Interoperability - Healthcare, Mayo Center for Innovation

3 Reasons Why Interoperability is a Word Everyone in Health Care Should Know

Post Written By Paul Nordlund from the Center for Innovation

HIMSS 2016 has come and gone and the adrenaline rush from attending has finally started to wear off. Attending a conference that challenges our current Health Care IT structure as well as presenting and pushing us into the next step of interoperability and integration, is nothing short of exhilarating. One of the most unexpected discoveries I saw was a use case for drones as remote delivery of first aid gear to stranded people in remote areas by Miami Children’s Hospital.

If you asked me, which I was asked to do, to sum up HIMSS 2016 in one word it would be: Interoperability. The ability to share patient data across all the current EMR/EHR systems and be accessible from one standard interface.

There is a universal standard that is now coming into place for Health Care IT called Fast Healthcare Interoperability Resources (FHIR), which is the standard for exchanging healthcare information electronically. This is going to bring health care interoperability into the modern era with fast development of patient programs and portals, app store-like development across health care systems, and access across the full spectrum of patient data. There are three great advantages for interoperability to finally come into it’s own.

For the Patient

Rather than having you as a patient sign into multiple portals and being responsible to reconcile all of your own data, with FHIR and interoperability in place you will have the ability to access all of your data across all of the health care delivery systems through one portal or interface. Access to the information, analysis, synthesis, and application of that data will be significantly simplified compared to the current system. So the next time you visit your provider you will be able to say, “Here’s all of my data” without needing to carry a banker box full of records that you aggregated yourself from across multiple Health Care sites and systems.

For the Provider

Just as the patient will see enhancements in their ability for data access and solutions around their health records, there is a lot of work going on for the provider side as well. With the new interoperability providers will have enhanced visibility around patient data: longitudinal data, data coming in from other providers, and better synthesis from multiple records. For example, one enhancement that will be easily recognized will be with the use of health risk calculators. If you think of the heart health risk calculator, instead of every hospital system needing to develop their own standards and algorithms, we will be seeing these calculators needing to only be written once with the SMART on FHIR app development, and the provider will have access to the best standards to help their patients.

For the IT Side

Each of the primary EHR vendors has made a pledge to interoperability and the use of FHIR standard compliance and full data release. Various Centers for Medicare & Medicaid Services (CMS) authorities are even letting it be known to report providers who may not be sharing all or providing all of your data, because there could be penalties applied if there is information being blocked. It’s now being recognized as a national interoperability standard and practice. By standardizing this level of interface, what we are hopefully getting to is unleashing an entire new world for an app-based ecosystem of Health Care solutions, much like the app stores we have for our smartphones. What that means is that you can write a Health Care app once, and deploy it across any EMR/EHR system that supports the SMART on FHIR standard. In fact, there are already prototypes out there around the SMART on FHIR app stack you could find out there on the web right now. This would allow us to deploy an app not only across the three Mayo Clinic sites, but our affiliate network as well in one shot.

The tenets of this initiative include improved consumer access to their records, no information blocking, and implementing federally recognized national interoperability standards and practices. Nearly every big name in healthcare technology has pledged to use standardized APIs, to make patient access easier and to not block information, Department of Health and Human Services Secretary Sylvia Burwell announced during her HIMSS16 keynote Monday night. Read the story. 

It goes without saying that with any advancement come concerns that must be addressed. The first concern that we all have is around privacy and security. What is the exposure of my data, what are we opening ourselves up to? How vulnerable will this be to hackers? Security and privacy are two huge areas that absolutely have to be managed to have this be an effective and efficient system and deployment.

The second concern many addressed at HIMSS this year is around a national security identification system. This need is integral so that we are sure we are accessing the correct data for the correct patient every time we use our EMR/EHR interface. Somehow a standardization around patient identification and access is still needed, whatever form that may take.

By using data points such as name and birthday, we run the risk of multiple errors in patient access to the wrong data, and this can bring an impediment to implementation of proper interoperability to take place. From a national standpoint, you run the risk of having dozens of people that have identical names and birthdates. Whether this identification takes the form of a national ID database, or another form, this hurdle will address concerns of your data privacy and proper care from providers.

On the whole, the benefits of interoperability continue to push the conversations and solutions forward towards implementation. Knowing what hurdles lay ahead allows us to prepare and overcome them, and ultimately prepare us to put the needs of the patient first.