When it comes to information access, modern customers have high expectations, and many increasingly expect to have immediate and ongoing access to records regarding their health and care. As a result, many healthcare institutions are constructing health information exchanges (HIE), which are specialized networks that rely on interoperable technologies to seamlessly and securely transfer electronic health information.

Although the adoption of EHRs was a positive first step in the creation of HIEs, there are still many issues that must be resolved in order to reach the level of interoperability needed to fully benefit from HIEs. Many healthcare providers and systems use customised EHR systems that can be challenging to convert to a standard format and share with others, despite the increasing popularity of standard record formats like FHIR and HL7 and the requirement of EHR vendors to provide APIs that support interoperability under new regulations. Additionally, given how frequently healthcare systems are the target of cyber security attacks, healthcare organisations may find it challenging to balance the need for patient privacy and security of sensitive information with the demand for readily accessible health information.

Challenges of interoperability in healthcare

While many healthcare professionals and leaders agree that improved interoperability would benefit healthcare as a whole, there are several typical issues that healthcare organizations encounter as they try to make their data and systems more interoperable. Let us look at those challenges and how businesses might solve them:

Disjointed coordination & Limited budgets

Improving interoperability necessitates close collaboration among various organizations, regulators, and leaders, as well as within businesses. Regulators set standards and procedures for healthcare organizations to follow, but organizations that wish to be proactive about interoperability should develop a dedicated interoperability strategy and prioritize interoperability planning.

Not many businesses have the necessary financial or technical resources to invest in the technical resources required to establish a truly interoperable system. Organizations should check to see whether they are eligible for government funds to modernize health records systems. Many cloud companies also provide pay-as-you-go pricing structures, which may make technical costs cheaper and more predictable.

Diverse technological requirements & Legacy Systems

Because organizations must adhere to varied norms and regulations depending on the type of care they provide and where they are located, many have highly specialized data. Organizations may assist in connecting various internal and external systems by utilizing a hybrid cloud platform that allows them to combine and integrate their data without sacrificing the modifications required.

Healthcare firms with older legacy systems must modernize their systems while simultaneously satisfying interoperability standards. Organizations can achieve both objectives by utilizing a hybrid cloud strategy to pull data from legacy systems and make it more available for contemporary apps and processes. This method allows enterprises to keep data flowing while they work on modernizing their systems.

Various levels of healthcare interoperability

Informatics specialists and the Healthcare Information and Management Systems Society (HIMSS) have recognized four degrees of healthcare interoperability. Some of these levels are currently achievable with existing healthcare IT architecture and IT systems, while others will necessitate innovation and further advancements in patient-centered technology.

These levels are as follows:

Foundational

This is the most fundamental level of interoperability, also known as simple transport. Data is securely transported from one system or device to another without being interpreted or transformed into a specific format. A nurse, for example, might download a PDF file of a patient's most recent lab results from the lab's results site and manually enter the information into the patient's health record.

Structural

When structural interoperability, also known as structured transport, is established, all data is standardized to a specific format that can be interpreted by numerous systems or devices. This data is structured in a specified manner so that the receiving system can detect specific data fields automatically. Data standards such as FHIR and HL7 enable structural interoperability, allowing records to be uniform, centralized, and easily transferred between systems.

Semantic

The semantic level of interoperability, also known as semantic transport, entails sharing data between systems that have completely distinct data structures. Imaging systems are a good example because there are numerous specific DICOM and non-DICOM image formats. Images could be transmitted from one system to another, interpreted, and included into the new system via semantic interoperability, regardless of the image's original format or source. However, deciding what data to gather and transfer can be tricky because different systems show the same information in different ways. As a result, some scientists believe that artificial intelligence will be required to achieve full semantic interoperability.

Organizational

The seamless interchange of data between organizations with varied requirements, policies, and purposes is referred to as organizational interoperability. To attain this level of interoperability, policy and governance changes, as well as technological innovations, must be implemented to ensure that consent, security, and integrated workflows flow easily between various parties. Though some experts believe semantic interoperability is the ultimate degree, others believe organizational interoperability is.

Why should healthcare organizations establish and increase interoperability? HIT interoperability is required for a variety of business reasons, including improved patient care and lower healthcare expenses. Let's look at the advantages of implementing interoperability in healthcare systems.

Improved care coordination among healthcare entities

It is undeniably convenient for a patient or healthcare organization to not have to manually transmit or update each patient record across different healthcare parties and their papers. This is a massive quantity of manual labor that can be easily automated.

Healthcare technology interoperability enables real-time electronic synchronization between healthcare records and IT systems. Collaboration schemes tailored to certain healthcare process actors, government organizations, and other beneficiaries who provide interoperable software platforms.  EHR/EMR workstations (client applications) are linked to lab databases, insurance company applications, health plans, patient CMS, and other systems, allowing all authorized users to see data updates in all required documents at the same time.

Better treatment outcomes and improved performance

In healthcare, technological interoperability enables access to the most recent versions of medical records and up-to-date information on patient condition for various physicians and clinical personnel. Reduced risks associated with medical errors; avoidance of superfluous testing (for example, repeated testing for some types of allergies). Before providing life-saving injections and making critical judgments, emergency personnel must examine every vital health information.

 Auto-filled papers and forms that extract data from shared databases reduce the overall time necessary for working with electronic patient forms and records. Nurses and managers can save time and energy by automating common procedures. Specific virtual nursing applications can be coupled with other clinical software, such as AI-powered decision-making systems.   

HIPAA Compliance and patient data security for all

Health IT system interoperability, through its security technologies and provisions, enables the following such as compatibility of security standards across various healthcare application providers, ensuring that there are no weak links between system components that could lead to data leaks or other problems. Different suppliers can create mutually compatible applications, such as medical software and equipment, that adhere to the same standards and can interchange data without any additional modifications. Physicians and patients can access and manage their records using multiple applications that use the same authorisation credentials and processes. 

In recent years, a variety of innovative technologies and techniques have been developed to aid interoperability in healthcare. These include blockchain-based data storage and sharing platforms, as well as machine learning algorithms that may help extract and analyze data from multiple sources. Furthermore, due to its distributed database architecture, blockchain provides faster approvals, allowing for the secure transfer of digital assets without the involvement of third parties.