In “Mending Wall,” 20th century poet Robert Frost questions the veracity of the proverb: “Good fences make good neighbors.” Interoperability proponents have long been against the “walls” that prevent the sharing of clinical records between healthcare organizations, arguing that they compromise patient care. As a former hospital nurse turned HIT expert, I agree.Interoperability

What exactly is interoperability and why is it so important? According to HIMSS (Healthcare Information and Management Systems Society), “interoperability is the ability of different information systems, devices and applications to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally.”

To date, many healthcare systems have been reluctant to participate in interoperability efforts such as record-sharing with competing organizations, for fear of losing patients and market share. Some have also expressed concern about the difficulty and expense involved in migrating clinical records to competing EHR platforms.

On March 9, 2020, the U.S. Department of Health and Human Services (HHS) finalized interoperability and patient access rules, with the focus on driving interoperability and giving patients better access to their healthcare data. The new regulations prevent anti-competitive behaviors, such as information blocking, and call for the seamless flow of information between patients, payers and providers.
 

The Role of Accessible, Trustworthy Data

 
At MediQuant, we believe that data stewardship without walls results in more coordinated care, lower costs and better patient outcomes. Given my former role, I have a firsthand understanding of the inefficiencies and errors than can result when disparate systems do not share clinical data.

As patients move between various institutions and health systems, they find themselves having to repeat the same historical information to different providers. As a result, things can be overlooked, missed or misunderstood. Redundant testing, procedures and assessments that delay care and have a financial impact for patients, providers and payers can ensue. How much easier it would be if this information were available at every point of care!

For interoperability to work, the data must also be accurate and for that we need standardization. For example, mismatched patient identities have resulted in incorrect tests, diagnoses, treatments, procedures, billing and worse.

In my current role as chief clinical officer for MediQuant, I, along with my team, help hospital systems transition to a new HIS by helping consolidate their legacy data in one location where it is readily available and useable. With the addition of referential matching to our current EMPI (Enterprise Master Patient Index) strategy, we now connect, retrieve, clean and match archived legacy data, creating a single-patient-record view across both old and new EMRs. That means that the patient who existed in three different systems under three different versions of their name now gets one patient identifier. And that drastically lowers the margin for error.

Easy access to the right patient record also saves hospitals time and money, as staff, including nurses, don’t have to scour, review and match fragmented records when it’s time to release information to other providers, payers or patients. It eliminates the risk of information landing in the wrong hands. And it enables better data analytics, which can inform future care.

In healthcare, the only good walls are those that protect patient privacy. For interoperability to work, we need to build bridges that unite us in our common goal, that of ensuring better patient outcomes.

Kel Pults, DHA, MSN, RN

Kel Pults, DHA, MSN, RN

Chief Clinical Officer

About the Author:
Kel Pults is Chief Clinical Officer for MediQuant. The first nurse to be hired by the company in 2014, she began helping to build the company’s clinical archive offering. Today she is one of 12 nurses and multiple others at the company with advanced degrees and both clinical and informatics experience.