Healthcare organizations should be actively working on their interoperability, and federal officials are pushing FHIR (Fast Healthcare Interoperability Resources) as the best way to ensure that EHR systems can share data. The military has now deployed a single EHR system, paving the way for interoperability in the Department of Defense, using the FHIR data standard. The government has now required certified EHR vendors to make the FHIR APIs (application programming interfaces) available to customers by the end of 2022. This makes it possible for the healthcare industry to standardize and share data – if – they all rally behind FHIR and update accordingly.
Why is Interoperability so Important?
The Interoperability and Patient Access final rule (CMS-9115-F), published May 2020 promised to
“Put patients first, giving them access to their health information when they need it most and in a way they can best use it.”
This promise means that as part of a patient-centered health system, data must be able to be exchanged seamlessly.
When patient health data is siloed, it cannot be easily accessed by others who need the data to provide patient care or the patients themselves. For example, when patients switch doctors, go see a new specialist, or spend time in a long-term care facility, all the new healthcare professionals need access to the patient’s previous data. Without interoperability, the sharing of patient records becomes a slow and manual process that requires medical release forms, delays care, and introduces error. Interoperability is the key to having safer, more seamless care delivery from one provider to another, and from one location to another.
Many healthcare systems don’t “talk” to each other – or can’t share data across systems and departments. When this happens, healthcare professionals can be operating without all of the information and medical errors can happen. Tests can be repeated, medications can be incorrect, and patient history may not be known. Systems use programs called interfaces to connect systems so that they can share data.
At the federal level, interoperability and portability of health information has been a goal for a while as part of the strategy to promote better heath outcomes and value-based care.
Interoperability is very complex within the healthcare ecosystem. Data exists in many forms – from numeric fields to narratives to radiology images. According to the Healthcare Information and Management Systems Society (HIMSS) there are four established levels of interoperability that must be met to reach the full potential.
- Foundational (Level 1): This level establishes the inter-connectivity requirements needed for one system to connect to another and securely communicate and receive data.
- Structural (Level 2): This level defines the format, syntax, and organization of data exchange to make interpretation possible.
- Semantic (Level 3): This level provides for common underlying models and codification of the data, including the use of standardized definitions of data elements. This shared language provides understanding and meaning to the user.
- Organizational (Level 4): This level includes the governance, policy, social, legal, and organizational considerations needed to facilitate the secure, seamless, and timely communication and use of data. This is needed both within and between organizations, entities, and individuals. This highest level of integration enables shared consent, trust, and integrated end-user processes and workflows.
Interoperability Standards
To further understand interoperability, it is important to know what a standards development organization (SDO) does. These organizations develop, coordinate, revise, and issue standards that are intended to address the needs of a wide range of users to exchange different types of health information. These are basically common communication methods used for a unified purpose. Some SDOs are vocabulary/terminology standards, while others are for content, transport, privacy and security, and identifiers.
For interoperability purposes, transport standards are particularly important – basically a common language used for the exchange of information back and forth.
What is FHIR?
Fast Healthcare Interoperability Resources (FHIR) is a transport standard (SDO) for exchanging healthcare information electronically, made up of modular building blocks called Resources. It is a next-generation standard created by the development organization Health Level 7 (HL7). FHIR has several advantages over older standards:
- Provides standardization for APIs.
- Facilitates interoperable exchange with legacy standards.
- Has lower overhead costs.
- Requires a shorter learning curve for users.
- Has the ability to transmit only the necessary pieces of information (important for HIPAA).
- Has the potential for patient-mediated data.
The potential for big data and public health analytics grows exponentially with the implementation of FHIR. Social determinants of health priorities and health equity initiatives depend on compiling and trending large amounts of data from disparate sources. FHIR connectivity between government and health organization systems, as well as the CDC can make that level of insight a reality.
Another opportunity to employ modern technology in the form of AI and machine learning exists if FHIR is implemented consistently. This means that a huge amount of legacy data, as well as the new data can be put together in one place. That huge amount of input can be leveraged through artificial intelligence to harvest new insights about population health, current trends, and employ predictive analytics.
FormDr provides tools to electronically connect patients and providers to provide a seamless care experience. By using HIPAA-compliant templates and medical release forms, medical practices support their interoperability efforts from the beginning. For more information about how FormDr can become part of your practice’s efficient workflows, contact us to request a demo.
