Sensmeier on integration and interoperability

By Bernie Monegain
08:45 AM
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Interoperability

The umbrella of informatics is fairly broad. Really it’s applying technology to a particular area. So, in this case, it’s applying it to healthcare. It’s analyzing what components of technology are necessary to improve things. As you apply it to interoperability, for example, it’s taking a look at the components that you need to allow systems to communicate. I see my role as nursing informatics, but in interoperability and IHE (Integrating the Healthcare Enterprise), it takes it more broadly beyond nursing.

The umbrella of informatics is fairly broad. Really it’s applying technology to a particular area. So, in this case, it’s applying it to healthcare. It’s analyzing what components of technology are necessary to improve things. As you apply it to interoperability, for example, it’s taking a look at the components that you need to allow systems to communicate. I see my role as nursing informatics, but in interoperability and IHE (Integrating the Healthcare Enterprise), it takes it more broadly beyond nursing.

Every couple of years we do a survey of our nursing community at HIMSS. For a number of years, their response to the question: ‘What is the biggest barrier that you see to being able to do your job well?’ their response has been typically finance – getting enough resources to do their job as they would like to do it.

The last time we did that survey in 2011, the response was lack of interoperability. I found it extremely interesting that now nurses in the informatics role understand that for the systems to really give the nurses information that they need, they need to be interoperable.

At the point of care, the nurse would really want to have information about that patient regardless of care setting. So if a patient came from a nursing home or a long-term care site to have that information pulled forward. If they came up from the emergency room rather than have to get on the phone and wait for that face-to-face or phone dialogue about the patient, that information should be available through the system.

That’s giving a simple example within a hospital environment. The whole idea is it’s critical to have all of the data that you need to give effective patient care. Nurses understand that.

The other thing I believe that’s happening with mobile healthcare and with mobile devices being connected with the systems, there are even more places of disparate data where, for example, vital signs, are being captured on machines – and that should flow clearly and safely into the electronic health record. To do that we have to have interoperability solved to have nurses be able to take advantage of that. So I’m kind of intertwining my nursing background with giving a case for why interoperability is important.

We’ve been working on IHE for about 11 years. We have developed a very comprehensive technical framework that describes how standards should be implemented in electronic health record systems so that they can communicate from a Cerner system to a Siemens system to an Epic system, etc. Every year we have a Connectathon where we host the testing of that work. Vendors can come and bring their systems and do the testing to see that first of all they’re complying with IHE specifications, but secondly that they’re able to have information flow from system to system.

What’s been interesting is that the Connectathon now is being used for other purposes including the vendors working with each other to resolve problems before they go to a customer site. Another use this year was that the health information exchanges came and were beginning to test with each other to see how the information was pulling in. They were using IHE specifications to make that health information exchange be realized. So they were using the Connectathon to test that out. That’s been a very important product that we have built as a result of our IHE effort.

The last piece of that is what we see at the HIMSS conference and that is the Interoperability Showcase. That has grown hugely. We have a very large component of that that shows the Office of the National Coordinator and the different projects that they have funded and now are beginning to realize interoperability as well across the federal agencies. The vendors are participating in IHE and using real world cases.

Both of those events – the Connectathon and the Interopeability Showcase at HIMSS have grown exponentially. We had nearly 500 systems engineers at the Connectathon and about 140 vendor systems there that were being tested.

Then at the Interoperability Showcase, I think it’s about 80 vendors participating in that this year. So, these are two examples of efforts that HIMSS has invested in that I try to help lead and influence. Multiple individuals and companies and organizations and government agencies participate to move this big snowball up the hill.

The Connectathon has been going for 11 years. The Showcase has been since 2006, and that was really my project, initially, sort of my brainchild, so to speak. But, it has grown way beyond my initial thoughts. It was originally more focused on IHE’s – vendors that were implementing IHE and then it grew to incorporate all standards-based health information exchange – primarily IHE, but not exclusively anymore.