The Continuing Challenge of Data Interoperability
There is some expectation that healthcare interoperability may yet become a reality in the very near future. The legislative foundation was laid in 2019, the process has likely been accelerated during the pandemic and the benefits to the sector are obvious. That said, there are still major hurdles to overcome.
Dr. Blackford Middleton, chief informatics and innovation officer at the health IT vendor Apervita, has said that true interoperability will require a 10-year rollout, and others believe it will go a long way toward enabling those in the industry to meet the quadruple aims of improving quality, the patient experience and the provider experience, while also lowering costs. It is his belief, in fact, that the advent of interoperability will result in a staggering $78 billion annual benefit to the sector.
At the same time, he added, the challenge lies in achieving both syntactic and semantic interoperability, which he likened to the obstacle once faced by the U.S. Postal Service. It is one thing, he said, to be able to send a letter from one place to another, quite another to be able to read what it says.
And indeed, difficulties with data management and maintaining data standards across multiple platforms are frequently mentioned as the greatest barriers to digital health adoption, with the specific obstacles related to interoperability being such things as affordability and inadequate training.
Yet innovation proceeds, as the need is no less obvious. Some 45 percent of the physicians responding to a Harris Poll in June 2021 said their organizations had accelerated IT adoption as a result of COVID-19, and 62 percent concluded that those changes normally would have been implemented over several years. Further, over half said their organizations had been “neutral” to such changes before the pandemic.
Not coincidentally some 93 percent of hospitals now rely on electronic health records (EHR), up from 73 percent in 2011. Additionally, Karsten Russell-Wood, portfolio leader for post-acute and home at Philips, told Healthcare IT News that telehealth solutions have been instituted so rapidly during the pandemic that it has not been unlike “building a plane while flying it.”
But again, it is a matter of breaking down the language barrier between all these systems, as Middleton noted — ensuring that clinicians have access to every shred of information, giving them a holistic view of each patient. Nearly every physician who responded to the above survey (95 percent) believes that interoperability improves outcomes, and 86 percent believe it cuts back on the time it takes to diagnose patients.
In addition, 84 percent believe digital tools decrease workplace friction and stress, 61 percent believe they lessen administrative burdens, 60 percent believe they improve work/life balance and 57 percent believe they alleviate burnout, a major concern among clinicians today.
In total, 89 percent of the physicians surveyed stand in favor of interoperability. Their views were best summarized by Neal Lappage, the Public Sector Solutions Lead for the cybersecurity firm ITC Secure, who told Healthtech Magazine the following:
“Because healthcare is a team effort that is not delivered by a single healthcare professional or practice, sharing information about patients between practices in a secure way will ultimately deliver improved outcomes and patient-centered care.”
As mentioned, the governmental groundwork for interoperability was laid in 2019, when the U.S. Department of Health and Human Services (HHS), the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) all took steps related to this concept.
The HHS introduced new rules that would enable patients to more readily gain access to their health records, while the ONC and CMS took aim at data blocking. The hope is that at some point there will no longer be “a Betamax-VHS fight in healthcare,” as Aneesh Chopra, U.S. chief technology officer in the Obama administration and now president of the healthcare consultancy CareJourney, put it at the time.
Specifically, the goal is to standardize all systems and processes according to Fast Healthcare Interoperability Resources (FHIR) guidelines, thereby “promoting scalable data-sharing and a model that supports the flow of information across the entire healthcare system,” as then-CMS administrator Seema Verma said in 2019.
Far more recently — in July 2021, specifically — Google Cloud introduced a tool that would enable healthcare organizations to access data from various sources, including EHR. This new technology builds on previous Google innovations like Cloud Healthcare API — i.e., application program interface — and leverages analytics and artificial intelligence, providing for clinicians the holistic view of patients that leads to the best possible outcomes.
The other tech giants, like Microsoft, Apple and Amazon, are also making inroads in the interoperability space — Microsoft through the development of a healthcare-specific cloud service, Amazon through a search/analytics tool and Apple via an FHIR-friendly iPhone feature that enables individuals to share health data with providers.
It’s clear, then, that the need for interoperability is widely understood, as are the benefits. Certainly there are hurdles to cross, but they are surmountable. Further, they are being attacked from the public and private sector. It seems only a matter of time before workable solutions are found, ensuring a promising future for one and all.
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