What Are the Biggest Health Care Interoperability Challenges?

By Emily Newton, Editor-in-Chief, Revolutionized
LinkedIn: Emily Newton
X: @ReadRevMag

Like many industries, health care is amid a period of rapid digitization. As hospitals rush to embrace electronic health records (EHRs) and the Internet of Things (IoT), some have achieved new efficiency and security standards. At the same time, this movement has made interoperability in health care a larger issue.

The new digital systems medical organizations rely on don’t always work with each other, and some entities still use manual paper methods. The nation must promote more interoperability to deliver a consistent standard of care for all patients, but several challenges stand in the way.

Lack of Universal Standards

The biggest obstacle to interoperability in health care is the absence of any universally accepted standard. Even if every hospital switched to EHRs, different communication and encryption protocols would limit transfers between institutions. Similar discrepancies limit the IoT devices any one organization can use together.

Thankfully, the industry is moving toward standardization. More than 550 technology companies joined forces to launch the Matter connectivity standard in 2022. As it matures, more IoT devices will be interoperable off-the-shelf.

EHR standards have progressed more slowly but are moving in the right direction. The U.S. Department of Health proposed regulations in April 2023 to standardize EHR platforms for more interoperability. In the meantime, organizations can learn what protocols other in-network hospitals use and opt for the same or compatible platforms while lobbying for more regulatory guidance.

Reliance on Legacy Systems

Even if the industry embraces a single EHR standard, many organizations still rely on outdated solutions. Most hospitals use EHRs, but that leaves lagging adopters and their patients — often in rural, less connected areas — at a disadvantage that may quickly become more severe.

New, interoperable data and device standards may also be incompatible with older technologies. Consequently, embracing the latest industry-accepted EHR solutions may mean sacrificing connections with other equipment, such as the hospital’s network infrastructure or older data-gathering endpoints.

Health care organizations must modernize all patient data-related technologies and supporting infrastructure to enable true interoperability. That will be a long, expensive process, so it’s important to approach it carefully. The key is upgrading the most mission-critical systems first, then slowly addressing the rest as ROIs start to show.

Costs and Disruption

The cost of health care interoperability poses another problem. An industrywide standard will require at least some facilities to upgrade, and these optimizations are expensive. Those barriers may hinder some organizations from pursuing interoperability.

Even when hospitals can afford it, transitioning to a new system is disruptive. It requires planned downtime and likely a few technical hiccups before it works as intended, so planning and patience are essential.

Medical organizations can account for this cost and complexity by looking for other areas to save. Switching to oil-free air compressors for anesthesia and other sanitized air applications reduces expenses because they’re less prone to breakdowns and require less maintenance. Newer systems across all applications will save money in the long term, and hospitals can maximize these ROIs by embracing a slower, more heavily monitored approach to upgrading.

Cybersecurity and Privacy

Cybersecurity discrepancies also stand in the way of interoperability. In some cases, accepting an EHR standard favored by another entity could mean using a less secure option. Health care cyberattacks affected 45 million people in 2021 alone, so that concession is unacceptable.

The solution is to ensure regulatory interoperability standards use the most secure platform. Before these regulations emerge, if there’s ever a discrepancy between two systems, the party with the lowest level of security should be the one to adapt.

The other privacy issue with interoperability is that wider data-sharing introduces more opportunities for breaches. Organizations must embrace secure data transmission solutions like blockchain and minimize access according to the principle of least privilege to stay safe.

Stakeholder Pushback

Employees and managers may also pose an obstacle to interoperability in health care. Theoretically, all industry stakeholders should want interoperability, as it enables more efficiency and promotes better patient care between facilities. However, staff accustomed to one system may hesitate to embrace another.

Switching to a new standard will require retraining, disrupting normal workflows. Adding this disruption to already-high workloads could push the 46% of health workers experiencing burnout to quit, worsening talent shortages. Even if they stay, they may refuse to learn a new system to prevent further stress.

Thorough communication before, during and after implementing a new EHR system is crucial to preventing these outcomes. Health care organizations can also create more room for training by automating repetitive or non-mission-critical tasks.

Interoperability in Health Care Is Challenging but Crucial

Ensuring interoperability in health care is essential. Without it, patients may not experience the same treatment at different facilities, widening medical disparities nationwide.

Reversing that trend won’t be easy, but it’s possible. Health care organizations recognizing the largest obstacles can adapt to pave a clearer path toward interoperability.