Looking toward the future of interoperability

Leigh Burchell, Vice President, Policy and Government Affairs, Allscripts

Interoperability in healthcare has rapidly revolutionised over the last two decades, corresponding to the increased expectation that the industry should have the capability to ‘do better’ with data and leverage it to advance patient care. With the heightened demand for smart applications in healthcare, there is a need to take a deep dive into the next phase of interoperability and the wide-ranging possibilities that can be realised from unencumbered data exchange.

What will the average hospital or healthcare practice look like ten years from now? How does one envision the future healthcare model, and how does it fit into the interconnected global economy? What will it take to get there, and will the industry achieve it?

These enduring thoughts are pondered by decision-makers in the healthcare world, where organisations and providers strive every day to work towards a solution to these nuanced and complex questions. Globally, countries are exploring how the effective integration and use of health IT will further transform the future of care, especially in an environment made up of complex healthcare systems and differing delivery models spread across diverse demographics. Accordingly, there is a heightened demand for smart applications in healthcare as a part of larger detailed plans and carefullycalculated longer-term strategies, with each building on overarching interoperability efforts. Collaboration between industry stakeholders is also well underway as experts forecast what advanced interoperability will facilitate before the next decade begins.

As the healthcare industry as a whole shifts from digitising within the four walls of individual care environments to coordination with other organisations also seeing those patients, there is a need to take a deep dive into what the next phase of interoperability will look like by 2030, as well as the wide-ranging possibilities that can be realised from unencumbered data exchange.

Healthcare with IT interoperability: Seamless, efficient, and effortless data access and exchange

Interoperability in the healthcare industry has been rapidly revolutionised over the last two decades, corresponding to the increased expectation that the industry should have the capability to ‘do better’ with data and leverage it to advance patient care. There is a spotlight on the effective use of healthcare information that is housed across disparate EHRs and enabling crossexchange and cooperation with each other. Looking ahead, it is clear that more standardisation and alignment in the industry around data transmission and consumption is expected, continuing the growth of interoperability adoption in the years leading up to 2030.

Different EHR systems have typically offered varying enhanced interoperability capabilities, which has resulted in isolated islands of patient data, housed and confined within the four walls of different

healthcare organisations. Conversely, advanced interoperability functionality can smoothly enable connections between health information networks, ensuring care providers are able to access a patient’s data from wherever he or she receives care, with no compatibility barriers. Further, as patient data flows more freely between different EHR systems, subsequent transparency around data provenance can follow, building higher levels of clinician trust in the information presented to them and allowing them to deliver increasingly informed care to their patients. This improved access to real-time, harmonised information from across the care continuum demonstrates clinically meaningful interoperability at its best.

Building open, connected communities of health, accessible to everyone

Interoperability is expected to deliver a new scale of efficiency to healthcare professionals as the world enters the next decade - a level they have long desired. The act of transferring information from one EHR to another EHR will now be a simple one, no longer a frustrating, timeintensive process.

With the introduction of artificial intelligence and machine learning technologies, data will be mapped and made usable automatically, saving valuable time and resources that are vital in the healthcare world. For example, comprehensive data mapping technologies will remove strain associated with patient-matching and identification during the exchange between and retrieval of information from disparate systems, presenting a win for patient safety. This paves the way for people to better deploy their time to focus on more valuable and high-impact tasks rather than mundane, administrative aspects.

An example of this is the South Western Sydney Primary Health Network’s (SWSPHN) innovative Integrated Real-time Active Data’s (iRAD) interoperability project in Australia. There was an identified need in the country’s healthcare sector for an application that was capable of accurately sharing agreed-upon, critical patient datasets between hospitals, general practices and other connected healthcare professionals on-boarded within disparate systems. As part of iRAD, SWSPHN implemented Allscripts’ dbMotion platform during its pilot phase over a 12-month period, enabling healthcare organisations to share patient-consented health records across the continuum of care securely and judiciously. The healthcare network was then able to focus its efforts on care delivery, emphasising informed decisionmaking and high-quality patient outcomes rather than time-consuming records retrieval or other administrative tasks. The project also provided the healthcare network with the foundation to scale up at speed across its region, achieving an Australian-first integrated health system that is fit for purpose.

In addition to improved efficiency, the increased adoption of application programming interface (API) standards is already enabling EHRs to interoperate with smart apps, platforms and connected devices, all of which elevate the quality of care for the patient and convenience of the process for all involved. Care delivery will be able to further transition from being primarily hospital-based to taking place in the patient’s home, which is usually less costly, while still supporting the necessary real-time alerts delivered to the dedicated care team whenever needed. Bringing acute-level care to patients with the assistance of technology can also provide them with the choice and comfort to recover from procedures at home in a familiar environment, as well as age in place as they get older, all with the option of engaging care teams as needed. And as patients choose to receive care outside of the hospital, virtual and augmented reality technologies will dramatically expand their options as we currently know them, elevating telehealth capabilities beyond simply voice and video to even incorporate holo-tech in the near future. The pandemic has already re-adjusted the broader market’s perception of in-home care, with surveys showing that patients and healthcare providers alike are now more receptive to it and accepting of such an option. Adding enhanced interoperability to that can facilitate advancement of a wellsupported healthcare ecosystem that enhances care delivery.

Improved interoperability capabilities will not only support the use of technology within the care setting, it will also accelerate the pace of clinical research through the extraction of realworld data from EHRs, moving toward the goal of achieving safer clinical outcomes. Interoperable data will equip research teams with a well-rounded, inclusive and more comprehensive view of patient populations, contributing to a more equitable care experience for all. As therapeutics and devices go-tomarket, fast healthcare interoperability resources (FHIR)-based clinical decision support hooks will point clinicians in the EHR to relevant information and newly-determined best practices at the point of care, where much of it will also be based on real-world data derived from EHRs. The COVID-19 pandemic and ensuing lessons learned about vaccines has shown us just how critical time is and can be with respect to research and development.

As interoperability progresses within each individual country, this also a multiplier effect when barriers to data exchange between different countries also come down over time. As standards are harmonised, adopted and implemented across international borders following agreement between standards development organisations, this will increase data liquidity and allow for greater transfer and transport of public health data. This also translates to broader benefits for the good of patients around the world. The pandemic has demonstrated and shown how healthcare, while local, also plays a global role in advancing public health. In a nutshell, good healthcare anywhere is good for healthcare everywhere.

Forging ahead: The path of interoperability and the ‘end goal’ with it for healthcare

The future of interoperability – in the form of an open and secure health IT ecosystem that the international community envisions and strives towards – is both aspirational and attainable. The end goal for all healthcare stakeholders remains to collaborate across patient advocacy groups, public health representatives, provider organisations, technology partners and policymakers to achieve this vision. The required technology, tools and know-how already exist, waiting to be integrated, implemented and put to work. The pace at which the industry is moving presents great opportunity for tremendous progress by the year 2030, all for the good of patients everywhere.

--Issue 54--

Author Bio

Leigh Burchell

Leigh Burchell advocates not only for the interests of the software development community but also the company’s almost physician clients and hospitals. Burchell is also active in many industry associations, including the Electronic Health Record Association (EHRA), where she was a past Chair and currently leads the Public Policy Workgroup; the eHealth Initiative, where she sits on the Leadership Council and the Policy Steering Committee; and HIMSS, where she is an active participant in the Public Policy Committee. She speaks frequently on topics ranging from information exchange to the digital intersections with social determinants of health, information blocking to how health IT can assist with opioid crisis.

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