Making Progress Toward Healthcare Interoperability

September 19, 2019

When healthcare leaders talk about things like improving efficiencies, lowering costs and using data more effectively to improve individual and population health, the discussion invariably turns to interoperability.

But just what is interoperability?

HIMSS defines it as “the ability of different information systems, devices or applications to connect, in a coordinated manner, within and across organizational boundaries to access, exchange and cooperatively use data amongst stakeholders, with the goal of optimizing the health of individuals and populations.”

That’s quite a mouthful. The reality is, the definition often depends on who you’re talking to. In practice, interoperability means different things to different stakeholders. But one thing is clear: The seamless exchange of data and the centralized technology to make it possible are going to be instrumental to healthcare’s transformation.

Interoperability: A Closer Look

In a recent episode of our podcast series, How I Transformed This, Dr. Ashwini Zenooz, Salesforce’s SVP and General Manager of Global Healthcare and Life Sciences, shared some of her experiences from her time working as Chief Medical Officer at the VHA, where she headed up its digital modernization efforts.

Dr. Zenooz, who’s also a past board member of The Center for Medical Interoperability, notes that the VA has amazing hubs of innovation and talent within it. In fact, it’s where the electronic medical record (EMR) was initially developed. But because of all the innovation going on, there were 130 different versions of the single EMR across the organization and multiple disparate systems of record outside the EMR. The organization realized that the separate systems and data would ultimately become a roadblock to transformation.

“You need a holistic system that’s interoperable to bring all those records together,” she says. “And the data has to be good data.”

A technical person thinking about the interoperability of that system will naturally be looking at all the technical aspects involved in getting those various systems, apps and devices connected. For a clinical person, on the other hand, interoperability is about having a seamless exchange of information that allows you to take better care of people.

Ultimately, Dr. Zenooz says, it’s the combination of both. That’s why she recommends centering back on the patient’s needs and asking: What’s required to provide the best care to the patient in order to get the best outcomes?

That question will help you determine what you need from the system—essentials like good clean data, structured in a format that enables analytics, and the ability to go with the patient where the patient needs their care to go.

Interoperability and the Patient Experience

In the context of the patient experience, it’s important to recognize that interoperability is much more than just the clinical component, though. When healthcare leaders talk about the patient experience, they often focus on the patient’s interaction with the doctor and the clinical record. The EMR is great for that. But there is still so much more that could and should be automated beyond the EMR.

Consider the time-consuming administrative processes both patients and physicians still have to deal with that happen outside the EMR and the doctor visit. Whether it’s filling out forms, dealing with bills, filing claims, managing medication reorders or any number of other aspects of the experience, there’s a whole host of processes and systems that continue to lag behind when it comes to interoperability.

Most healthcare leaders recognize the benefits of integrating all these fragmented, often complex systems. Interoperability can enhance the patient experience in addition to improving operational efficiencies, data visibility and decision-making. But the task can seem overwhelming. That’s why Dr. Zenooz is particularly enthusiastic about Salesforce’s ability to facilitate these critical changes, especially considering its track record of bringing together disparate systems and processes to create better experiences and alleviate administrative burdens and inefficiencies in other industries.

As you work toward interoperability, remember that it means different things to different people—and all of those definitions are important to ultimately putting in place a system that will help clinicians and administrative staff succeed in their jobs while delivering the best possible outcomes for patients.

As Dr. Zenooz says, “We have to think more holistically when we have these conversations, which means you have to bring a lot of different stakeholders to the table.”