What is cloud-based interoperability?
Cloud-based electronic health records (EHRs) provide the independent physician with security as well as cost savings over server-based EHRs. When the EHRs are in the cloud, much of the burden is shifted to the Software as a Service (SAAS) provider, including maintenance and updates, which enables the practice to spend fewer resources on the system itself and to spend more time with patients.
In simple terms, interoperability is the ability of these cloud-based systems to communicate with each other. In more technical terms, it is the capacity of multiple information systems, devices, or applications to exchange information in a collaborative manner, and to use that information to optimize the health of individuals and populations. Data is then more readily available for use without additional support from the end user.
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A white paper published by the Cloud Standards Customer Council states that, in cloud computing, the most significant interacting components are those that belong to the cloud service customer which interact with components of the cloud service provider. The nature of the interaction is a network connection using a prescribed interface or application programming interface (API).
There are typically multiple separate interfaces, each dealing with a different aspect of the cloud service. For example, there are the functional interfaces of the cloud service itself, authentication and authorization interfaces, interfaces for administration of the cloud services, and business interfaces for billing and invoicing. The ideal of interoperability is that the interfaces are standardized in some way – i.e., they are interoperable.
By introducing technologies that deliver providers the data they need in a seamless fashion across organizational boundaries, interoperability empowers healthcare providers to effectively address the health of the individuals in their communities.
Instead of the independent practice having to store data on a PC drive, in a cloud-based EHR the information is backed up virtually through structured procedures and protocols. Cloud-based systems decrease the likelihood of a cyberattack and, in the rare event of data loss, the automated data backup process in the data center or cloud makes recovery easy. Patient data is safe and secure, and easily shared with others who need the information, in a cloud-based, interoperable EHR solution.
The Healthcare Information and Management Systems Society, Inc. (HIMSS) has defined a set of recommended metrics that can guide measurement activities to produce richer data capture and a more robust understanding of the interoperability landscape, including:
1. Basic transactions, defined as the ability of two or more technologies or systems to exchange information in a way that can be natively used by the receiving system. This metric would measure the volume and type of transaction. It is suggested to measure these transactions as follows:
2. Partners and/or stakeholders that the interoperability network or market supplier supports. These may include measurement of exchange on an individual level, i.e., between patients, providers, payers and other authorized entities, and at the population level, i.e., registries, reporting, etc.
3. Standards used in the transactions. Proposed metrics include capturing message type such as identity, admission, orders, results, referral, discharge, etc.
4. Transactions defined by profiles such as IHE, an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information, implementation guides, and test venues.
5. User characteristics such as bed size or number of registered network users, i.e., clinicians, rural, or urban locations, etc., to understand the settings using interoperable transactions.
6. Timing of these transactions, i.e., whether the information is sent real-time (<15 minutes), delayed, or as a batch at a later time.
7. Volume of transactions for each of the technology types as well as network-reported trend data in the form of significant increases or decreases or being flat.
8. Future plans, e.g., one to two years, to expand on types of transactions a healthcare setting plans to support.