By Drew Ivan, Rhapsody and Corepoint Health
Interoperability gaps are everywhere in healthcare. Presently one of the bigger challenges facing the industry is the ability to send and receive patient records to and from disparate hospitals, health systems and other venues of care. The recent Information Blocking Rule put forth by ONC has been introduced to help motivate provider organizations, IT vendors, and information exchanges to eliminate barriers to the free flow of electronic health information. Consequently, hospitals and health systems will likely soon be mandated to pursue more robust interoperability solutions. While this rule may seem in some ways to imply intentional withholding of information and data, for most organizations’ information blocking is much more a matter of “can’t” than “won’t.” The reason being – many organizations “can’t” properly address information blocking due to either a lack of resources or sufficient business incentives. When hospitals and health systems have the necessary motivation (for example sending electronic claims to CMS), they take the measures required to connect with outside organizations.
Interoperability limitations have persisted for decades, and while many organizations have been strategic in their adoption of integration tools, others have pursued the minimum levels of interoperability to support their essential data-sharing requirements. Innovations in healthcare at all levels – clinical, operational, financial and technical – continuously increase the difficulty and complexity of the interoperability challenge, leaving many organizations significantly compromised in their ability to support innovation or meet new government standards. While some of the limitations of the EHR prevent information from being accurately and comprehensively shared with external systems, if they are properly prioritized and the right tools are leveraged, these barriers can be overcome. This is what the information blocking rule will ultimately aim to address.
Closing the gaps in interoperability and addressing its challenges is far from straightforward. EHRs present some of the most common and prevalent interoperability challenges across the healthcare industry. While there has been a great deal of normalization across the major EHR systems, at their core these platforms have different geneses and workflow dynamics. On top of that, EHRs can vary significantly across different health systems, specialties, and individual clinicians, creating significant challenges to successful data sharing, aggregation and analysis. Additionally, there are many health organizations that have not implemented any type of sophisticated integration layer or tools, either because they lack sufficient incentive, or because of differing technical and financial priorities.
By enacting a mandate like the Information Blocking Rule, the government is effectively making the adoption of robust interoperability a matter of compliance, and some organizations will be worse off than others when it comes to following the new rules. Taking measures to address and prioritize interoperability gaps is incredibly important as this will help set organizations up to effectively navigate and manage any interoperability challenges they encounter, but we must account for the disparities across healthcare organizations when it comes to their interoperability capability.
Hopefully this rule motivates organizations to be more strategic as today’s interoperability challenges will only be compounded by tomorrow’s. However, if organizations simply view this as a matter of compliance, and only focus on prescriptively meeting the requirements of the rule it may end up doing more harm than good. In order to stay ahead of these regulations, organizations will need to shift their perception of the mandates and seek innovative approaches to build out and achieve interoperability as a strategic asset. Additionally, as we move toward enforced record portability, organizations that do their best to quickly and accurately share information with any destination system, will enjoy competitive advantages, including higher patient satisfaction.
While concerns about sharing sensitive patient data with competitors will surely persist, we expect them to be overshadowed by the benefits of a stronger interoperability foundation, including improved outcomes, operational efficiency and patient experience. Knowing there are many health organizations that have yet to pursue interoperability (for understandable reasons), it would make sense for this upcoming rule to provide a grace period with incentives to begin implementing the appropriate tactics and strategies.
The proposed Information Blocking Rule will help to alleviate some of the industry’s persistent interoperability barriers – including those of business disincentives, technical challenges, and operational and usage variation. While it makes sense that some organizations have dragged their feet on interoperability, the industry’s heavy reliance on technology make it an existential imperative to prioritize data integration. As organizations look to the future, the pursuit of strategic interoperability capabilities as a core competency will not only be essential from a business perspective but also an outcomes and satisfaction perspective.
About The Author
Drew Ivan is EVP of Product and Strategy for Rhapsody and Corepoint Health.