Interoperability between healthcare payers, providers, and patients is one of the most significant requirements in providing high-quality care, but it can also be one of the most difficult to achieve.
There are some significant challenges of interoperability in healthcare as systems move towards this more centralized approach. Through standardization, integration, and interoperable technical solutions there is the ability of the different health information technology (HIT) systems to connect within and across organizational boundaries. However, this will require complex EHR or legacy system upgrades, development of Application Programming Interface (API) capacity, and adherence to the HL7-FHIR standards for data sharing.
In order to improve patient experience and achieve greater efficiency and value from health delivery systems, there is a growing need for integrated care across the nation. The aim is to address fragmentation in patient services and enable better coordinated care. The need to integrate care through interoperability is essential as old models, using siloed systems on their own, are not working.
Interoperability for Trauma-Informed Care
The healthcare system, particularly for children, faces significant challenges in identifying and addressing risk factors for complex physical, behavioral and mental health conditions. The earliest signs of a problem in youth may present outside of clinical care. Integrated care brings together medical, mental health, and youth development services. What makes the integrated healthcare approach important is the sharing of information and the establishment of a comprehensive whole person treatment plan that incorporates the primary care, behavioral health, and social determinant needs of the person.
Older care models are not effective and provider agencies have grown exponentially more acute and complex. There is a need for managing and treating the extreme behaviors of the youth in their care which requires a high degree of collaboration and communication among health professionals.
Challenges for Patients, Providers, Payers & EHR Vendors
Interoperability faces several challenges due to disparate data sources, uncooperative vendors, and the complexity of various standards that can create barriers in data exchange. Standardized data exchange is the foundation that underpins patient access to their health information, improving patient experiences, and achieving better patient outcomes.
Although the ultimate goal of a health information exchange is the safe and fluid movement of accurate standardized patient information, the process has typically been siloed. There are disparate EHRs and legacy systems that may not utilize standardized Application Programming Interface (API) capabilities.
Healthcare payers and providers will need access to validated measures of patient‐centered outcomes across a spectrum of health conditions. Health care systems will need a credible way to measure these outcomes in order to address potential gaps among subpopulations and identify groups in most need of services.
Moving Toward the Solutions
Ultimately HIE and interoperability solutions will positively impact the quality of health care and facilitate benefits for patients, providers, and payers. Improving workflow and lowering costs through accurate and efficient billing while eliminating duplicative paperwork. This movement towards greater connectedness and streamlining healthcare data will strengthen services from providers and ultimately allow for more personalized, integrated, and accountable care.
Recent changes with Health and Human Services (HHS) rules give patients more control over their health data empowering them to access and manage their personal health care information. Patients will be able to ensure their medical history is accurate and up to date and have control over what information can be shared. Providers in turn will be able to quickly access and securely share a client’s medical history, and other pertinent health data with other clinicians across counties and providers, improving coordinated care and patient outcomes.
Access to population health data for automated analysis can proactively identify high utilizers along with their unique configuration of needs thereby guiding targeted treatment and promoting collaborative and systematic coordination of care. Organizations can become highly effective through real-time evaluation of services they provide and demonstrating improvements in the health outcomes of their population.
Overcoming Interoperability Challenges with the eINSIGHT Platform
The eINSIGHT FHIR Lite and eINSIGHT CDR-HIE Enterprise solutions recognize the obstacles and challenges that come with the implementation of an interoperable solution. eINSIGHT delivers with HL7-FHIR standards so that health care providers can focus on effective coordinated care of patients that leads to improved population health outcomes. Payers can provide an agile and affordable solution for their network of providers, and EHR vendors can engage a reliable partner to leverage a best-in-class HIE solution for their patients.
As an independent contractor, eINSIGHT applies solutions with tools to overcome issues with multiple vendors through a master Clinical Data Repository HIE that represents a ‘single source of truth’. The HIE consolidates disparate client data making it possible to implement automated queries to proactively identify high utilizer patients, deliver coordinated care based on unique client needs, and monitor improvements in population health outcomes while lowering costs.
In April 2020, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) announced a brief pause in enforcement around implementation of the final interoperability regulations to provide additional time to focus on addressing the COVID-19 pandemic. ONC has published a new compliance date/time frame chart on its website, making it clear that some provisions will still be expected to go into effect in late 2020 and implemented by 2022.
Want to streamline cross-communication between providers, counties, EHRs, payers and other systems? Learn more about the eINSIGHT HIE solution.
Dr. Weatherbee has spent decades working in education, behavioral health, public health, and more. He has experienced the unique challenges that exist in this field from multiple disciplines. His work in program evaluation lead him to create eINSIGHT to empower behavioral health service providers to improve client outcomes.