After more than a decade of effort, healthcare finally appears to be turning the corner in terms of achieving true clinical interoperability – and it can’t come soon enough to satisfy the needs of clinician users.
When the HITECH Act was passed in 2009, the government signaled its intent to get serious about EHR adoption. The legislation included billions of dollars in incentives for the implementation of EHRs, plus requirements for the secure exchange of medical records. Today EHR adoption is nearly ubiquitous – though more work remains to achieve true interoperability between healthcare organizations.
While providers and vendors have figured out how to make the most of various HL7 exchange standards to transmit clinical care documents that satisfy regulatory requirements, too often the shared records are in a format not easily accessible to the receiving clinician. Instead, important clinical information is stored as unstructured text within a PDF or similar file, forcing users to waste time searching through multiple tabs to find relevant details—which is especially inefficient at the point of care when clinicians are trying to focus on their patients.
With the passage of the 21st Century Cures Act in 2016, stakeholders were hopeful that interoperability would improve. The interoperability rules were finalized in March 2020 – but enforcement has been delayed in the wake of COVID-19’s many unforeseen challenges.
Not only has the pandemic forced a pause to interoperability advancements, it also has revealed the depth of our data-sharing deficiencies. The inability to efficiently share clinical information between clinicians, researchers, and government entities has often hampered efforts to identify outbreaks, track mortality rates, and deliver efficient patient care.
Fortunately, awareness about interoperability limitations has surged, and today more people than ever are convinced it’s time for regulators, providers and vendors to get serious about making true interoperability a reality.
Also helping to advance interoperability is the growing acceptance of FHIR (Fast Healthcare Interoperability Resources) as the information exchange standard for healthcare. With FHIR as the acknowledged standard, more and more are vendors offering open APIs that facilitate data sharing and extend the usability of their existing platforms. This is great news for clinicians who may finally have a means to send and receive clinical information that is meaningful and actionable at the point of care.
As we move towards this new level of interoperability—something the new head of the National Coordinator for Health Information Technology Dr. Micky Tripathi has referred to as “authentic interoperability”—healthcare leaders still need to keep the needs of clinicians at the forefront. For example, just because FHIR and open APIs will facilitate the exchange of more data, we need to be cautious not to inundate clinicians to the point that they waste time wading through to find the patient- and problem-specific information they need.
When expanding their interoperability infrastructures, healthcare organizations must include technologies that can intelligently filter the clinical information on behalf of the clinician—which is one of Quippe’s many capabilities. Rather than physicians hunting through every document in a chart, Quippe works in the background to search and sort on their behalf. When in front of the patient, the clinician is then served the relevant information rapidly on demand.
For example, instead of searching through a chart for everything related to a patient’s diabetes or hypertension, Quippe enables a “diabetes view” or “hypertension view” directly within the clinician’s normal workflow.
I predict we’ll see significant interoperability advances in the coming months and years. To ensure these initiatives meet the needs of clinician users, healthcare leaders must continuously ask physicians and nurses what they need to perform their jobs effectively and efficiently—and then embrace the right technologies to drive success.