To better support health organizations and help improve their interoperability literacy, we are rolling out a three-part series to unpack three of the most common interoperability myths and the truth behind them.
Myth #1: Interoperability is hard. When we talk about the interoperability problem in healthcare it is really more of a discussion about wanting healthcare IT vendors to make their systems work together more seamlessly. The challenge of sending and receiving information between disparate systems due to each individual product’s communication protocol idiosyncrasies is in large part a non-issue these days. However, not all healthcare organizations have prioritized interoperability, which is often where we run into barriers.
Due to competing priorities, not all organizations have given much focus to the pursuit of interoperability. Hospitals and health systems must be willing to make time for and find resources to invest in (and take advantage of) the technology that already exists. Another area of concern is in IT implementation fatigue. Organizations often run into a back log of IT projects (which include: regulatory compliance, customer requests, and new features to bring to market) resulting in critical but less urgent issues like interoperability getting bumped to the bottom of the priority list.
In order to achieve interoperability, there are typically three ways to approach it: monolithic, point to point, or an interoperability layer.
- The monolithic approach forces as many departments within a health system to use one product (e.g. Epic) and solutions within its approved partner ecosystem.
- Point to point interoperability means there are users on a variety of applications within a health system and these applications are integrated with each other on an as needed basis.
- An Interoperability layer (aka integration engine) allows the use of a variety of applications, integrating each one into a universal translator that handles all of the connections and data transformations.
There are pros and cons for each of these options. While the monolithic approach is most simple, it limits organizations options significantly. The point to point approach is more flexible, however with each ever growing list of integration points, there is increased potential for vulnerabilities and expenses. That said, the interoperability layer offers the most flexibility, allowing health systems and organizations to use higher ranked applications – regardless of whether or not they naturally work together and automatically solving the variations between contending systems. This option is also the most future-proof in the sense that it is the most flexible option and supports new data types, standards, and use cases yet to be. Though this option does require more financial investment upfront, it more than makes up for it in the long run.
The biggest interoperability barrier for most organizations is not a lack of solutions, but a lack of resources (time, money, and people) to help them get from their current circumstances, to a place where information exchange is effortless. Additionally, the more reliant the healthcare industry becomes on technology, the more putting off interoperability is really no longer an option. These days the criteria for meeting the needs of patients is expanding. Health systems are now acting as the hub of healthcare communities across the country, serving as the epicenter for patients, independent providers, and all other players within the healthcare ecosystem to help improve quality of care, patient experience, and reduce overall costs.
At this point, interoperability is no longer as difficult as it once was. The challenge now is changing the way organizations prioritize and think about interoperability. If hospitals and health systems can think of the long term benefits of implementing something like an interoperability layer, they will be less likely to run into issues down the road. Regardless of how an application works with another, the interoperability layer will enable seamless communication to address any issues between differing systems. When organizations take the necessary steps to address the true barriers to interoperability, the floor will open up for more interesting conversations about the critical issues impacting the disparity in interoperability access.
We’ve covered two other common misconceptions when it comes to interoperability in recent posts on our blog: everyone is using FHIR and interoperability is an EHR problem.