Contact Our Experts
By definition (Oxford languages): Interoperability (Noun)
The ability of computer systems or software to exchange and make use of information.
I have always had a “thing” for interoperability since the time a family doctor referred me to a specialist after receiving a blood test in 2002. When I got to the specialist, she said, “I need you to do a blood test. The same blood test that you did with your family doctor, but unfortunately I don’t have access to your results and I need you to do it again or go back and request it from your family doctor and bring it to me.” The only interoperability device that was available at the time was the “FAX” machine, a device that some of my current readers possibly have not heard of and many of the readers have not used in their lifetime. Yet, there exist healthcare organizations today that still send faxes to each other.
Naturally, I did the blood test again for the sake of the “here and now” and to save everyone’s time. I recall thinking at the time, apart from it being a nuisance to me having to get blood drawn again as a patient, it is also an expensive process for insurers and taxpayers.
Interoperability is indeed a technical function that involves computer systems, applications, databases, and today often the internet. However, the outcome is much more than that. The outcome is delivering the “relevant patient-related information” to the care provider at the point of care in order for them to make an informed decision.
For cuts, bruises, colds, and flu the episode of care can be simple in most cases and rarely requires more than a single isolated visit to the family doctor. However, as we all know, we live in an era of chronic illnesses and improved care means we live longer. Our global population is aging and this, in turn, translates to more complicated episodes of care that often require multidisciplinary teams to work collaboratively together for a single patient’s care.
This is well and good if the team is under one roof working with the same system, but often the systems that your family doctor uses are not suitable for other clinicians and vice versa. The answer, in this case, comes back to interoperability and how we best utilize that to provide continuity of care.
Scenario A:
A known 73-year-old female patient, Judith, with Diabetes, has a care team engaged and looking after her. In this scenario, the laboratory knows who the care team members are and as long as one of them CCs the others on the request, then all members are likely to receive an electronic version of the results assuming they are all set up for it. In this scenario, the system works well from a sharing results perspective, but not so from a diagnosis and notes-sharing perspective. Care providers revert to a traditional model of communicating via “letter writing” to each other, which can also bring its own set of challenges, costs, and risks.
Scenario B:
A 68-year-old male patient, Arnu, presented with symptoms that pointed to Diabetes. His family doctor wanted to investigate given the symptoms and his family history. Sure enough, her assumptions were correct. She now needs to engage a care team to look after Arnu before his situation worsens as his Diabetes causes more damage to other organs and his quality of life deteriorates. However, in this scenario, the flow of information from the laboratory is not seamless and the doctor has to revert to writing a letter and include the blood results manually for the care team to review. Apart from the extra effort required by this doctor to communicate the results and the diagnosis, the results are not in a format that can be easily searched, plotted, or extracted by the other clinicians because they are receiving it in the body of a letter.
APIs (Application Programming Interface) are one method of achieving interoperability between software applications and there have been a few standards introduced to improve the quality of information that is being transmitted between applications. One of those standards is FHIR.
FHIR is quickly becoming the accepted standard, globally for interoperability. Most of the large vendors (Epic, Cerner, InterSystems and others) have adopted the FHIR protocols and this has now set the pace for everyone else to follow. HL7 Australia has launched SPARKED, the FHIR accelerator program designed to drive the adoption of FHIR in our healthcare system.
The point here is that interoperability in healthcare is much more than just APIs and computer programming. Interoperability in healthcare is understanding the needs of care providers and the outcomes they want to achieve in order to provide the best quality of care for their patients and then using software engineering skills to achieve those outcomes.
At Clinovera, we are proud to say that our 500-strong team made up of informaticians, engineers, data scientists, and clinical personnel collaborate with our clients to work through healthcare-related technology problems and find solutions. Our approach is to consider the best possible outcomes for our client’s clinicians and patients but not lose sight of their need to realize a return on investment.
For a larger conversation around healthcare or healthcare-related topics, please reach out to me directly:
Rafic Habib, rafic.habib@clinovera.com, Managing Director at Clinovera for the APAC Region.