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Undeveloped interoperability in healthcare isolates patient data

Interoperability in healthcare isn't as advanced as it is in other industries. One innovator used an existing health IT standard to make it easier to share disparate data.

Achieving universal interoperability in healthcare is far from a given, though examples from other industries should...

give hope to healthcare professionals. Consumers can manage their finances by viewing their account balances and spending habits in a single Web portal, even when dealing with accounts from different financial institutes.

The ability to view financial data coming from different sources proved to be a valuable accomplishment. Many patients are unable to view all their health data in a single patient portal. Patients also can't take their records anywhere they want, because EHR vendors aren't offering data connectivity in their systems that allow external entities to retrieve health data.

Some of today's EHR vendors offer a Web portal through which patients can download, interact with and manage their personal health record (PHR). This poses a significant challenge for many patients who are cared for by providers from different health systems and have to pull their records from multiple sources.

An important aspect of helping patients and engaging them in their care would be to offer them a simple way to interact with all their health data, and allow them to upload patient-generated health data into their record. Patients should be able to see the complete picture of their health.

Recent attempts by technology companies to offer patients a user-friendly PHR platform have not resulted in mass adoption. Microsoft, Google and a few other major technology players attempted to attract patients to choose them as their medical data repository. Patients didn't buy into these efforts, in part because of the poor interoperability in healthcare, specifically between EHR systems.

Many patients today are very satisfied with their patient portal. Some of the common capabilities they enjoy are appointment scheduling; viewing billing statements, lab results, notes; and interacting with their providers. Challenges arise when a patient's caregivers aren't all part of the same health system and use multiple platforms to deliver protected health information. This disconnection of interoperability in healthcare puts the burden on patients to manage their health information across multiple systems.

Presidential Innovation Fellows member tackles interoperability

The recent federal program, the Presidential Innovation Fellows (PIF), included innovators from public and private entities to address some of the challenges facing patients. Gajen Sunthara, director of innovation research and development at Boston Children's Hospital, and a former member of the PIF, led a yearlong initiative, and developed ideas to help vendors and healthcare entities solve some of the data sharing and transport problems that are preventing interoperability in healthcare.

Sunthara built a Fast Healthcare Interoperability Resources (FHIR) server that translates healthcare data into Health Level 7 International's standardized FHIR format to help organizations solve some of their interoperability and data sharing challenges. He made his server to assist in two key transaction areas in healthcare:

  • The first is health systems delivering health data to patients. In this use case, Sunthara's project offers health systems the opportunity to add Blue Button functionality to their patient portals. This change would let patients download their PHR and allow them to exchange information with third parties, such as Apple Health and Fitbit.
  • The other use case that Sunjara's server addresses is health-system-to-health-system interactions. In these situations, the FHIR server can read and write the information from the source and destination databases, allowing two different EHR systems to exchange information.

This platform is capable of handling large patient populations. For that reason and others, it has already attracted the attention of software developers, and a handful of them have branched off the project to customize it to their needs. From a patient's perspective, this can empower them to see their health data from a single place.

With its clean design and helpful patient charts, this PIF and Office of the National Coordinator for Health IT initiative is likely to get more attention over time. Health IT startups and existing EHR vendors will evaluate how they can use this platform to help providers achieve better interoperability in healthcare.

Next Steps

Healthcare living in the past with paper records

Patient referral portal gives out mobile alerts 

Providers blame their peers for lagging healthcare interoperability

This was last published in December 2015

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