What is interoperability? It’s the ability of computer systems or software to exchange and make use of information. Why is it important? It provides the right information to the right people, through the right channels, in the right intervention format, at the right time in the workflow for decision making and action. How does all of this affect EMS? As hospitals look for efficiency, they’ll need to partner with EMS and build stronger provider networks. Interoperability allows for an improved patient experience, improved population health and therefore reduced healthcare costs. The following is a high-level cheat sheet to get you, and your organization, up to speed on interoperability.

3 Reasons Interoperability is Important to EMS

1. Interoperability empowers individuals to use their electronic health information to the fullest extent. Patients with access to their health information are better able to manage their conditions coordinate care, and advocate for their own health.
2. Interoperability enables providers and communities to deliver smarter, safer and more efficient care. When care teams have a holistic view of the patient’s health, they can check for drug and allergy interactions, monitor complex diseases and co-morbidities, and track patients. Think about how powerful it would be if your medics had easy, instant access to a patient’s health records – we could provide better, faster, cheaper treatment for patients, and maybe even avoid costly care options. Beyond that, healthcare providers can start to see the true impact of the care they provide. They can analyze trends, looking at the effects of medications and protocols over the patient’s lifetime, and learn how to treat specific patient populations. All of this data analysis leads to more proactive care for patients, which leads to longer and better quality of life for the patient in the long run.
3. Interoperability promotes innovation at all levels. I’m sure a number of great ideas popped into your head when you think of the possibilities we could make a reality with all of that data; the good news is that vendors are developing some of those great ideas right now. As access to the data becomes less of an issue, the market opportunity opens up significantly and makes it a lot more appealing for vendors to invest in the healthcare space.

Why Haven’t We Figured Interoperability Out Yet?

You might be thinking, if banks can share information, why can’t we? Well, I want to start by saying we’ve made a ton of progress over the last few years, and we’re going to see vast leaps forward in the next couple of years. This is a complex problem that’s hard to summarize in a blog post, but I’ll try. Here are the six primary reasons we, after all this time, are still working the interoperability problem.

1. Priorities and Resources. There’s been a tremendous push for hospitals and clinics to move toward interoperability for many years, but we all know about balancing competing priorities with resource constraints. And there certainly have been a number of market forces and fundamental structural issues with healthcare that got in the way of interoperability in the past.
2. Proprietary Vendor Technology. We started with a bunch of proprietary technology that was developed by highly competitive, profit-seeking companies who fully understand the value of data and work hard to protect that data. Technology vendors weren’t incentivized to make data highly portable because it makes more business sense for them to have high switching costs. However, that’s changing as the industry and requirements for Certified EHR Technology (CEHRT) keep evolving. With the 2015 edition of the CEHRT, EHR vendors had a lot more interoperability mandates to fulfill before they could be certified. And last year at HIMSS 2016, a number of vendors came together to sign an interoperability pledge.
3. Competitive Health Networks and Hospitals. Competition didn’t stop with the vendors. As you know, there’s also tremendous competition between hospitals and health systems. Sharing information about patients could mean losing that patient, so there was “selective” information sharing between entities. That’s coming to an end as well. There’s a new mandate in the Medicare Access and CHIP Reauthorization Act (MACRA) or the Quality Payment Program that providers must attest that they will not engage in information blocking and that they will enable EHR functionality to support data sharing.
4. Non-Standard Standards. Standards in healthcare have taken some time to mature. It’s tough to get a room full of healthcare providers to agree on anything, right? It’s the same when we’re trying to get everyone to agree on terminology and definitions. However, a number of industry organizations have stepped up to help define useful, comprehensive standards that cross modalities, transport mechanisms and care specialties. (Stay tuned for Part Two for more information on this.)
5. Security Concerns. There are also some unique security concerns related to healthcare information. Health Insurance Portability and Accountability Act (HIPAA) and patient privacy laws have been used as an excuse to shut down information sharing. Now, with the new legislation mandating information sharing, the government is helping to educate healthcare providers and patients about how they can protect their information while still facilitating interoperability.
6. Reimbursement Model. Our reimbursement model hasn’t been doing interoperability any favors. Providers who were paid on a fee-for-service basis for the services they provided were incented to accrue multiple visits for their patients. Interoperability didn’t really fit well into that landscape, which is part of the reason for payment reform.

This article was originally published in July 2017