The need for interoperability health IT systems requires vendors to look in the mirror and answer some important questions.
These days — with COVID-19, new rules from the CMS and ONC, and patients who are increasingly seeking care outside traditional healthcare settings — health IT vendors can’t simply make great products. If your solutions don’t include interoperability features that allow healthcare providers to easily use the data your product generates, you’re going to have trouble surviving in the age of value-based care.
Interoperability isn’t just a nice-to-have. It’s a must-have. Providers, payers, and other vendors expect it.
“Vendors develop products and services that do not interoperate ... We need our healthcare technology and software systems to work in real-life settings and in concert with many other vendor technologies if we expect them to meet the needs of patients and providers now and in the future,” said Christopher Rehm, MD, LifePoint Health Chief Medical Informatics Officer, in his March 2019 testimony to the Senate Health, Education, Labor, and Pensions Committee.
The products you develop play a major role in how well data flows throughout the continuum of care. As you work on bringing more value to your customers, here are 10 questions you should be asking yourself about interoperability.
- Are you ready for health data to become even more complex?
Data connections are becoming more complicated in terms of the transactions flowing across them. Reporting of health data — in particular data such as COVID-19 deaths, and number of positive viral deaths — is also increasingly demanding. In addition, healthcare is moving to more distributed sources of data, such as healthcare apps and remote patient monitoring devices. The more data that’s out there, the more complex it’s going to become with standardization and normalization of that data.
- Are you thinking beyond the EHR?
Many health IT vendors have one stream of data they’re trying to connect to: the EHR.
The good and the bad news for health IT vendors is that there’s not just one source of data. Vendors can now access many more sources of data, which can be complex. Instead of getting just one VPN set up to the EHR, vendors have to be more flexible in connecting to different data sources and being able to manage those operationally.
- Are you knowledgeable about current health IT standards, and how standards will evolve in the future?
In an effort to promote interoperability, CMS and ONC released their final interoperability rules in March 2020. The rules specify the use of a particular health standard, FHIR R4. This new requirement is an important tool to enable integration inside and across the firewall. HL7 FHIR is an international standard, and local constraints will be mandated through profiles, such as the US-Core profiles. There are also specific use cases to be aware of, such as payer-provider data exchange being addressed by the HL7 DaVinci Project. In addition, the IHE organization plays a valuable role in defining how data is transferred between organizations using profiles. The products and services you’re developing now should include FHIR capabilities.
- Are you reactive or proactive?
Health IT companies start like any other. They win their first customer. Then their second one. These initial customers use the product and help the vendor figure out how to improve it. In other words, vendors react to customer requirements and build new features as needed.
Contrast this to a more proactive strategy in which vendors look broadly at the entire landscape of potential customers. With a bigger-picture view, vendors should consider a general-purpose capability around interoperability, rather than something that’s specifically tailored to each customer’s business requirements.
- How flexible and agile is your data infrastructure?
As data becomes more heterogeneous in terms of where it’s stored and where it comes from, vendors must respond quickly. If you’re not flexible and agile with respect to your underlying data infrastructure, it will hinder your ability to develop new features for your product or app. You need intellectual and architectural flexibility so that no matter the format or source of data, it can be integrated and used through your data store.
- Is your attention where it needs to be?
Software and technology companies, regardless of industry, do best when they’re focused and disciplined. Siphoning off your development resources to tackle interoperability issues keeps your attention away from your mission.
- Are you recreating something that’s already out there?
There are hundreds of years of experience out there from others who’ve blazed the trail before you —who have figured out ways to connect with every conceivable type of data, and who spend all their waking days and sleepless nights thinking of nothing else. It would be difficult for a vendor to create a method of interoperability that is better, more advanced, easier to use, has lower total cost of ownership, or is more agile than some of the platforms already in place. The key is to leverage what is out there, rather than recreate the wheel.
- Is data integration taking up most of your investment?
The majority of what the customer is paying for should accrue to your application, rather than data integration. Without a strategy here, it’s easy for the data integration to take over. It can become a significant majority of the total technology investment if you’re not careful.
- How different do you really want to be?
Walking into a provider’s office with a product or service that has a novel interoperability feature — that may not integrate with systems they already have in place — is not going to go over well. Your product should help providers leverage investments they’ve already made. This will help them reduce friction and probably makes your product easier to sell.
- How prepared are you for security threats?
Healthcare IT moves slowly. Cybersecurity moves extremely fast. Are you able to enable data exchange in a way that security isn’t breached in any way? No data governance approach is going to be completely foolproof, but paying attention to security best practices is a must. Making sure that you and the applications you use comply with HITRUST, SOC 2 Type 2, OWASP, and others will provide a head start to making sure that data is kept secure.
The bottom line? The way healthcare is delivered, managed, and paid for is rapidly evolving. To help bend the cost curve and allow healthcare providers to deliver higher quality care at lower costs, health IT vendors must develop solutions that allow all players in the ecosystem to better communicate with one another. To rise to the challenge, health IT vendors may need to rethink the way they view interoperability.
For further reading: