Interoperability Update: Part 2— Hot New Concerns FHIR-ing Up Changes

A short time ago we posted article on interoperability and its power to translate healthcare data from different sources and providers to speak the same language across platforms. Since then there have been hot new concerns, including recent regulations and the rapid advancement of the modern interoperability standard protocol called the Fast Healthcare Interoperability Resource (FHIR, pronounced “fire”).

Getting all FHIRed up.

Everyone in healthcare at all levels and responsibilities is affected by interoperability in the next decade of the 21st century, yet to paraphrase the 80’s hit Billy Joel song, “We Didn’t Start the FHIR.” But what’s fueling FHIR standards going forward is tremendously relevant to all of us tied to caregivers and for our patients.

“In a nutshell, interoperability means enabling different systems and organizations to communicate with each other and work together,” says However, according to Forbes, the recent changes made to the FHIR standards signal that “… health care IT professionals have plenty of work to do to remain at the cutting edge. One of the biggest challenges faced by IT experts is building a system that works in the moment—but then also has enough flexibility to be reconfigured as technology evolves.”

The Forbes post goes on to say, “By creating these ‘building blocks’ for future versions of FHIR, providers at different levels in their evolution to true interoperability can work together, understanding that the secure communications they need to transmit patient data between one another will be compatible regardless of the particular version each is beholden to. That’s a big step, and the good news is, the future looks even brighter…

It’s time to get FHIRed up about the future of health IT.”

FHIR has become so easy even a child can understand it.

“FHIR is a modern interoperability standard that is more flexible and more functional than the standards in current use in healthcare today,” explains Healthcare IT News. “It is bi-directional, read or write; flexible to different levels of granularity, individual data elements or whole documents; and, it supports pluggable apps, like one might download from the Apple App Store or Google Play.”

In fact, the newest FHIR 4 standard brings healthcare interoperability to the present using off-the-shelf programming APIs (application program interfaces) that our kids are learning in school today. Healthcare IT News goes on to say that, “Having a standard mechanism such as FHIR 4 is critical for interoperability and for giving clinicians access to patient information, regardless of where the data originated.” 

FHIR 4 promotes health information exchange and interoperability across the healthcare continuum, including EHRs, research, imaging, financial and decision-making resources, and even patient clinical information access from their providers.

This adds up to a major leap forward!

HIMSS rewrites definition of interoperability

In a recent effort towards achieving global interoperability, the Healthcare Information and Management Systems Society (HIMSS) explained that there are four layers to interoperability:

  • Foundational interoperability develops the building blocks of information exchange between disparate systems by establishing the inter-connectivity requirements needed for one system or application to share data with and receive data from another.
  • Structural interoperability defines the structure or format of data exchange where there is uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data is preserved and unaltered.
  • Semantic interoperability is the ability of two or more systems to exchange information and to interpret and use that information. Semantic interoperability takes advantage of both the structuring of the data exchange and the codification of the data.
  • Organizational interoperability encompasses the technical components as well as clear policy, social and organizational components. These components facilitate the secure, seamless and timely communication and use of data within and between organizations and individuals. cross and within organizational boundaries.

Beyond foundational interoperability.

Nearly 75 percent of respondents indicated that they are beyond a foundational level of interoperability—that being the ability to exchange data between system of record but not necessarily being able to interpret the information, according to a recent HMISS survey

“Chief among those best practices for interoperability is signing on with an HIE (health information exchange) to essentially let it handle the technical components of exchanging health information, followed by using natural language processing and voice recognition technologies and migrating to a single enterprise EHR. Going the EHR route, however, will primarily help with internal-system data sharing and, in certain instances, exchanging data with other health entities that use a similar version of the same vendor’s EHR,” the HIMSS survey reveals.

CMS and ONC rules are pushing interoperability.

The CMS (the Center for Medicare and Medicaid Services) and the Office of the National Coordinator (ONC) for Health Information Technology recently released their long-awaited interoperability and data-blocking proposals that require many types of insurers to provide electronic health data in a standard format by 2020.

In two long-anticipated rules, the CMS and the ONC proposed requiring healthcare providers and insurers to implement open data-sharing technology to ensure data can move from one plan to another, potentially by way of patient apps. The information that must be provided will include data on diagnoses, procedures, tests and providers that a patient has seen, and will provide insights into a beneficiary’s health and healthcare utilization.

Encouraging the use of technologies that allow seamless health data can help patients more easily share information with providers to reduce duplicate testing and promote continuity of care. “By ensuring patients have access to their information and that information follows them on their healthcare journey, we can reduce burden, eliminate redundant procedures and testing, and give back valuable clinician time to focus on improving care coordination,” according to a Modern Healthcare article.

What’s next?

“Interoperability, at its core, is a reflection of the healthcare industry’s need to coordinate care for patients across an increasingly large subset of players in a way much better than it currently can,” says Healthcare IT News. “The healthcare industry cannot optimize interoperability without creating data and adhering to data standards; this initial step can take the industry to a whole new level of interoperability and consumption.”

It’s essential to develop interoperability workflows. The system that generates the data is less important than delivering the information to those who need it. The key to facing the growing list of interoperability challenges is having knowledgeable, ready-to-step-in assistance that meets your needs.

Blue Eagle Consulting’s training/consulting experts will help you analyze your current interoperability situation, determine how you fit into CMS protocols, understand where you need support, train your staff, and FHIR up your organization so everyone is speaking the same language as healthcare providers and patients across the nation.