Chasing the tail of interoperability

By Gary Palgon
08:19 AM

Cat and dog owners know that pets that chase their tails will eventually catch them – but they won’t stay caught for long. Healthcare providers who manage the exchange of health information understand the feeling.

As health systems, physicians and other providers implement solutions to enable the exchange of health information across departments or specialties, the typical first reaction is to mark “achieve interoperability” off the to-do list and move on to the next item. Unfortunately, however, achieving interoperability is not a once and done activity. Just as your pet has to repeatedly catch its tail, healthcare leaders must continuously monitor and update systems to ensure the optimum, ongoing exchange of data.

There are several reasons to maintain interoperability standards. For example, as interdisciplinary diagnoses and treatment plans increase, the ability to access patient records across the continuum of care is not just a matter of maintaining compliance with regulations; it is also an integral part of an organization’s competitive edge. Access to real-time information that enhances cost savings and clinical quality attracts and retains patients – as well as payer contracts.

Although accessing patient information and maintaining interoperability is a constant task for hospitals and health systems, it doesn’t have to be a hassle. The first step is to understand that “interoperability” means more than just “connectivity.” Organizations seldom encounter ongoing challenges with connectivity, yet the language – or semantics – used across different disciplines changes frequently.

Even when disciplines share the same semantics, changing regulations, such as the conversion from ICD-9 to ICD-10, require updates to health information exchange platforms. Physicians may still write a diagnosis of “breast cancer,” for instance, but ICD-10 will create a multitude of new codes that describe the patient’s specific breast cancer for reporting and billing purposes. These changes require new formats that categorize the roughly 68,000 codes [1] in ICD-10-CM and “translate” them into language that is accessible by all.

Changes affect all communications

It is not just diagnosis or procedure codes that require updates to enable information exchange. Physicians have always had to rely on clear communication with device suppliers regarding such information as the sizes, dimensions and capabilities of artificial knee and hip joints, for example, to find the best solutions for patient needs. When issues with defective joints were discovered, regulators began requiring providers to document the serial numbers for all implanted devices. As a result, new fields in the data record also were required.

Maintaining the staff resources and expertise to monitor and implement the many changes like these is a challenge for any organization, yet staying up-to-date on new standards is just one interoperability challenge faced by hospitals and health systems. Not only must an organization be able to add new users to a system who use disparate technology, it must also be able to support data exchange among users who have different versions of the same systems. While some data exchange participants routinely update software to the latest version, others do not. The latest updates must be made available, but the organization must also be able to support users who choose not to update their programs.

Cloud-based solutions provide an effective solution to the data exchange resource challenges faced by healthcare organizations. The cloud’s economies of scale enable an organization to:

  • Rely on a third party to devote staff resources to monitoring and maintaining current standards to enable interoperability;
  • Address standards updates simultaneously for all users of a data exchange — a far more cost-effective and efficient process than tweaking and massaging software at each user’s location; and
  • Centralize the updating function to ensure the most current standards are in place for everyone’s use.

In addition, moving the responsibility for adjusting interoperability platforms to meet new standards out of the healthcare information technology department frees in-house staff to address the day-to-day needs of the organization.

As researchers, regulators and healthcare professionals continue to identify ways to enhance the patient experience and clinical outcomes, interoperability standards will continue to change. Fortunately for healthcare organizations, there are options available for helping to maintain data exchange platforms. Whether technology is being used to foster care coordination as part of an accountable care organization or identify new protocols for population health management, cloud-based solutions can help cost effectively manage and update it. This keeps in-house staff focused on the organization’s immediate needs, rather than continually chasing the tail of interoperability in today’s changing healthcare environment.

[1] (Accessed July 25, 2013.)

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