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Interoperability knowledge hub

Get everything you need to know about interoperability in healthcare and what it means for hospitals and providers today.

Why Practices Should Care about Interoperability

Proponents of healthcare interoperability emphasize how it can improve patient care, streamline business practices, and increase profit through government incentives and enhanced reimbursement. Over 60% of physicians gave the health care industry a failing grade (D or F) for achieving interoperability. Only 14% gave it a B or higher.3  Clinicians note poor flow of information at every point of transition in the health care continuum — even within the same organization. Only 44% of clinicians report that they can share patient information within and across the care organization in which they predominantly practice. Because most patients receive care from multiple health care practitioners, an overwhelming number of physicians – 93% – want a more patient-centered information exchange.3 

Patient Care 

The implications of a lack of healthcare interoperability for patient care can be extreme. An acutely ill patient receiving treatment in an emergency department setting is at risk for suffering serious adverse effects if the attending physician doesn't have access to that patient's EHR. Knowledge of possible adverse drug interactions as well as the patient's cardiac status, possible implanted devices, allergies, chronic diseases, and so forth are critical to delivering quality care. Thus, up-to-the-minute access to information across secure IT systems is essential to helping the physician provide the best care possible. Less emergent but no less significant implications for patient care include the ability to follow up regarding ordered procedures, medication prescriptions, diagnostic tests, and so forth. One inpatient study revealed that, of all adverse drug events due to medical error, 18% were related to a gap in availability of valuable patient information.4 

Business Practices 

In addition to the more obvious advantages during the delivery of care, individual practices and institutions can also reap benefits from interoperability. For individual practices, the ease of data transfer in a truly interoperable system would eliminate the administrative costs in money and time associated with transferring medical records. It could also reduce the number of chart pulls, leading to a more efficient workflow and decreased administrative time. 

For hospitals and large health systems, medication reconciliation could happen automatically, rather than requiring a pharmacist's review. In addition, an interoperable EHR would eliminate administrative costs associated with submitting reportable conditions and vital statistics.

At the national level, some estimates view interoperability as having the potential to save $77.8 billion dollars in health care–related costs each year.5 These decreases in cost and time include streamlining admission procedures; enabling scheduling access, billing, and claims across systems; reducing courier costs; preventing unnecessary readmissions with better discharge and follow-up coordination; improving referral and care transfer processes; and so forth. Plus, healthcare interoperability prevents unnecessary testing, duplicative and redundant testing, and eliminates the costs associated with adverse drug events due to insufficient information. Costs would also decrease due to smoother, easier preauthorizations and referrals. 

Incentives and Reimbursement 

The Centers for Medicare and Medicaid Services (CMS) Meaningful Use program offers incentives to practitioners who adopt EHR systems, creating an opportunity for those using interoperable EHR systems to earn more than those who fail to institute interoperability. In addition, more streamlined coding and billing processes inherent in an interoperable system can ensure quicker, more complete reimbursement to the provider, regardless of government incentives.

3 Source: athenahealth data

4 Pan, E., et al. The Value of Healthcare Information Exchange and Interoperability. Chicago: HIMSS, 2005.

5 Walker, J., et al. (2005 June 19). "The Value of Health Care Information Exchange and Interoperability" [Online]. Available: http://content.healthaffairs.org/content/early/2005/01/19/hlthaff.w5.10.full.pdf [2015 October 7].

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