Over the last decade, achieving true interoperability has been an ongoing pain point across the healthcare ecosystem. Provider organizations and payers alike have been slow to implement this technology under the guise that interoperability is complicated and potentially, not fully attainable. However, interoperability has largely been solved at a technical level. It’s now up to provider organizations to address these challenges by implementing an interoperability layer to support data normalization and sharing among disparate IT applications and sites.
Organizations can better support themselves, and improve interoperability literacy by diving into the truth behind these interoperability myths:
Myth 1: Interoperability is hard. While many healthcare organizations have yet to achieve interoperability, it is no longer the challenge it once was. From a technical perspective, interoperability has largely been solved. The real issue currently facing the industry is that of competing priorities. Organizations must be willing to make time and find resources to invest in and take advantage of the technology that already exists.
One of the things slowing this process down is IT implementation fatigue. Interoperability ends up low on the list of priorities with many organizations experiencing burnout due to the numerous co-occurring projects and regulatory changes. Additionally, physicians’ lists of responsibilities are mounting, so again, interoperability isn’t always top of mind.
To achieve widespread interoperability, a cultural shift needs to occur. Organizations need to think of healthcare in terms of communities of care; and to support this mindset, can adopt new best practices, workflows, etc.
Myth 2: Everyone is using FHIR. While FHIR provides great specifications for electronic information exchange, it does not solve interoperability and not everyone is using it. HL7 2.x is still the gold standard of international guidelines for the transfer of data; and many organizations comply with and take full advantage of all it has to offer.
The healthcare industry is ever-changing, and the idea that not only will FHIR solve all interoperability challenges, but also that all organizations must adopt FHIR to fully reach interoperability, is misguided. HL7 2.x solves interoperability; waiting for the industry to comply with FHIR will only hold organizations back from seamless information and data sharing.
Myth 3: Interoperability is about feeding data into and retrieving data out of EHRs. While it is true, EHRs are a key piece of the interoperability puzzle among hospitals and health systems, interoperability must be viewed in three layers. With the challenges of interoperability already having been addressed at a technical level, it is important to examine it in the context of these layers in order to achieve seamless integration at a higher-level:
- Community/regional level: exchanging information between different facilities. i.e. data sharing between health systems and pharmacies, public health organizations, radiology and labs, payers and researchers.
- Organizational level: exchanging information within an existing system. i.e. medical records, administrative systems, and medical and operational IT systems.
- Device level (Internet of Medical Things): enabling more seamless information exchange at the point of care. i.e. sensors and devices systems, personal connected devices, the patient, and the clinician.
At this point, with the technical aspects of interoperability having been addressed for the most part, the industry must shift its focus to higher-level issues. The disparity of interoperable access is not a consequence of a lack of technology, rather it is a matter of competing priorities. The next level of the interoperability conversations opens up the floor to fascinating and critical issues, from the practical and technical aspects of implementation to transforming the organizational behavior and shifting the line of thinking in the industry about its responsibility towards patients and members.