What is EHR Interoperability?

Frequently Asked Questions

What is EHR interoperability?

Interoperable electronic health records (EHR) allow the electronic sharing of patient information between different EHR systems and healthcare providers. Healthcare interoperability improves the ease with which doctors provide care to their patients, and can help their patients traverse the healthcare ecosystem. Interoperability may be central to electronic health records, but there are varying degrees to how a healthcare organization can interact with those in the care spectrum.

Interoperability is important because healthcare facilities must interact with each other to share and exchange patient information, but EHRs are not the only way to accomplish this communication. However, a variety of technologies and data silos make information exchange difficult. In regard to EHRs, most healthcare organization use different EHR systems, making it difficult to share information between practices and health systems.

According to the Healthcare Information and Management Systems Society (HIMSS), interoperability is the ability of different information systems, devices, or applications to connect, in a coordinated manner, within and across organizational boundaries. Interoperability allows for access to, exchange, and cooperatively use data — the goal being to optimize the health of individuals and populations.

Likewise, per the 21st Century Cures Act, “interoperability” is facilitated by health information technology that: (A) enables the secure exchange of electronic information from other health IT without special effort on the part of the user; (B) allows for access, exchange, and use of all electronically accessible health information for authorized use; and (C) does not lead to information blocking.

As defined by HIMSS, healthcare interoperability occurs at three levels. Foundationally, which includes “data exchange from one information technology system to another, but doesn’t require the ability for the receiving information technology system to interpret the data.” Structurally, which “defines the structure or format of data exchange where there is a uniform movement of healthcare data from one system to another. This exchange of data does not impede clinical or operational purposes, and the meaning of the data is preserved and unaltered.” And semantically, which HIMMS describes as the pinnacle of health data exchange. Semantic interoperability “takes advantage of both the structuring of the data exchange and the codification of the data, including vocabulary so that the receiving information technology systems can interpret the data.” Semantic interoperability means health IT systems speak the same language. They don’t need interpretation to make patient health information actionable.

Interoperability standards are designed to make health data electronic and in a shareable format, and eliminate communication taking place via paper, faxing, and phone calls. Increased interoperability between electronic health record systems makes health data universally sharable. Interoperability efforts facilitate better patient care and allow for ease of referrals, communications, and transitions between health providers.

What are EHR interoperability standards?

The most widely recognized current standard of healthcare interoperability is FHIR (Fast Healthcare Interoperability Resources). FHIR is a standards framework leveraging the latest Web standards, focusing on implementation. H Level Seven International developed FHIR.

No matter the standard, (HIMSS) says interoperability and exchange standards must allow data sharing across clinical environments, labs, hospitals, pharmacies, and patients no matter the technology or the vendor. EHR interoperability is an effort dedicated to creating a data-sharing community.

Despite any current data sharing limitation, interoperability standards must continue to be developed by organizations like HL7 International, HIMSS and other organizations.

Several current standards speak to healthcare messaging, terminology, documents, frameworks, application, and even architectures. For example, some guidelines driving interoperability include:

HL7 V2.X and HL7 V3 speak to the exchange of demographic, clinical, and administrative data.

DICOM, owned by the National Electrical Manufacturers Association, is the mechanism that enables medical imaging devices – like picture archiving and communication systems (PACS) — to exchange images with other systems.

ASC-X12 provides design for exchange procedures, patient eligibility, and benefit payments.

IEEE 1073 determines messages to exchange with biomedical instrumentation equipment.

ICD-10 (International Classification of Diseases) defines a catalog of diagnoses and procedures for statistical purposes, billing, costs, and paperwork.

HL7 CDA (Clinical Document Architecture), CCDA (Consolidated CDA) and CCR (Continuity of Care Record) provide standards for documents used to indicate the type of information included in a report. These bodies define a consolidated view of patient summary health information, including allergies, treatment, care plan, and list of current health issues.

