Healthcare News & Insights

Breaking down the silos: How to achieve EHR interoperability

Achieving electronic health record (EHR) interoperability is necessary for hospitals, but it hasn’t been achieved due to too many silos. In this guest post, Elizabeth Buckle, manager, product management at a health information technology and services provider, details what healthcare organizations should look for as they evaluate new solutions to achieve full interoperability.


Value-based payment models, population health programs and precision medicine are changing the healthcare market for providers and patients alike. Driven by data, these initiatives require effective communication across many systems, including the core electronic health record (EHR) solutions employed throughout the healthcare industry.

However, the industry still isn’t fully interconnected, leaving gaps in the wake and reducing the positive impact of these initiatives. At the core of the issue is interoperability. Interoperability in health care is all about unlocking patient data to drive proactive care delivery and better outcomes. Health IT systems must be able to communicate with each other to support accurate, efficient and meaningful exchange of clinical data.

But we’re not there yet. Too many silos exist, preventing the vision of true interoperability.

On average, hospitals use 16 distinct EHR platforms, according to a recent report by Health Information and Management Systems Society (HIMSS) Analytics. And 62% aren’t using patient information outside their own EHRs because external providers’ data isn’t available within their workflows, a recent Black Book Research survey reported. Moreover, 57% of hospital network physician practices operating on assorted EHRs reported they continue to lack the financial and technical expertise to adopt complex interoperability, which are “compulsory to attain higher reimbursements built into value-based care initiatives by both public and private payers,” said Black Book Managing Partner Doug Brown.

EHRs key to addressing interoperability

Despite use of multiple EHRs, Black Book’s survey reported 85% of network physicians are looking to their core health system’s EHR to enable interoperability among integrated healthcare delivery providers and support the variety of data-intensive initiatives the industry must address.

As administrators reevaluate their IT resources to meet the requirements for value-based care, they should examine interoperability on three levels – foundational, structural or semantic interoperability.

  • Foundational interoperability enables data exchange without requiring IT systems to interpret data. This generally means two systems can exchange data, but a person is needed to interpret that information and what it means to a patient’s care.
  • Structural defines syntax of the data exchange, allowing systems to interpret data at the data field level, requiring less human interpretation. Much of the data that’s received can be reconciled into a patient’s healthcare record without extensive manual effort or data entry, enabling faster, more responsive and efficient care.
  • Semantic or advanced interoperability – the highest level – supports meaningful exchange of information among disparate systems. In the context of health care, this means providers will have the most relevant clinical data to a patient’s care depending on the setting of care and a patient’s condition.

By recognizing the varying types or levels of interoperability, practice administrators can identify their workflow requirements to make sure the data exchange works within their practice. With enhanced data, practices can make better decisions for patients, ultimately improving visibility across the continuum of care.

Reaching true interoperability: What to look for in a vendor

As the industry moves into the more advanced stages of meaningful use (MU) and other national initiatives, healthcare organizations will need to achieve advanced interoperability to succeed in the quality-driven healthcare landscape.

So, what should healthcare organizations look for as they evaluate new solutions to achieve full interoperability?

  • Connections across the continuum of care – For value-based patient care, it isn’t enough for physicians to just communicate. True interoperability requires the ability to connect with all types of healthcare entities, including between hospitals and ambulatory settings, health information exchanges (HIEs), labs, immunization registrations and more.
  • Seamless data exchange in multiple formats – To be effective, data must be able to easily move between EHRs, practice management systems and other applications, which are becoming more important with the growth of connected consumer health-monitoring devices. Systems should be able to handle multiple forms of information, including demographics, financial information, immunization records, appointment summaries, scheduling information, clinical documents, orders and test results. In addition, for the data that’s consumed within the EHR, the practice must have access to streamlined data reconciliation to effectively manage all data elements both within the workflow and in a user-friendly manner.
  • Centralized, cloud-based network – Point-to-point solutions, deployed on-site at a facility are pricey, hard to maintain and responsible for creating the silos that hamper interoperability. Cloud-based solutions offer a centralized platform that can be accessed by hospitals, affiliated practices and others involved in patient care.

By keeping these three features in mind, providers and practices can begin to evaluate new solutions that help break down the silos preventing them from achieving true interoperability and delivering on the promise of value-based care and population health initiatives.

Elizabeth Buckle is a manager, product management at Greenway Health, a health information technology and services provider.



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