The world is getting smaller and smaller as more people connect with one another over networked computerised systems. Enhanced connections speed up reaction times as people can communicate more easily, but there are also gains being made as various software and computer systems link up with one another for automated data sharing.
“Interoperability” You’ve likely heard this term, and you may even understand what it means? Interoperability is the extent to which systems can seamlessly exchange data, interpret, and act on that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.
For HME providers that embrace interoperability, the business impact will be dramatic, leading to exponentially more referrals and increased relevancy within the post acute healthcare continuum. To put the importance of interoperability into perspective for the HME industry, look no further than the acute and ambulatory healthcare markets, where significant strides have already been made to digitise and begin sharing health information.
HISTORY OF INTEROPERABILITY
Driven primarily by payors and our government, interoperability is aimed at improving patient care and controlling skyrocketing healthcare costs through an outcome based reimbursement model.
In order to quickly drive the adoption of health information technology by hospitals and physicians, incentives were put in place. The first program was the Meaningful Use program, led by CMS and the Office of the National Coordinator for Health Information Technology (ONC). Meaningful Use is a phased approach that grants an incentive payment to eligible healthcare professionals and hospitals who demonstrate that they have engaged with certified Electronic Health Records) technology. As the initiative evolved, the program became cumbersome and physicians pushed back as comprehending and complying with the program took time away from their patients
In the year 2015, The Medicare Reform Law and CHIP Reauthorization Act of 2015 (MACRA) was passed. MACRA expands upon Meaningful Use, but considers quality, cost, and clinical practice improvement activities in calculating how reimbursements are determined; MACRA also measures physicians on their meaningful use of certified EHR technology. As this shift in model occurs, CMS and ONC have made it clear that a key goal for the new program will be to aggressively drive interoperability across the healthcare ecosystem that they paid to digitize.
LEVELS OF IMTEROPERABILITY
The HIMSS board established definitions for three levels of interoperability in 2013:
1. Foundational Interoperability
It enables one information system to exchange data with another information system. The system receiving this information does not need to have to interpret the data. It will be instantly available for use.
2. Structural Interoperability
It defines the format of the data exchange. This has to do with standards that govern the format of messages being sent from one system to another, so that the operational or clinical purpose of the information is evident and passes through without alteration. We are talking about information at the level of data fields, as in a database of patient records.
3. Semantic Interoperability
It is the highest level of connection. Two or more different systems or parts of systems can exchange and use information readily. Here, the very structure of the exchange of data and how the data itself is codified lets medical providers share patient data even when using completely different EHR software solutions from different vendors.
WHY IT MATTERS?
It helps reduce the time it takes to have useful conversations between providers as well as between doctors and their patients. This leads to increased patient engagement and better outcomes, since more time can be spent on the details of the illness or injury as the medical professionals devise a treatment plan.
Interoperability in health care results in easier access to things such as details in patients’ electronic health records, but it will only work to the extent that various medical software vendors will agree to share what often can be proprietary system information,
POTENTIAL IMPACT ON HME PROVIDERS
⇒In the HME industry, building and servicing referral sources has always been critical. But now, interoperability is beginning to have a major impact on the referral process.
⇒More and more referral sources are rapidly moving towards transmitting electronic referrals (e Referrals) through their EHR system.
⇒The benefits of this trend for the HME provider are realised when the provider can receive referrals and related documentation electronically into their own system.
⇒Although the percentage of electronic referrals to HMEs is small today, it is expected to rise significantly over the next few years.
⇒This presents an opportunity for HME providers who quickly embrace interoperability now to gain market share as the transition to e Referrals takes off in a big way.
IMPROVED EFFICIENCY
Interoperability in healthcare is designed to boost efficiency. When data is presented on a consistent basis no matter what the source, it’s easier for practitioners to quickly get to the heart of the matter as they make decisions about treatment.
SAFER CONTINUITY OF CARE
Continuity of care is crucial for patients, whether for chronic conditions or taking care of an acute situation with multiple health service providers. Interoperability enables safer transitions of care, which leads to better patient outcomes over all.
CAN HELP LOWER COSTS
Interoperability means that more useful information can be shared in a timely manner. So, the data from a patient who had a blood test last week at his doctor’s office can be used today during a trip to the emergency room, saving the time and cost of doing more (and unneeded tests) at the hospital. Improved efficiency through greater information sharing saves time and effort for staffers, leading to more cost savings.
STAY CONNECTED, OR YOU’LL BE DISCONNECTED
As important as interoperability will become to your HME business over the next few years, it is paramount that you select a technology partner who can deliver the most robust software and communications architecture. Also, the technology partner is only as strong as the connections it offers to your referral sources, payors, manufacturers, distributors, and others so that you are connected where you need to be to share data seamlessly across your care continuum. The day is coming where a provider will receive a referral electronically, automatically send forms to the physician for e Signature, and deliver HME product with reduced or no risk of denials.
THE FUTURE IS NOW
Embracing interoperability is not an option. It is imperative to the future of your business. As a provider, you must have a clear understanding of how your business fits into the dynamic healthcare ecosystem, and you must use a strong technology platform to succeed in this new interconnected world. The HMEs who act now will succeed, reaping the rewards that early adopters enjoy.
CONCLUSION
Recognising the importance of interoperability is crucial for any professional working in the healthcare industry. Given that so many of our systems and pieces of equipment are connected with one another over wired and wireless networks, we all need to stay on top of interoperability developments in government and industry.