Why is Interoperability considered the champion of Value-based care?

One size does not fit all- a concept, everyone in the world has to wrap their heads around at some point. Even in healthcare, there are several types of EHRs, wearable technology, cloud storage, and several data repositories and still, with significant advances in technology; a seamless data-sharing environment is yet to be seen.

Imagine a French-speaking individual trying to have a conversation with a person who only speaks Japanese. How effective will their conversation be? Now bring a third multilingual person who can speak both French and Japanese into the picture. Using a translator, the French and the Japanese can have an effective understanding of the information that each is trying to relay. The lack of a common way of data sharing requires nothing but an interoperable health IT environment.

Interoperability in Value-based Care has been a buzzword for quite a while, and rightly so. The progressive first steps in Value-based care require an ability to send and receive data and utilize that in a meaningful manner. To create an interoperable ecosystem, it is important to know exactly what it does and how it helps to succeed in the process.

Interoperability and its types

Interoperability, in simple terms, is the ability of data systems to exchange data and to use this data in a meaningful manner. The basic purpose is to enable a smoother exchange of data amongst different health information systems. The Healthcare Information and Management Systems Society (HIMSS) has divided interoperability into three layers:

The first layer is Foundational Interoperability. This entails the most basic of data exchange wherein data present in one HIT system can be received by another. However, it doesn’t require the receiving system to interpret the data.

The middle layer, Structural Interoperability defines the structure or format of data exchange through some pre-described message standards. Structural interoperability allows a uniform movement of health information from one system to another, avoiding any alteration and promoting the security of data.

The highest layer which is Semantic Interoperability is the ability of systems to exchange data and make use of the information. The information to be shared is encrypted, both the systems can exchange data, and there is a common platform that ensures there aren’t any technological gaps.  

Creating an interoperable health IT ecosystem

The amount of data in healthcare has shot up tremendously. About a decade ago, 9 out of 10 doctors updated their clinical records by hand and stored them in reams of papers. Today, it is expected that before 2017 concludes, about 90% office-based physicians in the U.S. would be using EHRs. Health records are changing, and a space as complex as healthcare can’t afford flawed data-sharing because of these reasons.

1. Data sharing among organizations: First of all, healthcare organizations face challenges in exchanging vital information. Almost 87% office-based physicians and 96% hospitals are using EHRs, and not all EHRs have been created equally. Providers should be able to collect, access, and share data across different platforms to ensure coordinated and timely care.
2. Effective population health management: Secondly, effective population health management requires consistent and accurate data quality. More than half of ACOs face challenges with the basic step of collecting and sharing data, let alone deriving insights from it, and making activity-based costing a barrier due to lack of better interoperability standards.
3. Overall patient care: No matter the number of barriers, the health of every and any patient has to be the priority. The patient is the ultimate benefactor in healthcare and inadequate interoperability should be the last thing affecting the delivery of overall, quality care.

Succeeding with interoperability

Accountable Care Organizations have interoperability as their foundation. Without a common platform to share data and workflow differences, ACOs can’t succeed in delivering quality, timely care to their patients. By encouraging a common standard for data sharing and streaming all vital network information into a single stream of truth, an increasing proportion of ACOs has generated savings above their minimum savings rate each year. 120 out of a total of 392 ACOs (31%) managed to generate savings above their Minimum Savings Rate in Performance Year 2015, as compared to 92 out of total 333 ACOs (28%) in Performance Year ’14 and 58 out of 220 total ACOs (26%) in Performance Year ‘13.

Additionally, by using health information exchange, a value-focused organization was successful in reducing total office visits by 26.2% and increasing the number of scheduled telephone visits to the hospital by eight times.

The upward trajectory shows nothing but the significance of interoperability and how it is a basic requirement that goes a long way- ensuring EHR adoption, improve information sharing, and digitizing healthcare across the country.

Challenges that remain

True, healthcare interoperability has witnessed great progress. Yet, providers and stakeholders struggle to leverage existing information sharing capabilities. There happen to be some major barriers on the road to complete interoperability:

• Inadequate standards and getting stakeholders on board with one common way to send and receive data.
• A lack of proper infrastructure equipped enough to transmit data nationwide.
• Inadequate budgets to implement health IT infrastructure within healthcare organizations.
• Information Blocking by some vendors is also very common. Despite its illegality, some vendors keep selective information blocked for a period and later offer that for a raised price.

The Road Ahead

The increasing focus towards value-based care models means that interoperability is a must-have to meet quality standards. There is no quick fix to the challenges interoperability face. The challenges may be daunting but as healthcare stakeholders work together to drive the adoption of standards enabling seamless data exchange. Along with that, it’s equally important to address the technological and financial aspects associated with effective interoperability.

To bring the continuum of care to a full circle and tap the potential of digital health, interoperability must be recognized and realized. An interoperable health IT ecosystem is much more than effective communication that will help improve the quality of care, it’s about striving to deliver better care to communities, and lower healthcare costs and in turn, lead us to value-based care.  

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