Interoperability in Healthcare — Where We Are & Where We Want to Go

In an ever-evolving world of healthcare, connectivity and collaboration are critical in realizing positive health outcomes for patients. That’s why interoperability, particularly in recent years, has become one of the foremost healthcare concerns — marking the cornerstone of thriving organizations and seamless data exchanges, all while saving you time and money.

Interoperability in healthcare aims to securely exchange crucial health information between systems, providers, and clinics, allowing physicians to provide superior and timely care to their patients.

With regulations paving the path and clinicians beginning to adopt a can-do mindset, readily embracing change, interoperability is beginning to grow in significance. New regulations, laws, and incentives lay the groundwork for successful cooperation and a more efficient healthcare system. The good news is that we’re on the right track.

 

Key Interoperability Regulations 

Regulations encouraging interoperability in healthcare are imperative in achieving a shift in operational procedures within medical facilities, as they set forth guidelines and standards required for all to follow.

21st Century Cures Act 

The 21st Century Cures Act was introduced in 2016 and aims to accelerate innovation and new medical products.¹ In 2020, the U.S. Office of the National Coordinator of Health Information Technology (ONC) added delayed provisions, specifically addressing interoperability and the issue of “information blocking.”

Almost simultaneously, the U.S. Centers for Medicare and Medicaid Services (CMS) introduced interoperability regulations that were based on the same standards as ONC. 

Both the ONC and CMS strive to establish standardized processes involving data exchanges in the grand framework of interoperability. The 21st Century Cures Act is considered the first practical step in spurring interoperability in the healthcare setting.

TEFCA 

The Trusted Exchange Framework and Common Agreement (TEFCA) mandated by the 21st Century Cures Act is clear in its messaging on required data sharing for all — establishing a common ground and guidelines for interoperability in healthcare.²

While helping to reduce costs, CMS incentives are planned for organizations that comply with TEFCA standards. Surveys indicate that today the majority of organizations support TEFCA but struggle with privacy laws and data security, noting that more guardrails are required to fully implement TEFCA standards.³

 

Where Is Interoperability in Healthcare Headed? 

Interoperability is certainly a process and it will take time for barriers to be removed completely. However, organizations are beginning to transition, more and more towards an interoperability mindset — particularly in light of regulations now providing explicit directions.

Clinical Trends 

For medical facilities, sharing clinical data is essential for both operational purposes and the prime goal of providing quality patient care. A survey conducted last year found that about 83% of health information exchanges happen in support of patient care or scheduled patient visits.⁴ 

Having data readily available to evaluate and treat a patient when he presents to the office is a key aspect of medical record sharing. A report also found that about 71% of survey respondents felt comfortable sharing health data — however, a significant percentage was not comfortable sharing data with insurance companies versus hospitals.⁴ 

Much of the research into interoperability indicates there’s progress and an overall shift happening. About 91% of surveyed hospitals indicated that they have been sending patient records digitally to outside organizations.⁴  This shows that facilities are becoming more willing to provide vital clinical information to other treating physicians. 

In fact, as of 2021 more hospitals than in previous years were engaging in all domains of interoperability, marking a promising 21% increase.⁴

Further research found, however, that most diagnostic vendors were sharing information solely on a regional level or with facilities from within the same state.⁴ While interoperability is happening to some degree, there certainly is more capacity for growth in the clinical setting. 

How Care Models Are Being Shaped 

Alongside interoperability advances, care models are beginning to change, allowing value-based and hybrid-type care models to thrive. Today, interoperability allows providers to analyze clinical data in-depth, significantly contributing to a comprehensive understanding of the patient’s:

  • health information and diagnoses,
  • health outcomes,
  • membership plan,
  • and the cost of patient care received.

With more clarity on crucial aspects of a patient’s health, value-based care (VBC) is more easily implemented. Since VBC requires a thorough risk assessment, a more accurate risk score can be generated for each patient. This means that adjusted payments can be collected wherever applicable. 

