Healthcare IT leaders have been calling for interoperability of electronic health records since they were first introduced. Now, almost everyone uses EHRs. Since the healthcare community has been talking about interoperability for years, why is it still so elusive?
Why It Matters
Today more than ever, healthcare is focused on holistic patient-centered care. Holistic, because we are no longer simply trying to treat sick patients. We want to help sustain healthy patients. The goal is to promote total health so that patients are less sick. Patient-centered, because people should be able to own their health.
During a person’s lifetime, they will likely visit many different physicians, potentially in different locations. In order to be treated in a holistic and patient-centered way, their care providers all need access to the full picture of their medical history. This is why interoperability matters, and as a healthcare community, we are getting closer to achieving this vision.
The Original Problem: Communication Across Interfaces
The original barrier to achieving interoperability was the inability to communicate between differing interfaces. Despite the fact that most people have moved to electronic health records, you cannot simply share data from one EHR system to another. These disparate systems are complex, and sharing data requires a complex solution.
Not only is it difficult for these systems to communicate, there is also the problem of private patient information. The method in which this information is shared needs to be extremely secure and hack-free. There are promising technological advances however, such as blockchain technology, that give hope for solving the technology issue of interoperability.
The Bigger Problem: Business Models
Here’s the crux of the matter: healthcare is still a business. Patients are customers. Even if we completely figure out a secure, easy way to transfer data from one EHR system to another, many vendors and healthcare systems would not want to cooperate. It’s almost like asking Google and Microsoft to share customer information with each other. Even though they could easily communicate customer information back and forth to each other, they would never do it. Why? Because they are competing for the same customers!
The same is true of different healthcare providers. At the end of the day, even though their job is to provide the highest possible quality of care to patients, the underlying motivation is to make money. The government can and has tried to step in. Government mandates against information blocking, however, only prevents vendors and healthcare systems from keeping patient data from the patient themselves. The government can’t do anything about preventing one company from sharing information with another.
When it comes to achieving interoperability, we need to be patient. We are overcoming more than just technology issues; we are attempting to bring competing healthcare businesses together to create mutually agreed upon standards of sharing patient data. It will take time, but it will ultimately be worth it.