One of the most controversial topics in the healthcare world is the debate over when and how to move to a fully interoperable health data ecosystem. In an ideal world, a collection of coordinated, universal, un-hackable systems would securely host the health data of every person in the country (or world). This data would be accessible across clinical, laboratory, medical, pharmaceutical, and personal uses, regardless of location, applications, or vendors. But, that’s the ideal situation. At present, we’re far from true healthcare interoperability. In the first post of our 3-part series, we’ll examine what healthcare interoperability is, the three levels of interoperability, and EnsoData’s vision for the interoperability requirements needed to usher forward the future of sleep medicine and patient care.
What is Healthcare Interoperability?
Interoperability, often abbreviated as i14y in the tech community, refers to a computer system’s ability to communicate and exchange fundamental data elements with other systems. A fully interoperable system is one whose interface, data, and products are completely understandable to outside systems, and vice versa. Not only that, but access must be past, present- and future-facing, with adherence to data standards, clinical ontologies, and best practices.
A 2008 congressional act, the
21st Century Cures Act, (Cures Act), put meaningful use and care quality measures behind interoperability in the healthcare space by demanding through public policy that healthcare organizations big and small achieve the following i14y ends:
- Enable the secure exchange and use of electronic health record (EHR) data information without special effort or technology on the part of the user
- Allow for complete access, exchange, and use of all electronically accessible EHR data for authorized use under applicable law
- Do not participate in “information blocking”
The US federal government has stated that for the betterment of the people, data must be accessible to all. It will take some time to get there, but it’s simply critical to continue making major progress here in 2020. Why? It’s been over a decade since the Cures Act was enacted in 2009, and progress is still trudging along slowly, with some vendors even fighting the changes needed to support a more accessible, effective healthcare system.
Back in 2008, health records could be paper records at a local hospital or digital records. After the Cures Act became law, healthcare providers had to switch from paper to electronic health records. Among many other industry-changing factors, the Cures Act outlined expectations for health information technology (HIT) to electronically exchange fundamental data and to enable the most basic levels of patient care coordination, both within a clinic and between providers. To get there, we have a few steps (or levels) to take.
What are the three levels of Healthcare Interoperability?
The three levels of healthcare interoperability are the foundational level, the structural level, and the semantic level. Each of the three levels dives into the interoperability discussion with a different lens, and builds upon the previous stage.
As the infographic mentions, a system that integrates at all three levels of i14y is the holy grail of interoperability, and some companies,
like us, are making this semantic level the focus of their development, knowing it is the future of healthcare.
EnsoData’s Vision: Complete Physiological Data Interoperability
As an industry, healthcare companies and health systems alike have been promising meaningful interoperability in healthcare EHRs for 11 years. The highest-priority core patient data has been exchangeable for over 30 years, and that’s the same data that systems are currently held accountable for exchanging by the government. However, technology has surpassed that threshold. Right now, we are at a point in time where we’re able to exchange physiological data at the same speeds and with the same levels of security and compliance.
The reason “healthcare interoperability” is about to be a trending google search is that all core patient health data must be exchangeable by the end of 2021 as the
grace period for core data interoperability nears its end. But this government rule only applies to core data, not the full range of data that
can be, should be, and in many’s view needs to be interoperable.
Remember, better data access can prevent complications in surgery, help standardize documentation and treatment protocols, provide a more holistic patient history in out-of-network emergencies, and to adequately understand a patient’s risk for future conditions and avoidable, adverse outcomes. For example: there are several crucial data points recorded during prenatal care, labor, and delivery that are not covered by the core data exchange requirements yet. It would be monumental for labor and delivery care if maternal health information was included in the exchange mandate. And just as this information is crucial in maternal healthcare, the same is true for sleep medicine, along with other medical specialties.
The Future of Healthcare Interoperability is Upon Us
As we’ve seen in recent years, sleep is promising to be a gold mine of data and information. Currently, foundational markers of health that are mandated to be exchanged, like hypertension, typically involve comorbid issues, allergies, or past complications, and thus are important for others to know immediately. But if physiologic data embedded within sleep studies can help predict comorbidities at higher rates, like the correlative relationship between Obstructive Sleep Apnea and Obesity or Hypertension, why shouldn’t sleep data be an interoperable requirement?
At
EnsoData, we’re ready to make healthcare interoperability a reality in sleep with
EnsoSleep, our
Waveform AI scoring and analysis software, but we need everyone on-board. This is not just a strategic imperative for the future of patient care, this is a movement for all of us as patients, to democratize access to our own data and to be able to take agency over our own health, quality of life, and the providers we choose to work with to support us.
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