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Health Data Interoperability: We Have the Tools We Need — Let’s Use Them


Health data interoperability can encompass different types of data: Clinical data, social determinants of health (SDOH) data, community-based organization (CBOs) services and appointments data, and claims data, to name several.

Health data interoperability can involve many parties: Patients and families; providers, surgery centers, lab and imaging centers, hospitals, health systems and pharmacies; dentists; allied health personnel; public health; community-based organizations; state agencies; payers; and so forth.

For purposes of this short discussion, I will narrow the scope to clinical data used at the point of care with providers and health care facilities. I would argue that to ramp up interoperability, we don’t need to invent any more tools right now — we just need to make it easier for more providers to make better use of existing tools.

The exchange and use of clinical data leads to the most demanding definition and the most important use case. The working definition of interoperability is to render patient information coming from outside your organization just as timely, useful, and organized to providers and patients as data already within your organization. The most important use case is having sufficient information at the point of care so that the provider is fully informed and the patient derives maximum benefit.

Most providers use multiple electronic tools to collect patient information, not including fax or efax. The five main tools providers use today include hospital event notification, Direct Secure Messaging (like secure email), a local or regional health information exchange (HIE), a national HIE like Carequality, and a single electronic health record (EHR) vendor’s HIE, like Epic’s. Each tool comes with national data standards. The current mix of available tools, if implemented, can adequately inform providers at most care transitions.

One way to measure interoperability at the hospital level is to look at their ability to do the following tasks: Send data, receive data, search and query data, and integrate the data into the hospital’s EHR. In 2019, 55% of hospitals were able to do all four functions. For office physicians, only 10% were able to do all four functions, and only 29% were able to do the single function of integrating outside records into their office electronic medical records (EMRs). Without EMR workflow integration, outside patient information requires extra steps. Hence, fax machines persist in physician offices, the last bastion of this technology.

The standards are now in place for exchange of most of the clinical information needed for routine care — the trick is to get providers and health systems to use the standards-equipped tools. Essentially all EHRs and EMRs are now certified to exchange data with these standard tools, but providers are not required to use the tools. Even with EMR certification, providers incur additional cost and need technical assistance to turn on the exchange functions in their EMRs. Let’s apply newly available funds to assist providers, including dentists, behavioral health and post-acute care, with acquiring interoperable electronic records and using these tools.

To increase interoperability now, we need to approach each provider or provider group and understand which outside organizations they most need to exchange data with. That analysis will suggest which one or more of the five current tools they need to implement and integrate with their EMR. Until then, slow and steady gap closure, using one or more available interoperability tools, wins the race and moves everyone forward with repeatable, standardized exchange tools.

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