The continued rise of data as the currency of the future continues bringing with it both strategic opportunity and challenges. Meeting those challenges is a must for any organization that expects to have a future vision of tech-enabled service delivery, a vision that will rely heavily on exchanging health care data (see Will Security & Interoperability Shape Our Health Care Future?).
How to get there was the focus of The 2016 OPEN MINDS Technology and Informatics Institute pre-conference seminar session, Standing Apart – Interoperability’s Strategic Role In Advancing Behavioral Healthcare Transformation, presented by Gregg Boyle, Chief Product Officer, Qualifacts Systems, Inc. and Sharon Hicks, Senior Associate, OPEN MINDS.
Mr. Boyle provided a snapshot of the current state of interoperability, and a definition – “Orchestration of health care data between healthcare systems so that all individuals, their families and health care providers can send, receive, find and use electronic health information to support the health and wellness of individuals through informed, shared decision-making.”
He also discussed the three levels of interoperability – foundational, structural, and semantic.
- Foundational interoperability allows data to be sent or received, but it cannot be interpreted by a computer system and requires a human to read and import the data.
- Structural interoperability means the sharing of data where the system understands key phrases, but not everything.
- Semantic interoperability is the seamless exchange and interpretation of data and information – humans are not required to translate the information. This level of interoperability has not yet been achieved in health care.
Right now, as a health care system, we’re somewhere between levels one and two – with some organizations making more progress than others.
But he also discussed the initiatives that are shaping the future. In October 2015, the Office of the National Coordinator for Health Information Technology released a shared nationwide interoperability roadmap (see Connecting Health and Care for the Nation A Shared Nationwide Interoperability Roadmap). The roadmap includes four steps for driving future interoperability including a coordinated governance that will establish operations and technical standards that will enable trust and allow information to be shared appropriately across the ecosystem, development of standards for interoperability such as a common clinical data set, clarify security and privacy requirements such as HIPPA, and encourage care providers and consumers to use technology through the development of consumer portals.
The question is how to get there. Whether you are operating a health home or medical home, joining an accountable care organization network, or are managing any care coordination services, you need to think about how your organization can share data within a care network. How do organizations go about doing this? There is a five-step process to help organizations plan for interoperability:
- Determine your care network and how you are connected to them: The first step is to determine the health care organizations currently within your consumer’s care network and then determine how you are connected with these organizations. Then ask yourself what three problems you could solve by connecting with these organizations – what information do you need about your consumers to make data-driven decisions that focus on the health and well-being of your consumers as a whole. Validate your priorities by talking with staff about the information they need to make better clinical decisions about consumer’s care.
- Identify your priorities: What information is most important for your organization to exchange in terms of clinical outcomes, staff satisfaction, and administrative costs. Then rate how hard it will be to accomplish the task. After rating the different tasks as a team, pick the most important tasks for your organization.
- Determine if you need to expand your care network: Now that your priorities have been established, it’s time to find where the gaps are in your care network and where you need to form partnerships to create a more complete data profile of your consumer population.
- Start the dialogue and build a plan: Approach the organization you are interested in partnering with and begin the conversation about the value in sharing information. Once a partner has agreed to exchange information, a plan needs to be developed that discusses the flow of information, the source for the information exchanged, and the appropriate consents. Additionally, you need to ensure that you have the tools you need to be successful. Do you have the business, clinical, and information technology expertise to actually operationalize the exchange of information? Does your partnering organization have the expertise they need?
- Operationalizing the interoperability: Moving forward with the plan can be the most difficult challenge. At this stage you should have identified how you have built your interoperability platform, how are you supporting it, and if your staff has the training they need. Finally, consider all the risks of data sharing. Exchanging information always has risks. It’s important to have a strategy that can identify risk and mitigate it before it becomes a large problem.
The road to interoperability isn’t always smooth, and unfortunately in health care there is no such thing as total interoperability. What organizations can do while we are waiting for the system to move forward is identify the most important areas for exchanging information and build the system you need to support the health and wellness of consumers through informed, shared decision making.
Wondering how other organizations stack up when it comes to data exchange? The 2016 OPEN MINDS Health & Human Services Technology Survey includes information on how organizations are exchanging data, as well as the use of electronic health records (EHRs), the use of new information technologies, and how organizations staff and budget for the use technology. The complete survey results are available for purchase now in the OPEN MINDS estore.