The Interoperability Challenge

The Interoperability Challenge 

As population health grows in importance in the healthcare industry, so too does the importance of interoperability.

That’s not really anything new. We’ve been talking about interoperability — or, more accurately, the lack thereof — for years now. And while we’re making strides across the industry in achieving full access to data, it seems that for every step forward there is at least one (or two or three) steps back.

Take, for example, these two studies that were released in August.

Interoperability is improving!

That was the takeaway headline from a study released by The Sequoia Project, which announced that more than 200 hospitals and 3,000 clinics are now able to share data despite using different electronic health record (EHR) providers.

See the full notes on the study here:

That would seem to be a great step forward in achieving true interoperability.

Interoperability is still a huge problem.

Until, that is, you read the second survey released within that same week.

According to the study, released by the College of Healthcare Information Management Executives (CHIME), more than half of the 100 organizations surveyed reported that they are unable to move imaging data between systems — including their own. This can mean, according to the survey participants, a delay in diagnosis and unnecessary repetitive testing.

See the full notes on the study here:

Matthew Michela, the CEO and president of lifeIMAGE, a healthcare imaging vendor that participated in conducting the study, said the results of the study were eyeopening.

“It was telling to learn that the majority of CIOs surveyed say meeting interoperability at their facilities remains a challenge,” Michela said in the release announcing the study. “Healthcare IT executives have an understanding of what needs to be done, because they’re seeing how unattainable image data can negatively impact patient care, but they haven’t yet solved the technical issues surrounding image interoperability. 

So, why is interoperability such a challenge?

That’s the big question, isn’t it? And to many outsiders, it doesn’t seem like it should be that big of a problem. After all, it’s 2016. If we can stream live video from our smartphones, we can make different healthcare platforms “speak” to each other, can’t we?

But, if you’ve ever tried to work seamlessly between a Mac and a PC, you realize it may not be quite as simple as it may seem.

“Once you build the software, it’s not like we all use Windows 1.0,” said Jitin Asnaani, the executive director of CommonWell Health Alliance, a nonprofit focusing on interoperability. “There are a lot of versions and most versions get better and better and better. So, the hard part is to continuously develop and improve [interoperability] just like any other product feature that you have already built within the old platform walls. It’s not actually that hard but that’s what takes a little bit of time.”

Asnaani, speaking to the online publication HealthcareDive (, said that progress is being made, but there are still hurdles. Just about one year ago, the Office of the National Coordinator for Health Information Technology announced a plan to make the healthcare system in the United States fully interoperable by 2025. But even that presents a challenge that most may not realize.

“There is variability on privacy in the consent laws from one state to the next and that’s a little challenging, especially if you are a national network and you want to make a simple and straightforward experience that’s relatively uniform,” Asnaani said. “You want to be Google. You don’t want to make a Google New York and a Google Texas.”

So, yes, there are still a great number of challenges ahead in achieving full interoperability … and some that we probably don’t even know exist yet. Every step forward — regardless of the size — should be celebrated, as they each make us one step closer to becoming more efficient and achieving better outcomes for our patients and our populations.

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