Interoperability In Healthcare

The ability to effectively communicate and exchange information within the context of a healthcare system is critical, both for effective patient care and accurate medical coding. This concept is known as interoperability. Interoperability, meaning the ability of two or more systems or components to exchange information and use the information that has been exchanged efficiently and effectively.

Interoperability in healthcare harnesses the ability of medical systems and their surrounding technology (like devices and applications) to effectively use and exchange data. However, healthcare interoperability is more than just the ability to exchange data between systems. It also refers to the ability to access and use data within the context of a specific application. Healthcare interoperability applies to a huge range of different healthcare organizations and settings, such as:

• Hospitals
• Clinics
• Insurance companies
• Telehealth
• Other healthcare providers

The use of interoperability in healthcare allows these entities to access and exchange information in a secure, consistent, and efficient manner. Through this exchange of patient data, healthcare providers can ultimately provide better care and allow for better tracking and management of medical services.

So what is the main purpose of interoperability in healthcare? Definitions and applications can be broken down into two main uses: the exchange of health information between different applications and systems, and second, the use of the exchanged information by those different applications and systems to better healthcare outcomes.

Interoperability means that healthcare systems can communicate, share, and understand data or information more effectively than ever before. This is also because interoperability is broader than just computer-to-computer communication— interoperability also includes human-to-human and human-to-computer interactions.

Types Of Interoperability

There are several ways that the concept of interoperability can be applied within healthcare. Practical interoperability in healthcare examples include:

Electronic Health Record (EHR) Standardization

The most common application within healthcare is electronic health record (EHR) standardization. This type of interoperability enables providers to easily exchange medical records between different EHR systems. These software components enable two or more EHR systems to communicate with each other through a standardized protocol or language such as HL7 or FHIR (Fast Healthcare Interoperability Resources). 

By using these standards, different EHRs can be connected so that they can send and receive data from one another quickly and securely. This ensures that all relevant patient information is accessible regardless of which system it originated from, increasing compatibility between organizations and creating faster, smoother communications.

Application Programming Interfaces (APIs)

Another type of interoperability involves the use of application programming interfaces (APIs). APIs allow applications to communicate with each other over the internet or other networks without having to be manually integrated into one another. This type of interoperability has enabled various healthcare organizations to securely share data while still maintaining control over how the data is used and accessed. 

Web-Based Technologies

Various web-based technologies have been developed specifically for healthcare interoperability, such as:

• Health Level Seven International (HL7)
• Continuity Of Care Document (CCD)
• Direct Protocols
• Consolidated Clinical Document Architecture (C-CDA)
• QRXML protocols
• X12 EDI standards

These technologies allow for secure transmission of health information between different organizations while ensuring privacy regulations are followed at all times. There are many practical ways this can be applied, including specific examples of success.

Interoperability Standards In Healthcare

So what kind of standards and quality control applies to the world of interoperability standards in healthcare? There are many technical specifications and guidelines that allow for the secure exchange of data between different systems. These standards enable healthcare providers and vendors to access and store medical information more easily. Healthcare data standards define the structure of data, such as how it is organized and formatted, and are crucial to ensuring patient information stays protected. The American Healthcare Information and Management Systems Society (HIMSS) has identified these four levels of interoperability in American healthcare information and management systems. They include:

1. Foundational

Foundational interoperability focuses on technical aspects such as data exchange and the ability of systems to communicate with each other. It enables information standards like HL7, FHIR, and Loinc to be used to enable interoperability between different healthcare systems. Messages and documents can be exchanged in secure, machine-readable formats like X12 and C-CDA. 

Foundational interoperability can be facilitated through the use of Application Programming Interfaces (APIs) and open-source interoperability frameworks like OpenMRS or InterSystems HealthShare.

2. Structural

Next, structural interoperability focuses on the ability of an individual system to receive and store data from another system in a standardized way. This could involve the use of standard clinical models like the Open Health Information Model (OHIM) to ensure a consistent mapping of data across different healthcare systems. This could involve using standard communication protocols like HL7 that allow for the successful exchange of information between healthcare systems. It may also include the use of authentication and authorization protocols to ensure secure data exchange. 

