Hospital consolidation is gaining momentum. At the end of 2016, Becker's Hospital Review predicted that this movement toward fewer but larger health systems would continue. Among the drivers are an increased focus on population health, disputes between payers and providers, and lower reimbursement.
This trend has been going on long enough that mega for-profit and not-for-profit provider systems, integrated delivery networks or IDNs (aka integrated health networks or IHNs), have taken root. They have brought with them a plethora of disparate IT systems, each chosen and implemented by once independent hospitals and care facilities. In some instances, this has bred a cacophony of data -- a specialist’s report turns somehow from “English to gibberish,” states the AHA; values appear in the wrong section of a lab report; data are dropped from critical fields in a care summary; inpatient data do not accompany patients transferred to outpatient facilities.
Going to a unified system that establishes a single platform throughout the IDN/IHN might remedy many of the problems but it usually is not economical to do so. Installed IT systems are often viewed as investments. But, as medicine moves from a fee-based to a value-based model, they must be managed to provide efficient and effective patient care.
In a single hospital, the challenge of connecting the various silos, each representing a different specialty, can be formidable. The subspecialties of cardiology may be viewed in much the same way, walled off from each other; patients entering and exiting different silos, data barriers reinforced by disparate IT systems--one for nuclear cardiology, another for echocardiography, another for cardiac cath.
Interoperability is the key to interfacing multiple information technologies throughout cardiology, just as it is the key to unifying IT systems throughout hospitals and the enterprise. And interoperability depends on standards.