Understanding the Different Types of Interoperability in Healthcare

Healthcare providers increasingly rely on electronic health data to make informed decisions and improve patient outcomes. However, without the proper exchange of information, the full potential of health technology can’t be realized.  

This is where interoperability—the ability for systems to exchange and interpret shared data—plays a critical role.   

But interoperability in healthcare is complex, with different types and layers underpinning the seamless flow of information. If you’re a provider trying to make sense of the HL7 standards in healthcare and FHIR resources, you’re in the right place.  

Below, we’ll not only break down the types of interoperability in healthcare but also explore the solutions, challenges, and compliance standards providers need to know.  

RELATED ARTICLE: Integration VS Interoperability: The Difference and Why it Matters  

What Is Interoperability in Healthcare?   

Interoperability allows health systems, devices, and applications to connect and communicate effectively, regardless of vendor or software differences.  

It’s about empowering health information exchange (HIE) (the electronic sharing of patient medical records between healthcare providers and patients) between systems while maintaining patient data integrity and privacy.   

Without robust interoperability, healthcare providers face barriers that result in fragmented care delivery. For example, a patient’s complex medical history stored in one system won’t be readily accessible to another without the right integration.  

Without this information, coordinating care across different providers becomes difficult due to the lack of available patient information, potentially delaying treatment decisions.  

The three main types of interoperability in healthcare, according to the Healthcare Information and Management Systems Society (HIMSS), include: 

1. Foundational Interoperability

• The standard ability of one system to transmit data to another.  

• Example: A patient is admitted to an ER, and their lab results are shared electronically with the provider.   

2. Structural Interoperability

• Ensures data shared between systems is interpretable at a structural level via standardized formats. It defines the format, syntax, and organization of data exchange. 

• Example: A lab report sent as structured data is readable by another system using the HL7 standards in healthcare. HL7 standards are a set of rules that govern how healthcare systems share electronic health information. 

3. Semantic Interoperability

• The “gold standard” of interoperability, allowing data to be interpreted and used meaningfully by the receiving system. It aims to create a common vocabulary that enables accurate communication, thus ensuring reliable data and optimizing patient and organizational outcomes.

• Example: Medication information encoded with RxNorm standards (a normalized naming system for generic and branded drugs) ensures consistent understanding across systems.  

When systems achieve semantic interoperability, the potential for innovations like personalized treatment plans and predictive analytics becomes possible.   

Why Interoperability Matters for Healthcare Providers   

Poor EHR interoperability is detrimental to patient safety and costly for health. Its consequences range from increased risks of medication errors and scattered patient data to additional healthcare expenses. 

Luckily, interoperable systems enable seamless communication and data exchange among healthcare providers. Why is this beneficial? Let’s break it down:  

Care Coordination

Effective exchange of health data ensures all patient care team members have access to the same information. This is vital in interoperability for care coordination, especially for chronic disease management or post-surgery follow-ups.  

For example, let’s say a patient is seeing multiple specialists. Interoperability ensures that each specialist is aware of the treatments and medications prescribed by the others. This coordination helps prevent harmful drug interactions and ensures that all patient care aspects are aligned.  

Effective information exchange between payers and providers, where clinical data and insights are shared, can also significantly impact the quality of care delivered.  

Improved Patient Outcomes

When electronic health record (EHR) interoperability standards are implemented, patients avoid unnecessary procedures and enjoy smoother transitions between specialists. Other improvements include: 

• Reduced medical errors: By eliminating the need to re-enter data or rely on incomplete information, interoperability helps minimize the risk of medication errors, misdiagnoses, and unnecessary tests. 

• Improved patient safety: A readily available medical history facilitates early detection of potential health issues or severe allergies, enabling timely interventions. 

• Better disease prevention: Reminders for important screenings and immunizations can be triggered based on a patient’s complete health record.

• Evidence-based decision-making: With comprehensive patient data at their fingertips, providers can make informed decisions based on the latest evidence and best practices.  

Operational Efficiency and Mitigating Costs

A recent report estimates that plans and providers fail to collect more than $26 billion in revenue because they cannot address and report the closure of gaps in care.  

Interoperability can address this revenue leakage by mitigating the extra costs associated with duplicate tests, unnecessary treatments, and administrative inefficiencies.  

How? By streamlining the flow of information and reducing the need for manual data entry and verification, healthcare organizations can operate more efficiently and cost-effectively. This benefits providers and reduces the financial burden on patients and the overall healthcare system.  

