Precision medicine, care coordination programs, and value-based payment models continue to disrupt and transform traditional healthcare markets for consumers, providers, health plans, and digital health vendors. Because these initiatives are data-driven, there is a need for seamless communication across disparate systems.
The shift to value-based care has also triggered a deluge of acquisitions and mergers in the healthcare industry. Although "merger mania” has led to better economies of scale, it has also introduced new challenges, particularly in the integration of clinical data.
Despite advances in healthcare technology, many providers and health plans battle with interoperability challenges, especially with EHRs being the preferred method for extracting clinical data. With thousands of EHR vendors, EHR integration now plays a crucial role in the success of data-driven care. However, the existence of so many silos makes EHR interoperability difficult.
According to a HIMSS Analytics report, hospitals use 16 distinct EHR platforms, on average. The majority of network physicians (that make use of different EHRs) report that they lack the technical expertise and financial means to implement complex interoperability, which is necessary to receive the higher reimbursements that are built into value-based care initiatives for private and public payers.
To help healthcare organizations forge ahead with quality care and the implementation of robust care coordination and analytics initiatives, let’s take a look at four tips for EHR interoperability in today’s value-based economy.
1. Evaluate new solutions
As the healthcare industry moves toward more advanced phases of promoting interoperability, success in such a value-driven healthcare landscape requires providers to achieve true EHR interoperability—and to also think beyond the EHR. Managing workflows inside and outside the EHR will require stakeholders to look for new integration solutions with the ability to connect with various kinds of healthcare entities, such as health information exchanges and accountable care organizations.
Solutions should also be able to handle multiple types of information, including test results, orders, clinical documents, scheduling information, appointment summaries, immunization records, financial information, and demographics.
2. Reevaluate IT resources
Despite using multiple EHRs, 85% of networked physicians (according to a Black Book survey) look to core EHR systems to support the variety of data-driven initiatives and enable interoperability among integrated healthcare delivery providers. As such, there is a need to reevaluate IT resources to ensure they meet value-based care requirements and can facilitate interoperability on four levels: semantic, structural, foundational, and organizational.
- Semantic: This ensures the highest level of interoperability by supporting the meaningful exchange of patient data among disparate systems. It means that providers have access to the clinical data that’s most relevant to a patient’s care.
- Structural: This addresses and defines the syntax of data exchange. It allows systems to interpret patient data at data field levels, thus reducing the need for human interpretation and facilitating faster reconciliation of patients’ records without extensive manual effort.
- Foundational: This level deals with simple data exchange among systems without the interpretation of said data. Human intervention and manual effort are needed to interpret data and what it means for patient care.
- Organizational: This encompasses technical and non-technical components of interoperability to facilitate seamless data exchange within and outside of organizational boundaries.
3. Define standard data sets
Viewing patient data
There are several thousand EHRs in the marketplace today, and because no two EHRs have the same schemas or documentation practices, migrating and transforming data is a major pain point, especially since the data received are usually in different formats (CCDA, HL7 feeds, X12 files, etc.).
Solving this requires health IT vendors to agree on the use of standard data sets for data exchange, but even then, there’s no guarantee that every vendor will implement those agreed-upon standards in the same way – one of the most prominent integration challenges with HL7 standards. Robust API solutions, like Lyniate Rapid, support the seamless exchange of data between EHRs, clinical, and administrative applications through universal, real-time REST APIs and a unified data model.
4. Widespread standardization
With the rapid adoption of applications that support patient engagement and care coordination, it’s time healthcare organizations stopped viewing EHR systems as the center of the universe.
In fact, a recent Gartner report predicts, "By 2023, 35% of healthcare delivery organizations will have shifted workflows outside the EHR to deliver better efficiency, experience and outcomes."1
Focusing on the usefulness and standardization of patient data rather than the functionalities of EHR systems will lay the foundation necessary for improvements in health data exchange and interoperability.
By following these tips, healthcare providers and organizations will take a giant leap toward achieving EHR interoperability, delivering on care coordination initiatives, and achieving true value-based care.
1. Predicts 2021: Healthcare Providers Must Accelerate Digital Transformation to Address Disruption, Sharon Hakkennes, Barry Runyon, Mike Jones, Mark Gilbert, 25 November 2020