Despite these standards, there is no single technical standard that’s going to solve the problem of health IT interoperability, FHIR included.

Why is EHR interoperability important?

Even if every medical practice in the country were to switch over to an EHR, the uses for patient information would be very limited if different physicians couldn’t easily access it.

EHR interoperability is important because it is designed to improve patient outcomes and patient safety through better healthcare communication. Interoperability also gives physicians, and nurses access to clinical data no matter the caregiver’s location, sometimes in real-time, meaning doctors can best treat patients at any point of care and within their network even if the data originates outside of the health system.

Interoperability also creates operational efficiency for health systems when patient information is available or retrievable and allows for real-time data to be made available immediately for any caregiver needing specific patient information. This patient data can reduce repetitive tests, image orders, and lab draws. Patients can gain better control over their health data and are more easily able to track it when needed. Administrative duties for collecting patient’s data from multiple sources also is lessened.

Without complete and seamless interoperability, the great promise of electronic health records, meant to enable patients, lead to better-coordinated care and lower healthcare costs, will never be achieved.

Healthcare organizations have different options for secure data exchange, which can expand provider access to patient records and aid the industry transformation to value-based care. One example is TigerConnect’s TigerTouch. Another example is the CMS program, MyHealthEData, which is designed to encourage providers to share information with patients as a way to engage individuals in their care. While the MyHealthEData program centers around access to EHRs through the device or application of their choice, the overarching aim is that improving healthcare communication is key to bettering patient care and outcomes.

These examples prove that interoperable data exchange can happen, and is happening, outside of the EHR when specific communication solutions are employed to close communication loops. Healthcare communication technologies can support EHR-generated interoperability, and perhaps improve the organization’s return on investment of the electronic records. While not EHR-based, a plethora of communications solutions – from text and secure exchange of information from a patient and provider – further healthcare’s interoperability efforts.

Healthcare Interoperability Solutions with TigerConnect

Interoperability is designed to provide for the ability to exchange electronic healthcare information freely, even outside an electronic health record system. With a connected communication technology solution, health data is collected, collated, and delivered through a structured format so that it can be interpreted and used at the point of care. Interoperability is the overarching concept that creates standards and guidelines to accomplish the sharing of this information. Interoperability creates a straight path toward efficiency, better exchange of data, and the provision of patient care.

The 21st Century Cures Act limits information-blocking practices through its interoperability guidelines which can lead to more efficient and safer care with better patient outcomes. Interoperability can also improve communication between the patient and the provider, which is critical.

At TigerConnect, we understand that patients are at their most vulnerable leading up to, during, and after a clinical event and that they have lots of questions but, access to their doctor can be limited, especially pre- and post-appointment. Our solution, TigerTouch approaches patient communication innovatively by pushing care information via secure text message to the patient’s preferred device. This is our contribution to healthcare interoperability. With TigerTouch, there are no portals or logins required for the patient, which improves care and increases communication between patient and provider.

Through TigerConnect, health systems can communicate directly with patients through video, voice, and text. TigerTouch, helps patients become more active in their care, and interact with physicians, nurses, case managers, and home health caregivers all controlled by the healthcare provider. This level of connection is critical for modern healthcare. Healthcare organizations that connect caregivers and patients see improvements in outcomes, patient safety, cost reduction, and staff satisfaction – all of which is the point of interoperability.

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About TigerConnect

TigerConnect is healthcare’s most widely adopted communication platform – uniquely modernizing care collaboration among doctors, nurses, patients, and care teams. TigerConnect is the only solution that combines a consumer-like user experience for text, video, and voice communication with serious security, privacy, and clinical workflow requirements that today’s healthcare organizations demand. TigerConnect accelerates productivity, reduces costs, and improves patient outcomes.

Trusted by more than 6,000 healthcare organizations, TigerConnect maintains 99.99% verifiable uptime and processes more than 10 million messages each day. To learn more about TigerConnect visit www.tigerconnect.com.