Overcoming Operational Fragmentation with Interoperability

March 27, 2024 • 4 minute read

One of the biggest challenges facing the healthcare industry right now is operational fragmentation. This fragmentation, especially evident as patients move through different stages of care, disrupts the flow of vital information needed for accurate and informed decision-making. From prescriptions to diagnoses and beyond, care coordination suffers as disparate systems struggle to speak a common […]

One of the biggest challenges facing the healthcare industry right now is operational fragmentation. This fragmentation, especially evident as patients move through different stages of care, disrupts the flow of vital information needed for accurate and informed decision-making. From prescriptions to diagnoses and beyond, care coordination suffers as disparate systems struggle to speak a common language, resulting in gaps and less-than-optimal patient outcomes.

Despite the promise of interoperability as a solution, there’s been significant reluctance among EHR developers to fully embrace it. The decision to prioritise seamless data flow between proprietary systems at the “expense” of business is one that vendors are still grappling with. Even as technology evolves to enable plug-and-play interoperability, there’s a lack of strong incentives, especially regarding the business case for full adoption. 

Most have capped their efforts at foundational interoperability, assuming that as long as data can be exchanged, their technology is compliant. But true interoperability is more than just data availability; it’s about ensuring its usefulness – enabling insights, trend spotting, and inference. Deloitte dubs this “radical interoperability” – characterised by open yet secure platforms and care that’s driven by consumer needs.

Understanding the Fragmentation

Despite the widespread adoption of EHRs and the departure from paper-based records, the persistent gap in data sharing that plagued paper-based systems remains. For instance, only 12% to 34% of discharge summaries reach outpatient providers before a patient’s first post-hospitalisation appointment, even in this age of  EHR. This lack of timely information during transitions of care has been directly linked to increased rates of re-hospitalisation.

The absence of a single standard of interoperability exacerbates this problem. Different standards exist for various types of data exchange, such as sharing medical images or exchanging demographic, clinical and administrative data. This fragmentation makes it challenging to break down the silos that hinder seamless data exchange and interoperability efforts.

Data interfacing and interpretation issues add yet another layer of complexity. Even when data can be exchanged between systems, differences in data formats, coding standards and terminology can lead to misinterpretation or loss of critical information. For example, one hospital may use a legacy EHR system that relies on outdated technology, while another may have implemented a modern, cloud-based solution. These disparities create interoperability barriers that may hinder data exchange between them.

Additionally, many EHR systems rely on proprietary standards for data storage and exchange. These proprietary standards are often developed by individual vendors and may not be compatible with other systems. As a result, it becomes incredibly difficult and costly to integrate data from different systems or share information with external partners. 

These challenges emphasise the importance of not only standardising data exchange protocols but also harmonising data interpretation practices to ensure accurate and meaningful exchange of health information.

Missed opportunities

When a patient begins their healthcare journey, they generate a wealth of data that only continues to grow over time. This pattern often repeats across various healthcare facilities as the patient seeks different forms of care. However, the absence of interoperability poses a significant obstacle to the seamless flow of this data especially when patients transition to new practices. In such instances, most practices tend to disregard incoming data from external sources, citing complexity and EHR fatigue for practitioners, who struggle to sift through vast amounts of data to extract actionable insights. Consequently, the receiving practitioner may opt to start anew, collecting their own data to match their specific standards. This can have numerous adverse effects including redundant procedures, sluggish processes, escalated costs, or even overlooking serious ailments, ultimately impacting patient outcomes.

Traditionally, the burden has fallen on the end user to integrate and connect historical health data, which adds to the patient’s workload and increases the risk of important information slipping through the cracks. This approach is counterproductive for practices interested in value-based care, as it leads to patient disengagement and focuses on singular goals rather than the holistic improvement of the patient’s life. Moreover, siloed data often neglects to consider social factors that influence a patient’s wellbeing, resulting in a myopic approach to healthcare.

Interoperability offers a solution by providing a single, longitudinal health record that promotes transparency and encourages a comprehensive, chronological storytelling of a patient’s journey.

Semantic Interoperability: The Gold Standard in Healthcare Data Exchange

The overarching objective of true interoperability is to ensure that data can be fully utilised by multiple, disparate systems, maximising its impact on patient care. This marks a departure from pseudo-interoperability, where data exchange occurs without an understanding of its meaning. Instead, the aspiration is for data to transmit meaning unambiguously across various platforms and systems.

Given the multitude of standards available, it is impractical to expect practitioners to master each one. Instead, their focus should be solely on documenting clinical actions, while the complexities of data standards are seamlessly managed behind the scenes by systems designed for this purpose. As developers, our role is to provide platforms that achieve this task adequately, ensuring that practitioners can focus on delivering quality care without being burdened by the intricacies of data exchange protocols.

Achieving semantic interoperability necessitates cooperation and commitment from all stakeholders in the healthcare ecosystem. Recognising the substantial cost incurred by the lack of interoperability, estimated at around $30 billion annually, is the first step. While legislation such as the HIT interoperability rules will propel the process forward, it is crucial that healthcare providers, payers, and third-party app developers connect with the necessity of achieving heterogeneity in order to prioritise it.

Our cloud-based system isn’t just a repository for data; it’s a dynamic platform that enables fluid and seamless transfer of information across systems. Imagine a healthcare ecosystem where data flows effortlessly, empowering people, teams, and businesses with actionable insights at every touchpoint. That’s the future we’re building—one where interoperability isn’t just a buzzword but a reality that transforms patient care.

But our journey doesn’t end here. We recognise that achieving true interoperability is an ongoing conversation—one that demands continuous innovation and evolution. That’s why we’re dedicated to rethinking our platforms, pushing the boundaries of what’s possible, and conforming to prevailing standards that will drive progress. From exciting new features to groundbreaking advancements, Meddbase is committed to leading the path towards a future where interoperability isn’t just a goal but a fundamental cornerstone of healthcare excellence.


blank

Büşranur Bilir