Effective sharing of patient information depends on getting different and often disparate systems to exchange data and, at the highest level, process those data.

This requires sturdy bridges between systems, interpretive and compatible algorithms, and integrated strategies for how different systems will be used and will work together.

SOLUTION: Managing Human Factors

Because people provide the care, the way they work has to dictate the way machines are designed.   Mismatches between IT and human processes can lead to what are often called "user errors." These would be more accurately described as human-machine errors.  Many might be prevented with designs more in tune with the way people work.

Nowhere are such errors more likely to occur than when processes are automated, which -- ironically -- is a major focus of IT developers.  Reducing the number of user clicks holds the promise of accelerating the performance of a job and streamlining care management. But automation helps only if it achieves the same or a better end result than the one that might have taken longer and more effort.  


When automating processes, therefore,  IT vendors must be vigilant that the automation not only accelerates performance but does so without compromising patient care. 


IT developers must also look for ways that information technologies can complement human processes – ways that make them easier and more effective.  In the end, healthcare is all about people--those who give care and those who receive it. Maintaining a win-win proposition for all involved through the automation of medical processes is critically important. 


What is Interoperability?

According to the Healthcare Information and Management Systems Society: interoperability is "the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities." It allows different IT systems and software applications to communicate, exchange data, and use this information.

The data exchanged by these systems may be fundamentally different yet critical to the proper management of the patient.  They may be DICOM (CT and MR images) and non-DICOM (digital snapshots of a rash or ECG waveforms); micrographs from pathology; or information drawn from patient histories – vital signs, such as blood pressure; patient allergies; or a list of medications.


With its emphasis on information systems, this common definition, however,  leaves out the most  important element of a healthcare system – people – the doctors, nurses, and staff who administer care.

To help patients, information exchanged among IT systems must be readily accessible by staff. 


Why Interoperability Is Important

Between 2010 and 2013, U.S. hospitals spent $47 billion annually on information technology (HIT), according to the American Hospital Association.  In 2014, nearly all (97 percent) of the hospitals tracked by the U.S. government possessed a certified electronic health records systems, according to the Office of the National Coordinator for HIT.  But, because patients use multiple providers in multiple locations and these locations may be in hospitals, physician offices, post-acute care facilities, pharmacies, retail clinics, labs and imaging facilities, it is difficult to put all the relevant medical information in the hands of those who need it. Years of IT specialism has spawned disparate  systems driven by particular strategies for handling specific types of data. Imaging specialists benefitted first through picture archiving and communications systems.  Other specialists and general practitioners followed with electronic medical records systems.

Today, as data are being spread across the enterprise and among specialties, the strategies that guided the acquisition, storage and transmission of  specific types of data are being homogenized to allow access to caregivers in multiple  departments and across enterprises regardless of the type of department or whether those data were collected in in- or outpatient facilities.

And so they should.  Patient health, after all, is the only reason these data are collected.  Care coordination facilitates good healthcare and helps keep a lid on costs by optimizing drug expenditures, testing, and billing, according to research published in 2003 by Excerpta Medica. 

It makes sense, therefore, that clinical data be acquired and shared interoperably  and seamlessly in forms usable by doctors, nurses, nurse practitioners, other staff and patients. This is particularly needed in cardiology, in which patients may be examined and treated at multiple facilities and as both in- and outpatients. This has  led some providers to seek out a “single-stack solution” -- a single IT system that  handles all facets of diagnosis and treatment. 

To serve the patient, data must be accurate. That accuracy must be maintained during the exchange. And the transmission must be quick.  

Critically important data must not be held up by methods needed to ensure its security, for example, its encryption and decryption – or because the caregiver doesn’t know the password. 

Efficiency is important also for the provider to remain financially viable.  Patients must be managed effectively despite continuing reductions in reimbursements as medical practice shifts from fee-based to value-based care.  

Effective and efficient data exchange is crucial for the patient to benefit and the provider to survive.

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