True interoperability between HIT businesses, vendors, technology, systems, and healthcare information is one of the substantial requirements when it comes to providing quality care. It is difficult to achieve as it cannot adequately meet the respective goals of operators in the sector.
Interoperability is a serious problem throughout healthcare as different complex processes, clinical standards, as well as vendors, create enormous barriers to the delivery of improved patient experiences along with better patient care outcomes.
Reduced Medicare compensations, rising costs, a shift to value-based care, and intensified pressure to enhance patient experience imply that the entire healthcare industry, including providers, must move toward better healthcare operability. Those creators of information systems, HIT, payers, providers, and other healthcare stakeholders be able to communicate with one another to accomplish an effective or interoperable healthcare system.
Healthcare must address these challenges but there are a number of difficulties that need to be resolved otherwise interoperability in healthcare will continue to remain nothing more than an intellectual talking point.
The following are the four significant challenges that are faced in the healthcare industry:
Lack of Criteria for Sending, Receiving, and Managing Information between Health Systems
Simply sharing or coping information from one healthcare technology or EHR software to another, as furnished by today’s vendors, is extremely difficult. Proprietary formats, mismatched fonts, as well as external data fields, is an indication that data must be manipulated carefully and modified before it can be exported to another system.
The adoption as well as the use of health data standards is the basis for enabling interoperability between EHR systems and across organizations. According to the Office of the National Coordinator (ONC), standards are conventional methods that connect systems, and these standards may pertain to data transport, security, data structure or format, terminology connotations, or code definitions. With standards in place, predictive analytics systems, health information exchanges, and other information exchange efforts can be foundationally established.
Throughout healthcare, several disparate Standards Development Organizations (SDOs) create, update, and even maintain health data standards via collaborative processes involving HIT users but a single, unified standard does not exist. With billions of dollars already spent on EHR implementation, a health system must be able to find efficient ways of connecting fragmented patient data, which is an increasingly consistent effort as the United States transfers from fee-to-services to the value-based healthcare system that focuses primarily on populations and outcomes. There is no interoperability standard whatsoever. This lack of common criteria or standard for capturing, receiving, transmitting, storing, and managing patient data causes significant inaccuracies as well as delays. This is a major obstacle to interoperability efforts.
Blocking of Information by Vendors
A lack of shared data in the healthcare industry is one of the challenges affecting healthcare interoperability. The practice of information blocking by some EHR vendors is a significant impediment that cannot be overlooked. And even if the information is eventually shared, a number of these technology companies end up charging exorbitant fees for transmitting data outside their system.
Without any doubt, such practices are profoundly disruptive to the flow of essential healthcare data. But many vendors continue this practice despite new efforts to end it.
For instance, the executive director of Health IT Now, Joel White, is calling for the publication of any authoritative rule on information blocking, which is required by the 21st Century Cures Act legislation. In an op-ed that was recently published in STAT, the executive director of the coalition of healthcare and technology companies stated that “More than 600 days after the enactment of the Cures Act, not one regulation has been passed or issued on information blocking.”
The ONC for HIT is responsible for publishing the regulation as well as the implementation of specific duties as required under the 21st Century Cures Act that was signed into law in December 2016.
The major components in the legislation include patient access to health data and promoting the interoperability of EHRs while discouraging the blocking of information. The law is presently receiving lots of positive attention due to its potential ability to free up the lanes for genuine data interoperability.
Lack of Uniformity When Identifying Patients
There is presently no consistent way of identifying patients across the healthcare spectrum, a network of providers, or even throughout prominent healthcare systems.
Patients are identified by their names, date of birth, as well as Social Security number. But the issue is that information is stored in different systems in different ways. This implies that patient identification can be subject to a lot of errors.
Numerous patient advocacy groups have asserted that the creation of a national, particularized patient identifier would be a great solution to this problem. The patient identifier, according to the groups, could be designed in a similar manner with the patient’s Social Security number and would be theirs throughout their lifetimes. This identifier will be utilized at any point of care in the course of the patient’s life.
Since the patient identifier will be something akin to a code, it will categorize as well as identify any individual no matter what provider or system is used. But the efforts for moving this impressive campaign forward appears to be locked in a political stalemate.
Advocacy groups such as CHIME and HIMSS, along with several other organizations, have been pushing for a national patient identifier for the past few years. They argue that as the exchange of health data continues to evolve, the need for an accurately consistent way of identifying patient health records is becoming increasingly pressing. As a result, this lack of a uniform patient identification system, which would be recognized nationally, has led to health data exchange inefficiencies, increased healthcare facility costs, and patient safety threats, among other problems.
The introduction of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 called for the creation of the coveted unique patient identifier. Congress overruled this mandate due to patient privacy concerns. An extremely vocal minority retain fears that industry or the Government will utilize patient data in a way that makes privacy even much harder to protect, especially if a patient identifier were to be used.
Nevertheless, without an identifier in place, it will be quite challenging to link heterogeneous data in order to obtain a complete picture of patient healthcare experiences. Therefore, before industry-wide and nationwide interoperability can become a reality, federal agencies need to sit up and prioritize the standardization of every aspect of patient health record exchange.
The Difficulty with Measurement, Analytic Thinking, and Transformation between Healthcare Systems
When healthcare systems do not communicate with each other in purposeful ways, it becomes difficult to readily quantify error rate, costs, and other created issues. Without the ability to track or measure outcomes, health systems, and healthcare organizations will not be able to improve its most crucial processes, and no genuine interoperability can be achieved.
The challenge confronting providers, their payers, and vendor partners is the lack of a regularized way to measure or evaluate the impact of interoperability failure and delays. As soon as providers can accurately measure issues throughout the entire healthcare chain, they will be able to analyze problem areas and make necessary changes. They will also be in the best position to keep tabs on how these changes can raise the quality of care as well as patient outcomes.
Data analytics is quickly becoming one of the most challenging undertakings in the healthcare industry today. Some providers are not yet conversant with the management and operation of their EHRs. However, they are asked to obtain critical insights from the clinical data right within the technology.
For organizations that can successfully integrate data-driven insights and bring them into their operational and clinical processes, the rewards – such as lower costs, visibility performance, potentially healthier patients, and higher patient and staff satisfaction – are astonishingly abundant.