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HIMSS Musings: Interoperability in Healthcare IT

Earlier this month I had a chance to attend HIMSS 2015, the annual conference of the Healthcare Information and Management Systems Society. I spent four days finding my way through 2.6 million square feet of exhibit space, brightly lit vendor booths stretching for miles, and hundreds of sessions with speakers from all corners of the healthcare information technology industry. With all this excitement, how far along is the HIT industry in attaining true interoperability, and thus, improving the quality of care?

According to the Healthcare Information and Management Systems Society (HIMSS), the goal of interoperability is “the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.”

Indeed, the federal government’s Office of the National Coordinator for Health IT (ONC) states that its “overarching goal for electronic health information exchange is for information to follow a patient where and when it is needed, across organizational, health IT developer and geographic boundaries.”

Interoperability is a formidable challenge in any industry. In healthcare, the data and systems are necessarily complex. Even more importantly, when it comes to patient care, the stakes are remarkably high.

So, how close are we to our goal? Is health information really traveling across boundaries, with patients, as they move through a complex system of hospitals, specialists, primary care doctors and pharmacies?

Not quite yet.

New Tools Bring New Challenges

One healthcare vendor we spoke to at HIMSS is planning on releasing a feature that will pull patient data from multiple points of care together. This sounds like a great start, but, the system on the receiving end of these records must convert and import the data in order for the provider to access the information. Far from the data following the patient and being available when needed, this solution puts the onus on healthcare providers and HIT vendors to locate and make use of patient data.

Although patient portals give each healthcare consumer access to their own information, in most cases, their data isn’t following them from practice to practice. As portals go mobile, it’s less and less likely that patients will print their healthcare details with them and carry them from appointment to appointment.

In healthcare, the point of care or delivery location can be a critical if often overlooked piece of data. The care a patient receives at a hospital ER may differ substantially from the same treatment given at a primary care office or an the new urgent care center up the street. But, because there is no standardized location identification nomenclature for healthcare settings, including this detail in a useful way to healthcare providers is in and of itself a hurdle. Even this small detail requires attention.

Connecting The Old With The New

The use of information technology in healthcare has been around for decades. HIMSS itself was founded in 1961, over fifty years ago. Many new systems run on web platforms and leverage mobile technology, but others, including some aspects of health IT infrastructure, use legacy platforms. Connecting the “old” to the “new” may take time, but industry changes like ICD-10 and Stage 2 Meaningful Use will potentially push the timeline for vendors.

Hospitals may have an advantage in this regard, as they purchase independent practices to expand their networks, ensuring all affiliated practices use the same EMR. But, the buying trend may be slowing as the costs of buying up practices starts to outweigh the benefits.

Besides, isn’t every practice, hospital, and pharmacy using the same system the antithesis of interoperability? The goal is for systems to talk to each other, in real-time, so that patient care is seamless and the data is always current. The complex nature of healthcare IT, with proliferation of technologies, standards of care, and government regulations, make interoperability increasingly challenging.