Interoperability

Patients who see multiple providers benefit greatly when their healthcare is appropriately coordinated. The primary care provider who is able to see visit notes and test results in the patient’s electronic health record (EHR), input by a specialty provider, is better equipped to work with the patient on improving their outcomes. The link between EHR interoperability and primary care is critical for the patient’s health and the practice’s success.

Making the right data available at the right time to the right people is the key to EHR interoperability. Improved workflows and reduced ambiguity are two of the major benefits for both providers and patients, as interoperability allows data transfer between EHRs and between healthcare stakeholders.

EHR technology standards are critical in creating an interoperable environment, including:

• How applications interact with users (such as e-prescribing)
• How systems communicate with each other (such as messaging standards)
• How information is processed and managed (such as health information exchange)
• How consumer devices integrate with other systems and applications (such as tablet PCs)

Interoperability is essentially the ability of different information systems to access and exchange data in a coordinated manner, to provide seamless and timely portability of patient information. The process results in the optimization of the patient’s health outcomes.

There are four levels of interoperability, as defined by HIMSS:

• Foundational (Level 1): Establishes the inter-connectivity requirements needed for one system or application to securely communicate data to and receive data from another
• Structural (Level 2): Defines the format, syntax and organization of data exchange including at the data field level for interpretation
• Semantic (Level 3): Provides for common underlying models and codification of the data including the use of data elements with standardized definitions from publicly available value sets and coding vocabularies, providing shared understanding and meaning to the user
• Organizational (Level 4): Includes governance, policy, social, legal and organizational considerations to facilitate the secure, seamless and timely communication and use of data both within and between organizations, entities and individuals. These components enable shared consent, trust and integrated end-user processes and workflows

The link between EHR interoperability and primary care can be seen in the results for the patient and the provider, including:

Reduced errors. When data is shared across systems and applications, the rate of medical error deaths is significantly reduced. It also gives providers insight as to how such errors can occur, so they can take action to further prevent them. To be fully effective in reducing medical errors, EHR interoperability must extend externally across healthcare organizations.

Increased efficiency. Consistent access to patient data in real time can mean the difference in the patient’s health and safety. When patients see multiple providers, data availability is crucial. Interoperable data can further enable the provider to quickly identify the cause of a patient’s medical issue, enabling the provider to make quicker, more informed decisions as to the patient’s care. The increased efficiency seen as a result of interoperable EHRs also reduces repetitive and administrative tasks, which can aid in reducing the provider burnout rate and impacting the quality of care.Improved patient experience. Beyond the coordinated care that can improve the patient’s outcomes, EHR interoperability also improves the security of the patient’s information. Protected health information (PHI) is more secure when the data is entered into an interoperable system. The patient’s privacy is better protected and patient-facing tasks, such as completing multiple, sometimes duplicate forms, are reduced or eliminated.