Health Information Interoperability Calls for Rock-Solid Data Governance
Federal efforts to create health information interoperability will force healthcare organizations to embrace common data standards and thorough data governance strategies in the coming years.
In 2016, "interoperability" is a key watchword for health information professionals. Health information interoperability not only means sharing data within an organization, but also sending and receiving data among various sources in the care delivery chain, including retail clinics, home health agencies and healthcare providers thousands of miles away.
The value-based care model is overtaking the healthcare industry, and it requires clinicians to have access to all of a patient's medical information, regardless of the source. This trend will vastly increase the amount of data providers must gather and store, and if healthcare organizations are going to use this data to garner actionable insights, there will need to be unprecedented industry-wide attention to common data standards.
The Road to Health Information Interoperability
In October, the Office of the National Coordinator for Health Information Technology (ONC) released an interoperability roadmap that addresses the current lack of industry interoperability. The document also sets forth a strategy for creating a unified information-sharing system that would allow healthcare providers to communicate more efficiently and share a full picture of each patient's medical history and current care.
While the ONC's full interoperability plan will take a decade to execute, its first goal is to see a majority of healthcare providers across the care continuum be able to send, receive, find and use a common set of electronic clinical information by the end of 2017. This initial goal includes standardized data elements, such as demographics, that will enable better matching and linking of electronic health information across all systems and platforms.
Overcoming Communication Barriers
The lack of health information interoperability has historically been an obstacle to effective communication between providers. Electronic health records from different vendors generally use different formats and data definitions, which makes sharing difficult or impossible. Even when providers have a formal business relationship as part of an integrated delivery network or accountable care organization, they often face technological difficulties when swapping patient information. When providers compete, those difficulties are compounded by business concerns, and successful sharing becomes even less likely. However, coordinating the best care for patients requires having complete information, regardless of where the data originates.
The ONC's interoperability roadmap calls for all providers to use standardized data formats so that any given piece of information is formatted the same way, making it possible for information to flow smoothly without human intervention.
"If sending and receiving systems are not developed and configured to adhere to a common and consistent set of standards for a particular use, then the users of those systems will have difficulty with interoperability," the ONC roadmap explains. "For example, while a health professional would readily understand that 'Tylenol' and 'acetaminophen' are used synonymously, two computer systems exchanging those phrases may treat the terms entirely different, if not bound to a standardized vocabulary or terminology."
Information Governance Standards
For successful data exchanges to be possible, healthcare providers must also follow similar documentation and information governance processes. The ONC's roadmap advocates for industry-wide adherence to several existing standards, including Systematized Nomenclature of Medicine-Clinical Terms for problems or conditions, RxNorm for medications and medication allergies, Logical Observation Identifiers Names and Codes for laboratory tests and CVX for immunizations. Electronic health record systems that are certified by the ONC's Meaningful Use incentive program already use these standards, as do systems from several other vendors, but there are still plenty of widely used systems that do not conform.
What does this effort mean for health IT professionals? If an organization's internal systems do not already conform to the recommended standards, IT staff should investigate ways to adapt them. Healthcare providers should also put health information interoperability at the top of their requirements list when it comes time to purchase new or replacement systems. They should be prepared to ask vendors and consultants hard questions about their expertise in interoperability. Finally, they should prepare for big changes in the way their organization shares data, both in the near future and for years to come.