Interoperability in Healthcare


In United States exchanging and accessing the Health Data in secure manner is always challenging. It is difficult to exchange and access the data because the health data is more sensitive and require higher level of privacy and security. To deliver the effective healthcare to population it is very important to share and access the data across the Healthcare Organizations is very much required when it’s needed. So having Healthcare Interoperability in place helps health companies to effectively share information, most significantly by avoiding mistakes. It enables healthcare providers to offer a more patient-centred and data-driven approach, which enhances health outcomes.

What is Interoperability in Healthcare?

Healthcare interoperability, commonly referred to as EHR interoperability, is the act of two or more systems integrating and exchanging information. This improves patient care, performance, and workflow for medical professionals and personnel.

Healthcare Interoperability Levels

As per Healthcare Information and Management System Society (HIMSS) defined four levels of Interoperability. These levels are called foundational, structural, semantic, and organisational by HIMSS, which is one of the biggest organisations helping to improve the world's healthcare industry.

Foundational – Foundational Interoperability, also known as simple transport. This level deals with transferring the data from one system to another without changing the data into any format. At this level, data can be securely exchanged between various software platforms and document management systems. However, without human support or other technologies, they cannot understand patient data.

Structural – This level deals about the ability of the recipient system understanding the data that is being sent from sender system. The data will be standardized to a particular format that can be understood by multiple systems. The data standards like FHIR and HL7 standards provides structural interoperability. So, data will be consistent, centralized, and easy to share between the systems.

Semantic – The semantic level of interoperability, deals with the ability of two systems not just to send information, identify and match data, but also seamlessly integrate each system to use the data from the other systems. If two systems are using different codified standards (SNOMED, LOINC. ICD-9, ICD-9 etc.,) it is difficult to achieve and requires coordination and collaborations between healthcare systems.

Organizational – This level deals with sharing and accessing the data securely within an organization or outside of the organization typically to promote public health. This will enable to share consent, trust, and integrate end-user processes and workflows.

Business Case for Interoperability in Healthcare

Human lives depend on timely, honest, and accurate information in the healthcare industry. Lack of interoperability in healthcare IT systems will result in a number of delays, issues, data losses that neither medical staff nor patients want to deal with.

In real life, this is how it would work: a patient would go from hospital A to hospital B. So, the patient must carry all the lab reports, prescriptions etc., which the patient might be maintaining in a folder. If the patient misses to carry any lab report which is required in hospital B, provider might suggest to go for a lab test again which will be again time consuming and increase in cost also for patient. Also it will be difficult to carry all the documents in paper form whenever he visits a new hospital.

So having Interoperability in the Healthcare Organizations streamlines the workflow, eliminates possible data loss and pursue better patient safety and improve experiences for the people they serve.

Challenges in Healthcare Interoperability

Even though Interoperability is very helpful for healthcare, EHR interoperability does have some problems. The primary issues are discussed below.

Complexity of Healthcare Data Exchange

In healthcare there will be many departments or individuals (nurses, doctors, lab technicians etc.,) works collaboratively in the treatment of patients. Each of these individuals generates the data which includes patient administration, clinical information, lab results that is needed by another. However, safe, and effective healthcare depends on ability of exchanging data between one person to another or from one organization to another organization. Few healthcare organizations might be unwilling to share the patient information to other organization even though they are in agreement to share information. Some individual providers may have their customized or vendor-driven software which will be incompatible and not interoperable with other systems.

Multiple Medical Records

When high volume of data being transferred between the systems there will be a high chance of patient data being duplicated. There will be high chances to get same patient data will be received from multiple systems. So, it will be challenging to maintain the large sets of data. So, there should be an additional tool or software which can identify the duplicated patients and consolidates the data.

Standardization Problems in Healthcare

Standardization of data in healthcare helps in improving the patient care by allowing the interoperability among different systems. Each healthcare organization will be using different standards to save the patient data in their system. Most used HL7 standards are FHIR, CCDA, HL7v2, HL7v3 messages etc., If one organization is using CCDA standards in representing the Patient data and other organization is using FHIR standards in representing the patient data. It will be difficult for the recipient system to understand the data received from sender system. So having the standardization of data across the systems in important in Healthcare Interoperability.

Use of Incompatible Clinical Ontologies/Terminologies

In healthcare field, there are many terminologies and ontologies to represent a same clinical concept. Each EHR system will use different terminologies and ontologies which will make patient data to be inconsistent and adds to the problems of not being able to talk each other. This challenge can be overcome if the EHR systems rely on agreement and uses the same terminologies and ontologies or mutually compatible ones.

Privacy and security challenges

Some organizations in the healthcare field will not be ready to share information with other providers. For example, urgent care clinics and hospital systems both try to get patients. When an urgent care clinic asks a hospital's EHR system for patient information, the hospital might not share data because of privacy and security reasons. The law says that health data should be shared and accessible across organizations and to patients themselves.

Our expertise and Solutions for Interoperability

The Xyram team has extensive expertise implementing interoperability in healthcare organisations while adhering to all rules and exceeding user privacy and consent expectations. The professionals at Xyram have extensive knowledge of HL7 standards, including FHIR, CCDA, QRDA, EDI, and HL7v2 messages, among others. Our team collaborated with well-known EHR suppliers to achieve interoperability and assisted in enabling HIE with additional EHR vendors.

There will always be a need for software systems to communicate with one another. If healthcare organisations want to meet patient demand for access to medical data, make the shift to value-based care, or fully utilise analytics, they will need interoperability and other advanced APIs (FHIR APIs). We will thoroughly comprehend your company's needs and be able to integrate interoperability into your current network. Our team has experience using a variety of cutting-edge technologies and adaptable development methodologies to construct FHIR APIs and other services depending on their complexity. Our team collaborated with HER vendors who had a lot of potential, helped them build FHIR APIs, and assisted them in obtaining 21st Century Cures Act ONC (g)(10) Certification. Please reach out to for further details and to help you in this journey 

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