What were you doing in 2006?
That’s when the American Health Information Management Association published an article on interoperability and noted that “Healthcare’s hottest topic finally has two things it has badly needed: plain language and a sense of urgency.”
Ten years later and surely millions of pages of plain talk later, it appears the author’s nod to urgency may have been a bit misplaced. Granted, healthcare interoperability is a complex topic. Just ask the Healthcare Information and Management Systems Society (HIMSS).
HIMSS defined interoperability back in 2005 as “the ability of health information systems to work together within and across organizational boundaries in order to advance effective delivery of healthcare for individuals and communities.” That early definition has evolved into one that today includes an emphasis on systems being able to not only exchange information, but actually use the information once it has been exchanged.
Emphasizing usability of the information exchanged is an important distinction. I see it as right in line with the U.S. government’s shift away from focusing solely on how healthcare is delivered and toward what healthcare outcomes are achieved. The Office of the National Coordinator for Health Information Technology obviously agrees, going so far as to state in the recently released roadmap that interoperability should occur “without special effort on the part of the user.”But enough with definitions. If we really want to speed up progress toward achieving interoperability, I believe there are three approaches that healthcare industry players can put into practice today:
Let Vendors Drive
Speaking from personal experience (and with an obvious bias), hospital staff aren’t usually the best candidates to design the HIEs essential to interoperability. Vendors, preferably those who are language and platform agnostic, are best positioned to transform vast amounts of healthcare information into the discrete data elements that information systems thrive on. Healthcare personnel still have an important role to play, especially when it comes to breaking down siloes among the many players involved in the patient care continuum.
Operate in Real Time
The days of monthly or weekly reporting are over. Whether you’re a front-line care resource manager or a CFO, you should be insisting on – or actively driving toward – the use of real-time data in clinical decision-making. More than a decade in, I think everyone understands that interoperability is a journey of a thousand steps. However, if we aspire to an ecosystem where the right patient care information is available at the right time, actionable, real-time case reporting is an important first step.
Toss Out Your Own Carrots and Sticks
Consider following the U.S. government’s lead and throwing out a few carrots and sticks to drive interoperability in your own organization. Maybe it’s a shared performance bonus for multiple departments. Or, possibly a performance management metric put in place to ensure accountability and create urgency. When Meaningful Use criteria were put in place by the government in 2011, EHR adoption by hospitals skyrocketed and today it has surpassed 75 percent. That solved one problem and introduced a host of others. The point is, financial incentives can be effective in driving human behavior.
Another way to change behaviors is through education. Non-profits like the Sequoia Project’s CareQuality initiative and DirectTrust on the provider side are both doing good work in sharing information and creating spaces for collaboration. Major segments of the industry are coming together, but people and companies will continue to veer off in pursuit of their own priorities.
For me and many others, 2006 seems like another lifetime. My hope is that 10 years from now, the healthcare interoperability we currently envision today will be a reality we’ve achieved and surpassed.