Solutions for Interoperability Planning
Interoperability is an ongoing effort to continuously improve your ability to receive and send usable clinical data. It is not a once and done thing. The HHS Assistant Secretary for Techinal Policy, ASTP, helps the US Healthcare ecosysyem plan and realize an interoperable healthcare ecosystem. See more on their mission for interoperability. Interoperability at ASTP.
Increasing interoperability is a key goal for enterprise data architects. To achieve increased interoperability, you have to assess honestly where you stand now and where you want to go, and with whom. This requires a great deal of stakeholder engagement. A common way to plan is to develop an 'As Is' and a 'To Be' Architectural plan along with data flow diagrams. This is commonly done by business analysts working with clinicians.
The U.S. health care interoperability plan for 2023–2028 aims to enhance the secure exchange of health care data across the nation. Key initiatives include:
FHIR Advancement: Promoting the use of FHIR standards for electronic health information exchange.
USCDI & USCDI+: Establishing a core set of data elements for interoperability.
TEFCA: Implementing a common set of principles and standards for nationwide electronic health information exchange.
APIs for Patient Access: Establishing APIs to facilitate secure sharing of patient information among providers and payers.
HHS Data Strategy: Fostering data sharing and addressing data use, needs, and capabilities across HHS.
Interoperability in Medicare and Medicaid: Streamlining processes related to prior authorization and improving patient access to health information.
These efforts are part of a broader strategy to improve patient care and healthcare efficiency by ensuring that health care data can be shared securely and effectively across different systems and providers.
Where to Start
In an enterprise or a single hospital system, one should start with an inventory of business processes, software systems, databases, data standards in use, reference data files and business partners. Once you identify the stakeholders, an Implementation Guide is developed by a Data Standards Architect and Enterprise Business Analyst and clinicians.
Implementation Guides and Standards
The development of Implementation Guides (IGs) and standards is a critical step in ensuring healthcare interoperability. These guides and standards provide a set of rules or guidelines that have been approved by recognized standards development organizations (SDOs) or in a de facto manner by general industry use. They are essential for maintaining data quality, consistency, and integrity across various health information technology (HIT) applications, including electronic health record (EHR) systems and ancillary systems such as laboratory, pharmacy, payer, public health, and research.
The American Hospital Association (AHA) emphasizes the importance of interoperability in healthcare, stating that it is the "ability of a system or a product to work with other systems or products without special effort on the part of the customer." This interoperability is made possible by the implementation of standards, which are crucial for the success of information technology implementations.
NIST has developed a comprehensive approach to improving interoperability, focusing on providing developers and testing bodies with automated and thorough conformance testing capabilities. This includes the development of HL7 v2 Conformance Methodology ANSI standard, which helps define requirements in a consistent, structured, precise, interpretable, and reusable manner.
The CDC's public health interoperability strategy includes principles such as standardization, openness and transparency, cooperation and non-discrimination, privacy, security, and safety, access, equity, and public health. These principles support nationwide exchange of electronic health information for better patient, population, and public health outcomes.
CMS supports the development of technical standards and Implementation Guides with standards development organizations, federal partners, and industry stakeholders. These resources are publicly available for use at no cost and are designed to promote the adoption of Health Level Seven® (HL7®) Fast Healthcare Interoperability Resources® (FHIR®) by stakeholders.
- Resources for Interoperability
- When performing requirements analysis, what factors limit interoperability?
- Increasing Interoperability Through LOINC Standardized Coding
Data standards and standardized terminologies that help achieve interoperability - UCUM : Standardized Units of Measure
Increasing requirements for interoperability between clinical information systems impacts budgets for IT architectural expenditures. Operational budgets need to take precedence, planning needs to occur at the CIO's level continually.