Background
Interoperability Lacks Meaningful Data Exchange
The healthcare industry prioritizes the three levels of interoperability. The foundational level is when data is exchanged between two systems but the data can not be interpreted [1]. The next one is the structural level where data is exchanged between two systems and interpreted [1]. The final level is the semantic one where two or more systems can exchange, interpret, and utilize data in a meaningful way [1]. The highest goal allows data exchange and interpretation between two or more systems that prevents errors and improves efficiency [1]. Being able to share and interpret large amounts of patient records is crucial to providing better health outcomes.
Common problems of interoperability include inconsistent data formatting and structure across different sources [2]. This can make it difficult to search for and use data when providers are unsure of what to look for. Furthermore, the lack of tracking of a patient’s health record even from within the same hospital system is concerning. For instance, if a doctor changes a patient’s treatment plan but doesn’t share it with the rest of the care team, then the patient can experience medical errors or adverse effects. Moreover, it is often difficult to create a unified system across various EHR systems that have different standards, technologies, and functions. Therefore, even in 2022, interoperability continues to be a futuristic goal.
Compatibility with Cloud Computing
Shifting towards compatibility in healthcare may be a more realistic and effective goal for increasing meaningful and accessible data. Compatibility allows different systems to communicate with one another even if they both come from different environments and backgrounds [3]. Unlike interoperability, compatibility does not require different systems to be in the same environment [3]. Implementing hybrid cloud computing promotes compatibility between various systems by increasing real-time data exchange and collaboration. Therefore, maybe it is time for the healthcare industry to shift away from interoperability, and focus more on compatibility.
Solution
The More Cost-Effective Solution
Shifting towards compatibility allows for more cost-effective data exchange between diverse systems. For instance, the cost of creating infrastructure and software that promotes internal interoperability is around $60,000 for the first year [4]. However, the cost of implementing cloud computing is around $5,000-$10,000 for the first year of a five-doctor practice [5]. Moreover, a survey assessed cloud-based EHR integration. They found that 90% of respondents felt that cloud computing decreased costs [6]. Even with decreased costs, respondents felt that cloud computing led to increased security, patient experience, and disaster recovery [6]. Cloud computing is more cost-effective because healthcare systems don’t have to worry about hardware, maintenance, and labor costs [7]. Furthermore, unlike interoperability, different systems can communicate with each other without having to be on a costly unified platform.
Creating More Effective Data Exchange
Ideally, hospitals should be able to communicate a patient’s real-time and complete health record, as well as updated information on a hospital’s resources between different systems. Interoperability requires hospitals to have the same communication and patient identification standards between EHR systems. This is commonly lacking since oftentimes, the data must be adjusted from one hospital system before it can be imported into another one [8]. The lack of standards required for interoperability prevents accessibility to meaningful data required for more positive patient outcomes. Furthermore, since interoperability lacks standardization in patient identification, it can lead to costly duplicate records, an increased risk for medical errors, and a lack of updated health records. Without the unlikely creation of a nationally standardized EHR system, interoperability will be costly, time-consuming, ineffective, and lead to poor data exchange.
Therefore, the healthcare industry needs to shift towards increasing compatibility. This can be achieved with cloud computing, which allows different systems to communicate with one another even on different platforms. During the pandemic, different hospital systems were able to assess real-time demand and were able to provide virtual care to a patient if deemed appropriate. Furthermore, a patient can be treated with the same protocols virtually and offline, and there is no difference in care between those admitted to a rural hospital versus an urban one [9]. Cloud computing also allows AI diagnostics and alerts that assist physicians in detecting diseases in critical moments [10]. Overall, cloud computing increases data management, helps to allocate staff & resources, and provides real-time and complete health record tracking all in one place. Therefore, it is no surprise that 63% of healthcare providers would adopt a cloud-based EHR system [10] due to its increased compatibility.
Conclusion
The healthcare industry has been trying to achieve interoperability for over a decade. It continues to be out of reach due to its costly and ineffective nature of requiring standardization between various systems. Therefore, it is time for the healthcare industry to shift towards compatibility through the implementation of cloud-based solutions. This shift focuses more on making systems compatible with one another rather than creating an error-prone unified system. Cloud computing also improves patient outcomes by updating health records in real-time to the entire care team, which decreases medical errors and repeated care. Overall, shifting towards compatibility and away from interoperability leads to more cost-effective and efficient data exchange, promoting more positive patient outcomes.
References
- https://www.gehealthcare.com/article/how-does-interoperability-in-healthcare-enable-better-patient-care-and-efficiency
- https://www.healthjump.com/blog/5-challenges-with-healthcare-interoperability
- https://beam.health/why-compatibility-and-interoperability-are-important-in-healthcare/#:~:text=Interoperability%20in%20Healthcare&text=So%2C%20in%20a%20nutshell%2C%20compatibility,inside%20of%20the%20same%20environment.
- https://www.ironbridgecorp.com/blog/healthcare-interoperability-build-vs-buy-maintaining-costs-scalability-and-launch-time#:~:text=Cost%3A%20Time%20and%20expertise%20are,employee%20HL7%20and%20FHIR%20training.
- https://www.hcinnovationgroup.com/interoperability-hie/cloud-computing-storage/article/13007784/the-cloud-more-affordable-than-you-think
- https://ehrintelligence.com/news/cost-conscious-hospitals-trending-towards-cloud-based-ehrs
- https://technologyadvice.com/blog/information-technology/4-ways-cloud-computing-can-save-money/
- https://healthcareweekly.com/why-healthcare-data-not-interoperable/
- https://www.forbes.com/sites/forbestechcouncil/2022/05/10/how-technology-puts-the-care-in-healthcare-the-role-of-the-cloud-during-the-pandemic/?sh=48de35b51113
- https://healthtechmagazine.net/article/2021/08/how-cloud-services-are-enhancing-patient-care
