The widespread and effective adoption of digital technology is key to creating a sustainable future for health and social care. However, that potential can only be fully realised when the growing volume of data that healthcare organisations produce is allowed to flow freely throughout the continuum of care and between different information systems.
Those providers who are able to deliver a seamless exchange of data will not only achieve higher levels of regulatory compliance, but also of patient satisfaction, according to published research by HIMSS Media for its study ‘Connected Care and the State of Interoperability in Healthcare’.
Unfortunately, in many healthcare organisations, a plethora of disparate formats, technical specifications and incompatible proprietary platforms prevent this from happening. Such a lack of ‘interoperability’ means that valuable patient information is all too frequently trapped in silos from which it cannot break free.
This not only limits clinicians’ ability to make an accurate diagnosis or prognosis, but means they are unable to share up-to-date information with their patients at the point of care, which lessens the degree of meaningful engagement and communication. It also impacts clinical research, which depends on the open exchange of data.
In many instances, the major impediment to interoperability is the question of how to manage unstructured data, which is an increasingly large portion of the patient record and critically important for healthcare professionals to access to gain a complete understanding of the patient’s health. Paper-based notes, discharge summaries, digital photos, surgical videos and the like still make up nearly three-quarters of patient information. Locked away in filing cabinets or siloed data stores, they are often inaccessible for review or analysis by other professionals with an interest in the patient.
With so much unstructured data in the system, day-to-day ‘basics’ like ordering, tracking and assessing the improvement or decline of a patient’s condition becomes a far from efficient process, with tests often having to be repeated, increasing costs and decreasing patient satisfaction.
EMR systems are designed around structured information that captures patient data in discrete fields. This structure makes it difficult for these systems to be a true single source of clinical knowledge on their own.
To compound the situation, even when in a digital format, patient information is often fragmented and dispersed across a healthcare organisation. For instance, according to HIMSS, 18 percent of imaging data is contained in devices such as smartphones and portable ultrasound machines, which are not integrated with core clinical systems.
Of course, advances are being made. The study also reveals that 35 percent of those surveyed already have in place an enterprise imaging strategy that gives them a more complete patient information picture, and does not leave them dependent on picture and archiving communication systems (PACS) alone for their medical imaging requirements.
While this means that two-thirds of organisations currently do not some 31 percent are planning to do so. We therefore appear to be heading in the right direction, with the question of interoperability coming into focus for more and more providers.
‘Connected Care and the State of Interoperability in Healthcare’ also shows that organisations are increasingly looking to integrate point-of-care images with workflows, using application programming interfaces (APIs) to connect health information technology (HIT) as they move towards implementing a single, integrated EMR system.
Technology enabled care (TEC) offers significant possibilities for delivering safer, more efficient and cost-effective healthcare. In fact, it is essential for creating a sustainable health and social care system for the future. But, if we are to fully enjoy these benefits as quickly as possible, we need to move beyond seeing interoperability as solely the remit of the IT or radiology departments.
Colleen Sirhal, Hyland’s chief clinical officer, has described interoperability as a ‘people issue’ that will require the involvement of a much broader range of stakeholders, to reach a consensus on what is the right data and how to get it to the right people, at the right time.
HIMSS, for example, is now talking of ‘organisational interoperability’ that encompasses not just the standards and formats for data exchange but also the policies and procedures that underpin it.
What this can look like in practice is connecting the EMR to a vendor neutral archive (VNA) that stores every type of medical imaging, no matter the source or data format. Providers should also look to integrate their EMRs with content management systems that store and manage a variety of unstructured healthcare documents and forms. When combined, these systems can ensure the EMR is a comprehensive single source of all patient information, making it a more valuable tool for clinicians.
If we are to meet such expectations and give healthcare consumers a connected experience and the opportunity to manage their health more effectively in conjunction with clinicians, then achieving interoperability must be seen as an enterprise-wide endeavour to be pursued collectively, by everyone involved.
Alexander Ryan is the Healthcare Alliances and Net New Sales manager for EMEA with Hyland Healthcare. www.hyland.com