Semantic interoperability focuses on the ability of two systems to interpret data exchanged between them in the same manner. This process also sometimes uses standardization of terms, (such as the International Classification of Diseases (ICD) codes), to ensure that systems can agree on and interpret data that has been sent and received. 

This concept sometimes also might include the use of common metadata that describes data and provides context and meaning to enable systems to accurately interpret the data exchanged, as well as the use of natural language processing (NLP) to bridge the data gap between different systems.

 3. Semantic

Semantic interoperability involves a deeper level of understanding and cooperation between different systems. It ensures that the meaning of the information being shared is consistent across systems and is facilitated through the use of standard terminologies such as SNOMED CT and ICD-10. Semantic interoperability enables computers to communicate more efficiently and enables effective data exchange. This can help improve many processes in the healthcare setting, such as patient care and medical research.

 4. Organizational

Organizational interoperability is achieved through collaboration between healthcare systems and involves the creation of organizations that facilitate data sharing between systems. It involves the use of national standards and policies to ensure consistent data sharing across organizations and includes initiatives such as Direct Messaging that enable data to be securely exchanged between healthcare providers.

Interoperability Standards Examples

So what is the interoperability standards advisory, or is there an official one? In recent years, several organizations and laws have also been established to help aid the goals of interoperability. For example, the Interoperability Standards Advisory (ISA) was established by the Centers for Medicare & Medicaid Services (CMS) in 2017 to guide on selecting appropriate standards for health information exchange. The ISA helps organizations identify which standards best meet their needs while also promoting a consistent approach across all stakeholders involved in health care delivery. 

Then in 2020, the CMS Interoperability Rules were issued as part of an effort to improve access to electronic health information for patients and providers alike. The rules require health plans participating in Medicare or Medicaid programs to make patient claims data available electronically via application programming interfaces (APIs). They also require providers who receive Medicare or Medicaid payments to use certified electronic health record technology (EHRs) that support APIs for exchanging patient information with other providers or payers.

A year later, the CMS Interoperability and Patient Access Final Rule was issued in 2021 as an extension of the 2020 rules and legally requires various healthcare organizations and care centers to make patient records available through APIs when requested by patients or their authorized representatives.

For the best possible outcomes to occur each time, interoperability standards examples are necessary. The rules and guidelines that they provide help to ensure that information is exchanged securely and accurately across different systems. These standards allow for the exchange of patient health information between different systems while ensuring accuracy and security. Relevant examples of data standards in healthcare include:

Semantic Interoperability

Semantic interoperability refers to the ability of two or more systems to understand each other’s data. This allows for accurate communication between various systems and organizations, which can lead to improved patient care. Structural interoperability examples include the use of common formats such as XML or JSON when exchanging data between two or more systems. This ensures that the data is properly structured so that it can be easily understood by all parties involved in a transaction. 

Clinical Data Exchange

Types of interoperability in healthcare also include clinical data exchange, which enables providers to share clinical records with other providers within an organization or across multiple organizations. This allows for better coordination of care and improved outcomes for patients by providing access to relevant medical information quickly and efficiently. Additionally, electronic health record (EHR) interoperability enables healthcare providers to access patient records from multiple sources, allowing them to make more informed decisions about treatments and medications based on a comprehensive view of a patient’s medical history. 

Cost Reduction and Efficiency

Interoperability is essential in healthcare contexts because it helps reduce costs associated with inefficient manual processes, improves the quality of care through timely access to accurate information, enhances safety by reducing errors caused by manual processes, and increases efficiency by streamlining communication between various stakeholders involved in providing care to patients. Interoperability also facilitates population health management initiatives, such as disease surveillance programs, by enabling real-time access to aggregated data from multiple sources. 

 Improved Patient Outcomes

Last but by no means least, interoperability plays a key role in improving outcomes for patients while reducing costs associated with inefficient manual processes in healthcare contexts. It supports and aids in secure communication between stakeholders involved in providing care while ensuring the accuracy and timeliness of shared data among different organizations across the industry.