FROM ONE OF OUR PARTNERS: How Interoperability Strategies Offer a Holistic Approach to Healthcare Integration 

Challenges of Interoperability in Healthcare   

Even with its numerous benefits, achieving interoperability comes with its share of challenges, including:   

• Data silos: Many organizations store data in incompatible formats, making integration difficult.  

• EHR vendor compatibility: Some EHR systems don’t communicate well with others.  

• Privacy and compliance concerns: Safeguarding patient data involves strict adherence to HIPAA and other regulations, complicating interoperability efforts. (Ensuring data privacy in interoperability is critical for every provider.)  

• Keeping up with standards: Standards like Fast Healthcare Interoperability Resources (FHIR), an HL7 standard for exchanging healthcare information electronically, evolve over time, making regular updates essential. Protocol variability makes it difficult for systems to interpret and exchange information accurately, leading to interoperability gaps. 

Addressing these challenges requires the right mix of tools, resources, and strategies.   

Compliance and Data Privacy in Interoperability   

When it comes to interoperability and healthcare compliance, providers must prioritize patient safety and adherence to governmental regulations. This includes safeguarding shared data (end-to-end encryption), maintaining audit trails, and adhering to guidelines like HIPAA in the U.S.   

For example, audit logs from EHRs hold untapped potential for understanding suspicious behavior and enables the detection of unauthorized access. Auditing also drives corrective interoperability action plans to improve security and patient data privacy. 

Solutions to Interoperability Challenges   

Here are four actionable steps providers should take to address interoperability challenges in their practice. 

Step 1. Utilize Open APIs in Healthcare

Modern Application Programming Interfaces (APIs) streamline transfers between systems and encourage innovation in interoperability solutions for healthcare providers. It acts like a technical instruction manual that provides details about an API and information for developers on how to work with it and its services. 

For example, In the context of EHRs, an “Open API” refers to a standardized interface that allows different healthcare apps and systems to easily access and exchange patient data within an EHR.  

This promotes interoperability and communication between different platforms, like patient portals, third-party apps, and other healthcare systems.  

Step 2. Embrace Fully Integrated EHRs 

A fully integrated EHR promotes interoperability in care by allowing seamless access to a patient’s complete medical history across different healthcare providers and systems.  

This connectivity lets providers view lab results, imaging studies, treatment plans, and notes from various specialists in one place, regardless of where the care was provided. 

For example, iSalus is a fully integrated All-in-One EHR solution that works as an extension of your care team to improve health outcomes, keep patients engaged, and drive a new revenue stream.  

Specialists can access all the data they need in one place and quickly view a graph of a patient’s vitals, medications, lab results, and more on a single screen.   

Step 3. Employ AI-Driven Platforms

Artificial intelligence (AI) and machine learning (ML) can aid in predicting patterns and uncovering gaps when integrating complex data sets. 

AI can combine data from different sources, like EHRs, wearable devices, and genomic data. It then uses that date to create a holistic picture of a patient’s health status. Getting this big-picture view can predict future health risks.  

For example, one review cites that ML models can analyze genetic data alongside lifestyle and environmental factors to predict the risk of developing conditions like heart disease, diabetes, or certain types of cancer. 

Step 4. Data Mapping and Standards Adoption

Mapping data points across systems ensures that newly integrated platforms speak the same language.

For example, utilizing standardized coding systems like ICD-10 for diagnoses and procedures allows different EHRs to interpret data consistently when exchanging information.  

The International Statistical Classification of Diseases (ICD) is a medical classification list that contains codes for diseases, signs and symptoms, abnormal findings, and external causes of injury or diseases. 

Implementing standardized data formats like HL7 standards in healthcare or FHIR also ensures consistent data interpretation across systems.   

RELATED ARTICLE: Exploring Upcoming Trends and Technologies in EHRs 

Next for Providers   

Understanding the different types of interoperability in healthcare is a great first step in learning how to manage patient information. However, effectively implementing scalable, secure, and compliant interoperability solutions isn’t a one-size-fits-all process. 

Providers will need to balance operational needs with the right tools. Implementing platforms compatible with EHR interoperability standards ensures your organization is future-proof and capable of efficient health information exchange.   

Ready to elevate how your healthcare data flows but unsure where to start? 

Contact iSalus today to explore customized interoperability solutions that improve workflows while driving better patient outcomes.