PJ Carter in a blog explained how the lack of interoperability resulted in extreme physical pain to his father who had to go into an eye surgery for the repair of a detached retina. His father was told by his eye specialist that and an urgent operation had to carried out. The operation began, but doctors could not access the past medical record of his father. Since doctors were unaware of the medical history, they had to carry out a painful operation of the eye without anesthesia! His father was awake the whole time and had to endure the pain.
Healthcare industry is lagging the most when it comes to advancements. There have been innovations, but equal implementation has been lacking. The cost of care has risen to over $10,000 per person in the US because there is huge expenditure on various digital infrastructures, but not for the meaningful use of them.
Interoperability and Its Types
Interoperability is a term that has no single definition. In broad terms, interoperability is the ability of systems and devices to exchange vital information and interpret it. For healthcare, interoperability is the ability of computer systems in hospitals to communicate, share critical information and put it to use to achieve quality health services delivery.
There are three levels of health information technology interoperability:
Scope of Interoperability
There has been a dramatic increase in population, and with that came the need to manage population health. The amount of information increased exponentially with the use of EMRs. They helped in storing the increasing information, but sharing was still doubtful.
In 2005, only about 30% of the entire group of office-based physicians and hospitals used basic EMRs which increased to 75% for hospitals by the end of 2011. The state of Indiana now connects more than 10 million patients across 80 hospitals, and about 18,000 physicians use this data.
How long till 100% Interoperability?
It has been accepted that health care, as a single entity, faces challenges in the exchange of information. Even the pioneer EHR vendors admit that although they have some complex connections established, not all of them were successful. According to a report, less than half the providers were satisfied with the way their information exchange was taking place. Stakeholders involved have always been concerned that EHRs, even the ones for Meaningful Use 2, are unable to share data effectively.
In the latest ONC report, it was mentioned that if all the providers were to come down to a common consensus, there happen to be two barriers on the road to complete interoperability. One, discord on how data should be transmitted. Second, a lack of proper infrastructure which is equipped enough to transmit data nationwide. It is very critical that the technology being used is updated and standardized to ease the flow of patients’ vital information to avoid any probable mishap.
Persisting problems in the path of interoperability
The Need of The Hour
System interoperability is all about multiple devices and systems exchanging their information and spelling them out meaningfully to simplify the process of information sharing, and this is what makes it the Holy Grail of the healthcare industry. In 2014, ONC released a ten-year roadmap to interoperability and here are some key milestones to be achieved in that roadmap in the coming years:
2017: providers and patients can send, receive and make use of a basic set of vital health information.
2020: Access to granular information and expanding the uses gradually.
2024: Self-learning healthcare systems.
A survey interviewed 220 providers, and almost 82% of them felt at least moderately successful when it came to achieving interoperability. Though only 6% of the providers could access information from exchange partners on a different EMR system effectively enough to improve patient care and which shows that we are only at the tip of the iceberg.
The Road Ahead
The ONC has realized that in this phase of transition from volume to value-based care, interoperability is a must and has taken a few steps to accelerate this development:
Even under MACRA, health IT interoperability plays a crucial role as health systems equipped with interoperability would benefit physicians planning to participate in an advanced alternative payment model. Moreover, the health systems eligible for MIPS need to meet specific health data exchange requirements that depend hugely on interoperable systems. With a new administration, we can be assured that all the initiatives associated with interoperability will not only be backed, but grow exponentially.
Not a long time ago, 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!
As the healthcare industry moves from fee-for-services to fee-for-value, much needs to be done to sustain the change and evolve with it. New measures need to adopted: right value, right care, and right living; and with these new measures, new pathways have to be developed to reach the point where every citizen can afford quality healthcare. But more than anything, the entire healthcare industry should strive towards attaining health IT interoperability- a high priority, but only partially realized.
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