Healthcare News & Insights

IT interoperability: Future outlook for hospitals

170883656One of the biggest challenges for hospitals with electronic health records (EHR) systems has been interoperability. It’s rare for different EHRs to transmit patient information seamlessly, although that was a key selling point for digitizing medical records.

As a way to give hospitals, providers and EHR vendors a better idea of what’s required to achieve this goal, the Office of the National Coordinator for Health Information Technology (ONC) has just released a new report, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap.

According to the report, federal IT officials want hospitals and other healthcare providers to make bigger strides toward interoperability with all forms of health IT, including EHRs, mobile devices like tablets, and digital medical devices that record patients’ vitals.

By the end of 2017, the feds want “individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level.”

Given the current state of electronic health information transmission, this may seem almost impossible to achieve, but the feds have a plan in place to help improve electronic information exchange. And it’s designed to address some of the biggest roadblocks facilities have with interoperability.

4 problems with data exchange

Currently, there are several barriers healthcare providers encounter when trying to share information electronically. Four big issues highlighted in the ONC report are:

  1. Electronic health information isn’t standardized across different systems. So once it’s transmitted, the facility or provider that receives the data often can’t interpret it effectively – or in some cases, even access it at all.
  2. There’s often a misunderstanding of the rules and regs that govern the sharing of electronic health information. That allows facilities to institute guidelines for sharing patients’ health data that may be unnecessarily restrictive.
  3. There isn’t currently enough incentive for facilities and providers to share information. The feds specifically highlight a lack of financial incentive, but there’s also the fact that the hassle just may not be worth the work for many hospitals and doctors right now.
  4. When electronic health information is shared, it’s only done among narrow networks of providers and hospitals. It’s not done on a nationwide scale with multiple different networks. And there’s no easy way to make that happen.

Hospitals are likely already aware of these problems – experiencing them on a daily basis when trying to electronically transmit discharge summaries and patients’ health records to various physicians and specialists.

The feds are aware of them, too – and they’ve proposed some specific strategies to deal with them.

Government’s response

One critical way they’re dealing with these problems is by working to establish clear rules hospitals and vendors must follow when it comes to interoperability with health IT, and how they relate to existing rules such as HIPAA guidelines. Details about these rules will come from the ONC in the near future.

The office will also put a specific process in place to address any issues with implementing or operating new health IT systems that may affect the seamless transition of health information, including technical issues. And it will hold facilities (and vendors) accountable for achieving interoperability.

While this does mean hospitals will have more federal scrutiny on their electronic data transmission process going forward, they won’t be flying blindly in the dark anymore trying to figure out what they need to do to achieve interoperability.

And to make interoperability more worthwhile to hospitals and providers, the ONC will place a significant focus on giving financial rewards to healthcare entities that meet federal targets for electronic data transmission.

These rewards will be separate from other existing IT incentive programs such as meaningful use, showing the feds are committed to advancing the exchange of electronic health information.

Standardizing data

Besides making rules to govern interoperability, the ONC will also be focusing on establishing common technical standards and a common clinical data set for health IT programs such as EHRs.

Technical standards will be based upon a program’s ability to transmit both clinical documents (e.g., care summaries) and specific data elements (e.g., a patient’s blood pressure reading).

The use of a common clinical data set among all health IT systems will help the feds create standards for what kinds of patient information must be transmitted among hospitals and providers. Ideally, the feds would like the standardized data set to include the following details:

  • patient’s name
  • gender
  • date of birth
  • race/ethnicity
  • preferred language
  • smoking status
  • problems
  • medications
  • medication allergies
  • laboratory tests and results
  • vital signs
  • care plan fields, with goals and instructions
  • procedures
  • care team members
  • immunizations
  • unique device identifiers for any implantable medical devices, and
  • provider notes.

While most EHRs have the capability to save this information about patients, it’s not always organized in a way that makes it simple to transmit across multiple platforms and different systems. Fixing this will help providers across the nation more easily share patient data with one another.

What to do now

We’ll keep you posted on any further plans the ONC makes to establish specific rules and regs for interoperability with healthcare IT.

In the meantime, it’s a good idea to start a conversation about your hospital’s capabilities for electronic information exchange with your EHR vendor and your IT department, keeping this framework in mind. Be sure to not only consider the interoperability of your EHR, but that of any other devices or equipment in your hospital that capture patients’ health information.


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  1. The push for health data interoperability won’t work unless
    the approach is modernized. The problem is not that engineers don’t know how to
    create the right technology solutions or that we’re facing a big governance
    problem. Rather, the real cross-industry issue is much bigger: Our approach and
    the methods we have chosen for integration are opaque, decades old, and they
    reward closed systems. One big problem is Most health IT systems create their
    own custom logins and identities for users, storing metadata about roles, permissions,
    access controls, etc., in an opaque part of a proprietary database. Without
    identity sharing and exchange, there can be no easy and secure application
    integration capabilities, no matter how good the formats are. ONC should
    mandate that all future EHRs use industry-neutral and well supported identity
    management technologies so that each system has at least the ability to share