In addition to financial benefits, VBC tends to focus more intently on positive patient outcomes, leading to an enhancement in the quality of care provided.

 

Promoting Interoperability in Light of Challenges 

Interoperability is becoming a new golden standard in healthcare, moving the needle closer toward higher patient and employee satisfaction. But how can we continue to promote interoperability as challenges arise along the way?

Data Security & Privacy Laws

Patient privacy has been a highly debated subject of concern within the interoperability realm as providers fear that protected patient health information is at risk of privacy law breaches. The main issue is complying with TEFCA and free information exchanges while, at the same time, trying to abide by HIPAA requirements.

Determining how exactly third parties, like outside providers (or patient portal vendors), are allowed to use clinical data is imperative. Furthermore, sending data electronically and utilizing digital interfaces in itself, both comprise an additional security risk to consider.

Due to this underlying fear, some providers engage in information blocking, preventing data exchanges and hindering interoperability from thriving. However, statistics show that since the introduction of TEFCA, medical facilities are slowly beginning to embrace this new norm and are becoming more open to exchanging relevant patient information with other offices.

Maintaining a Competitive Advantage 

There are many reasons why we should encourage interoperability and help it evolve, especially in light of it making for a great support pillar for our healthcare system. Besides revenue aspects, interoperability also yields a competitive advantage.

How so? — you wonder.

Patients value providers that are familiar with their medical history, even if they have not seen them before — the primary reason being that diagnosing and treating conditions won’t be delayed. It also gives the provider a sense of preparedness and the ability to offer immediate guidance. Patients will perceive their encounter as a quality care experience, leading to higher patient satisfaction and unwavering loyalty.

At the same time, a more efficient work environment, less paperwork, and reduced manual tasks allow clinical staff to free up time to bring in new patients — or expand on the encounter intervals with existing patients. 

Interoperability will help you:

  • attract new patients, 
  • maintain existing patients, 
  • provide superior care,
  • attract new talent, 
  • and retain your current workforce.

These factors offer a competitive advantage and allow for a positive perception of your medical facility within your community. While some providers are still reluctant about the traction interoperability is gaining, competition is fierce as with any industry. Successfully juggling quality patient care and employee satisfaction are two key components that will help you stand out.

 

Interoperability with Vivlio Health®

With interoperability at the forefront of our healthcare system, it’s imperative decision-makers seize the opportunity to connect and collaborate with other physicians. At the end of the day, the main directive is to provide the best patient care experience possible and for that to happen, early and complete access to clinical data is an essential component.

Vivlio Health is a software solution bridging the gap between systems and medical facilities, so healthcare can continue to thrive. We believe interoperability is a critical factor in accomplishing positive health outcomes, improving workplace efficiency, and saving clinics large sums of healthcare dollars.

An eager team of industry experts brought Vivlio Health to life so that medical records can be accessed more easily — allowing you to extract the clinical information you’re looking for within a user-friendly cloud-based solution. Book a demo and learn more about how Vivlio Health can help you.

Let’s keep moving interoperability forward, together.

 

References:
  1. “21st Century Cures Act.” 31 January 2020. https://www.fda.gov/regulatory-information/selected-amendments-fdc-act/21st-century-cures-act. Accessed 4 July 2023.
  2. “Trusted Exchange Framework and Common Agreement.” Undated. https://www.healthit.gov/topic/interoperability/policy/trusted-exchange-framework-and-common-agreement-tefca. Accessed 4 July 2023.
  3. “Distribution of support for the Trusted Exchange Framework and Common Agreement (TEFCA) in the United States as of 2022.” January 2023. https://www.statista.com/statistics/1365510/support-for-tefca-in-the-us/. Accessed 5 July 2023.
  4. “Healthcare interoperability – statistics and facts.” 23 May 2023. https://www.statista.com/topics/10863/healthcare-interoperability/#dossier-chapter1. Accessed 8 July 2023.