This is the second article in a series about interoperability in healthcare by Dr. Peter Schoch, MD. (The first focused on moving beyond technical jargon to make interoperability a more accessible topic.) With two decades of experience as a primary care physician and another 13 years as a health system physician executive, Dr. Schoch has a deep understanding of how to demystify interoperability. He hopes to drive the discussion surrounding connected health information sharing forward, from a technical conversation to an impact conversation.

At the heart of interoperability––the seamless exchange of data through connectivity and communication––is one thing: data. Raw data like symptoms, imaging scans, patient demographics, lab results and vital signs inform clinical decisions and impact patient outcomes.

For data to make the greatest impact in healthcare, it goes through a lifecycle beginning with collection, transitioning to organization, knowledge and eventually, wisdom. Interoperability is the crucial function that facilitates this evolution. Without interoperability, the seamless exchange and integration of data between different systems and stakeholders become challenging. This hinders the efficiency and effectiveness of healthcare delivery.

Currently, the healthcare industry as a whole has a bit of a preoccupation with gathering data, without a corresponding focus on utilizing that data to its full extent. According to the World Economic Forum, the average hospital produces 50 petabytes of data per year––around 137 terabytes every day. Such a vast repository of data, while important, is not effective unless we’re leveraging interoperability for knowledge generation. Only then will the data we are collecting and storing lead to improved patient outcomes and system efficiency.

The Data Lifecycle

Collection

Within the healthcare context, the lifecycle of all of this data begins at the point of origin. Clinicians have a question or hypothesis, and they use data collection to help answer it. For example, a patient complaining of pain or pressure in their leg may present all of the symptoms of a DVT clot. However, only with an ultrasound can the diagnosis be made. In the data collection phase, interoperability involves data being gathered from various sources, such as hospitals, clinics, laboratories, and pharmacies. Then it’s stored in a way that makes it easy to be shared and aggregated.

Transition

Collected data then cycles to the processing and organization phase. This involves structuring the data into a standardized format, such as HL7 or DICOM, and associating it with relevant clinical context, such as patient history or diagnosis. Interoperable systems allow for the standardization of data formats and protocols. This makes it easier to process and organize information consistently across different platforms. Standardization ensures that data can be accurately interpreted and utilized by different healthcare applications and systems. Therefor reducing errors and improving data quality.

Wisdom

As healthcare providers interact with the data and apply their expertise, the information is transformed into knowledge. This knowledge represents a deeper understanding of the patient’s condition, prognosis, and optimal care pathways. It may also involve the synthesis of data from multiple sources to identify patterns, trends, and insights that can inform clinical practice and improve outcomes. Here, interoperability enables the integration of data from diverse sources, including electronic health records, medical devices, wearable sensors, and population health databases. This integrated data can be analyzed collectively to identify trends, patterns, and insights that may not be apparent when considering individual datasets in isolation.

Ultimately, the goal of the data lifecycle in healthcare is to move beyond mere information storage and retrieval to achieve wisdom. With that, healthcare providers can apply knowledge gained from data to anticipate patient needs, prevent adverse events, and optimize care delivery. This process of collecting, organizing, analyzing, and applying data is essential for driving continuous improvement in healthcare outcomes and advancing patient-centered care. Interoperability supports the dissemination of knowledge, enabling providers to learn from each other’s experiences and successes.

 

The Unfulfilled Promise of EHRs

The transition from paper-based medical records to electronic health records (EHRs) promised increased efficiency, improved data accessibility, and enhanced patient care coordination. However, the reality has been more complex. While EHRs have digitized patient data, they often lack interoperability, making it difficult for different healthcare systems to communicate and share information effectively.

One obstacle is the lack of standardized data formats and protocols across different EHR platforms. Without common standards, exchanging information between systems becomes cumbersome and error-prone. Moreover, issues related to data privacy, security, and regulatory compliance further complicate efforts to establish interconnected systems.

 

Harnessing Interoperability to Enhance the Data Lifecycle

Clinicians are increasingly recognizing the importance of interoperability in addressing immediate practical needs within healthcare. Seamless connectivity and meaningful communication across systems enables healthcare professionals to access timely, relevant information at every stage.

To achieve interoperability, clinicians must continue to advocate for standardized data formats and protocols that facilitate efficient data exchange. By embracing tools like application programming interfaces (APIs) and initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA), clinicians can contribute to the development of interoperable solutions tailored to their unique workflows. In doing so, we can expedite the journey from raw data to wisdom. This aids in leveraging interoperability to unlock actionable insights and make better informed decisions that positively impact patient outcomes.

 

Conclusion

Ultimately, interoperability isn’t just about data exchange. Interoperability is about transforming information into actionable insights that drive clinical decision-making and improve patient care. By embracing interoperability and leveraging data to its fullest extent, clinicians can unlock a new era of healthcare delivery. Where wisdom can guide every decision and patient lives are profoundly impacted for the better.