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.

THE BASICS OF INTEROPERABILITY

CHALLENGES

SOLUTIONS

SOLUTION: Developing An Enterprise Strategy

Coming up with an IT strategy -- whether that involves a single-stack solution or the integration of multiple systems -- requires input from all stakeholders.  Problems are not always obvious. But they must be found before an effective strategy can be developed.

When developing a strategy, the means for measuring problems -- and success in overcoming them -- must be determined. The strategy is to draw a roadmap that identifies the tools that must be applied; where they should be applied; and when. When coming up with an enterprise imaging strategy, it is important to connect the imaging goals of the enterprise with those of the stakeholders in the enterprise.

Nowhere is this more obvious than in cardiology, which must deal with problems such as "dual charting," which occurs when an inpatient undergoes tests in the outpatient arena. 

In a healthcare system comprised of many departments spread over several campuses and dependent on multiple disparate information technologies, processes must be developed for handling differences that come from the use of these systems.  One critical example is the handling of patient identifiers.  When strategizing, ask whether the new approach will have the means to retain all the patient identifiers or must all those records be updated? Keep in mind that the need to manage multiple patient identifications will increase as patients become more mobile and travel between different care settings, a possibility made increasingly likely as medicine moves away from fee-based value-based practice.

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. 

 

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