To better understand the importance of interoperability in healthcare, let’s consider a hypothetical story:
Imagine a chronic disease patient who regularly sees a specialist at a large regional health system for her condition. Let’s call her Beth. Then imagine Beth recently learned during a visit with her primary care provider, who works for a small independent practice, that she also has an unrelated genetic bleeding disorder.
To decompress from the stress of her latest diagnosis, Beth goes on a skiing trip to a mountain in another part of the country. On the last downhill run for the afternoon, she tangles with some trees and knocks herself out. She’s bleeding and unconscious.
Ski patrol shows up to triage Beth, and she’s taken to a different hospital for stabilization and treatment. But how can caregivers at the new hospital make informed decisions about her care? Three separate institutions now possess three different facets of Beth’s healthcare history: a chronic disease, a genetic bleeding disorder, and now an unconscious patient in a hospital that’s never seen her before.
The team at the new hospital needs to accurately assess all of this critical information to develop and administer proper care. This data should be readily available, regardless of how it’s accessed, or from where. It should be comprehensive and complete, representing the entirety of the patient’s healthcare history.
But without interoperability, none of this is possible. Beth’s patient history is stuck inside several different, siloed systems that can’t talk to each other. For that new hospital, and for Beth, the inaccessibility to her long history with chronic disease — and her genetic bleeding disorder in particular — could mean the difference between surviving this accident and suffering a much worse fate.
As Beth’s story illustrates, the ability to access and share a patient’s data seamlessly across any number of health data systems is key to providing patient outcomes that are safe, effective, and accurate. Yet while that data is increasingly created and managed electronically, the repositories where that data is stored are often incompatible.
The underlying technologies that support a secure exchange and interpretation of healthcare data is called interoperability. We believe that interoperability is increasingly important in a healthcare system where the generation of patient data continues to grow at unprecedented rates — 36 percent compounded annually over the next five years.
With so much patient data to manage, we at Lumedic have made interoperability integral to the products and services we offer. We strongly believe that in any industry, and in healthcare particular, standards are everything. And — importantly — so is the adoption of standards.
So we’re active in the healthcare governing bodies that define, develop, implement, and promote healthcare interoperability standards, such as the Office of the National Coordinator for Health Information Technology (ONC), and Health Level-7 (HL7).
And where no standards exist today, we’re working openly in the healthcare community to collaboratively define new ways to securely and efficiently exchange and interpret patient data, wherever it might exist. One healthcare interoperability standard that we’re currently building into a product is called HL7/FHIR.
This should come as no surprise to those of us in the healthcare industry, as Fast Healthcare Interoperability Resources (FHIR) is very quickly becoming a de facto means for establishing well-defined channels of data exchange between disparate healthcare systems.
What does FHIR mean for active skiers like Beth who have healthcare conditions that might not be easy to diagnose if she’s unconscious? Or even for someone seeing their provider for their annual checkup? FHIR means that available information is presented in a way that any system can speak and understand.
FHIR can very quickly share information in a consistent and unambiguous way. Ask the question “What’s Beth’s healthcare history?” to one hospital system, and that exact question can be asked — and answered — by any other healthcare system that can speak the language of FHIR. As an interoperability protocol, FHIR is an extremely powerful mechanism for sharing patient healthcare data.
We’re very encouraged to know that FHIR has been recognized by the Centers for Medicare and Medicaid Services (CMS) and ONC Proposed Rules as a critical new technology in the future of healthcare interoperability.
As part of the FHIR standard, we’re also developing around an HL7/FHIR based initiative that addresses the needs of the Value Based Care (VBC) community, called the Da Vinci Project.
We truly believe that the guides and reference implementations from this project will help establish the groundwork for widespread interoperability standardization in healthcare.
Our current collaborations with select healthcare payors are, right now, using FHIR to establish automated and all-electronic checks for prior authorization. We imagine a much broader rollout of FHIR services to our payors as part of our standards-based interoperability strategy.
Stay tuned for more on interoperability in healthcare.