutical commercialization and healthcare overall, where data-driven decision-making can lead to better patient outcomes. Seeing progress made – and progress that impacts the lives of people that are close to you – is what makes this so rewarding.