5 purchasing strategies that can drive interoperability

As healthcare stakeholders look to the future and think about the next generation of health IT products, executives across the healthcare spectrum should consider purchasing new health IT based on their interoperable capabilities.

Such a decision would give interoperability a higher priority across the healthcare industry and would create a sharper focus on the need to implement interoperable solutions in a healthcare environment where many IT systems aren’t connected to one another and data is stored in disjointed architectures.

Healthcare organizations suffer when they use multiple devices that run on different platforms. Organizations are challenged when primary care doctors can’t access patient information from specialists that use different electronic health record (EHR) systems.

Additionally, many departments within a healthcare organization store patient information on different systems that don’t connect or “talk” to each other. In many cases, patients can’t access their medical records. Fewer than one in three hospitals can electronically find, send or receive, patient’s digital records when they receive care elsewhere, a report published in Health Affairs shows. To circumvent the problem, many providers rely on paper or fax when sending a care summary for patient discharges or referrals.

To establish a more robust patient-centered system, hospital decision makers must consider new measures that create a continuously learning healthcare system. To do this, the health IT network requires unprecedented access to health information that can be accessed by clinicians anytime and anywhere.

During the past decade, the industry has significantly improved its ability to organize patient data electronically, and the vast majority of healthcare organizations that provide care to patients have invested heavily in EHRs. Adoption of EHRs, as well as the establishment of regional health information exchanges, the development of data exchange standards and interfaces, and the use of mobile devices are some of the initiatives that have laid the groundwork for interoperability across the nation’s healthcare network.

Even with these advancements, however, true interoperability doesn’t exist. The ability to seamlessly and automatically deliver data electronically across a secure network to care providers when and wherever they need it, without interference, is still an elusive goal.

There are privacy and security concerns associated with the exchange of health information. Information blocking, which occurs when a health care provider, IT developer or EHR vendor knowingly interferes with the exchange and use of electronic health information, is still prevalent. Additionally, moving toward interoperability will require a cultural shift which is often difficult to achieve in healthcare settings.

The demand for interoperability will become more critical as the healthcare system pushes toward meeting the goals of population health and creating a value-based system. These initiatives require the exchange of patient information in a timely manner to quickly make clinical decisions.

Healthcare organizations also know that if they are paid based on outcomes, it’s imperative to gather as much data about a patient as possible from all their sites of care. Without interoperability it becomes increasingly challenging to improve the quality and safety of care and reduce total medical expenses.

A recently published report from the National Academy of Medicine, entitled Procuring Interoperability, charges that obstacles to the advancement of healthcare interoperability are not technical, but rather a “failure of organizational demand and purchasing requirements."

Instead of focusing on price and features in the procurement of IT, health systems should instead establish a comprehensive, ongoing purchasing strategy demanding functional system-wide interoperability. The goal is for healthcare systems to move away from serial purchases of individual software and hardware with proprietary interfaces, toward purchasing certified technologies that will interoperate with others through a vendor-neutral open platform.

The report recommends healthcare organizations and their system leaders implement the following five action priorities:

1. Commit. Declare interoperability a primary priority and form an organization-wide interoperability steering group or related capacity to champion the IT acquisition strategy.

2. Identify. Charge this group with identifying the set of interoperability goals, requirements, and model use cases for the procurement process to support organizational priorities and patient outcome goals.

3. Collaborate. Create a sector-wide strategy and partner with other stakeholders to align on common contracting requirements and specifications to move toward the next generation of interoperable health IT.

4. Specify. Use the collaboratively developed specifications to state clear functional interoperability requirements in existing and future proposals, purchases, and contracts.

5. Assess. Establish and monitor short-term and long-term metrics for the progress and contributions of interoperability to system-wide learning and improvement of health outcomes.

System-wide interoperability can only be achieved if healthcare stakeholders set about aligning the culture and governance structure with a sustainable business model. Selecting vendor-agnostic platforms that enable an open, fully-integrated IT infrastructure will be imperative in the move toward accountable, patient-centric care.

Hospital CFOs, CIOs and other health IT decision makers that view data sharing and accessibility as a component of a long-term business strategy can drive connectivity across the health IT network by prioritizing interoperability as a mission critical initiative.