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Clinical integration knowledge hub

Learn about the importance of implementing a successful clinical integration strategy, along with some obstacles to avoid along the way.

Obstacles to interoperability within closed systems

Interoperability refers to:

  • The ability of two or more systems to exchange information
  • The ability of those systems to use the information that has been exchanged1

In health care, interoperability is the ability of technologies to facilitate the integration of patient data from multiple settings and different systems. This is a major asset in achieving clinical integration, but it can also pose challenges for health care organizations not prepared to enable such an exchange.

The goal of interoperability is to ensure a smooth flow of clinical data across secure IT systems for better patient care. When patient information is easily and regularly exchanged among different settings, providers have an improved workflow and less information ambiguity, and can deliver better care by having the right data at the right time.

In recent years, some hospitals and health care organizations have tried to create internal hospital information systems (HIS) as a way to deal with and manage the interoperability issue. These entities try to own the entire necessary infrastructure—from physical servers to IT personnel—to create a single, “closed” HIS network for all participants.

One advantage to having a closed HIS is that providers do have access to a single, shared patient health record, where the same information is available to all providers in the system, regardless of where the patient goes in the network. But this structure does not support true interoperability because providers and trading partners outside the network will never be able to share information with the providers in a closed system, putting the HIS model at a major disadvantage.

Without true interoperability among all partners and systems—including labs, pharmacies, radiology centers, rehab facilities and more, regardless of location— a closed HIS network does not necessarily improve control over patient care and costs, nor does it help drive the right behavior or surface the right information across all settings.

Another crucial disadvantage to this approach is that patient information is typically not integrated within provider electronic health system workflow, so patient data is delivered without filters or other intelligence to help caregivers focus on critical information. As a result, providers must spend valuable time searching for relevant information, often during patient encounters.

True interoperability delivers access to the right information at the right time, designed for caregivers and health care leaders to make the right clinical and financial decisions—regardless of where the information originates. Affiliates and other partners across the care continuum need to be able to interface appropriately across a clinically integrated system that enables the easy exchange, connection and coordination of data among various providers.

Rather than building a bigger closed system through physician acquisition, a clinically integrated organization could instead emphasize interoperability, including strategies that embrace open platform and exchange capabilities. Ultimately, to best serve patients, health care systems will need to share clinical data across a wide range of clinical partners, and without boundaries.

1 Fridsma, D. Interoperability vs Health Information Exchange: Setting the Record Straight. Health IT Buzz. (January 9, 2013). Available at:

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