What Is Interoperability in Health Care? (With Benefits)

By Indeed Editorial Team

Published 23 October 2022

The Indeed Editorial Team comprises a diverse and talented team of writers, researchers and subject matter experts equipped with Indeed's data and insights to deliver useful tips to help guide your career journey.

Technology enables health care organisations to share information with one another to better meet patient needs. Interoperability is the functionality that allows different systems to exchange data. This practice helps providers communicate with one another in a standardised way to transmit information securely and accurately. In this article, we define interoperability, explain how health information exchange (HIE) relates to it, outline the four levels of it, share benefits and discuss standards.

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What is interoperability in health care?

Interoperability is the capability of health care information technology (HIT) systems to share vital information securely between different organisations. It allows medical professionals working in different facilities to coordinate with one another to treat patients, even if they're in different regions or countries. It also allows patients to access their medical information with their own devices, like phones and computers. This functionality optimises patient treatment, simplifies the process of seeking care and protects confidential patient information.

Examples include:

  • a doctor sending a prescription to a patient's pharmacy

  • a lab sending test results to a patient's doctor

  • a general practitioner (GP) sending patient records to a specialist they're visiting

  • a patient checking their lab results in their patient portal

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What is health information exchange (HIE)?

HIE is the transfer of digital medical information through different HIT systems. It allows providers and government agencies to control patient records and personal information and freely trade them with trusted parties in the medical field while maintaining the integrity of the documents. Those involved with HIE typically aim to develop efficient practices that optimise patient care.

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4 levels of interoperability

The ability to transfer health data works on four primary levels:

1. Foundational

Level one is foundational. This means that two systems have the core capabilities necessary to exchange data with one another. The receiving system is only responsible for accepting the information, not editing or interpreting it. For example, a provider might share a PDF of a patient's immunisation history with their new GP. Level one is useful when sending fixed documents and updating one another about basic information.

2. Structural

In level two, it's important that the receiving system interprets the data. To allow for this, the HIT systems define and organise the data during the exchange, deciphering encrypted data. The information stays unchanged during the transfer, but the receiving HIT processes it.

An example of two HIT systems transferring structural data could be e-prescriptions. A doctor may write a prescription and send it to the patient's pharmacy. For the transfer to occur successfully, it's crucial that the doctor's office and pharmacy both honour the same HIT standards. This allows the information to transfer between systems without alteration or issues.

3. Semantic

The third level involves the exchange of data between two or more HIT systems. A primary function of these exchanges is the ability of all receiving systems to codify the data to interpret it completely. This level can help with authorised transfers of patient information amongst caregivers through electronic health record (EHR) systems. Typically, a health care provider's use of this can help improve the security of transferred information and increase information delivery efficiency.

For these detailed and complex data transfers to work effectively, the HIT systems may have a comprehensive understanding of relevant vocabulary. This allows systems to recognise specifications like medication milligram amount or frequency of medication use. This level of information exchange can be the most complex, and software needs may continuously change to address new health care needs.

4. Organisational

The highest level of functionality refers to shared standards for privacy and confidentiality when exchanging health care information between organisations. As of September 2022, the Personal Data Protection Act 2012 and Personal Data Protection Regulations 2014 govern how providers can maintain and share private medical information. It's also important that providers are aware of laws and restrictions in other countries regarding health care data and patient confidentiality when exchanging information globally. Staying aware of any updates in ethical and legal guidance can help health care providers remain compliant and secure.

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Benefits of interoperability

Benefits of this functionality include:

Consistent care quality

Patients may receive care from many health care providers at different locations, like clinics or hospitals. Medical data exchanges can help them receive a consistent quality of care because their health care providers document and store a detailed history of each visit and interaction. Health care providers usually refer to these documents as a patient's Continuum of Care (CoC). Some examples of what these might highlight are:

  • previous procedures

  • past illness symptoms

  • medical conditions

  • recent injuries

  • known allergies

  • family history

Integrated HIT systems help prevent the possibility of limited access to these documents and streamline the care process for both patients and health care providers. This might minimise risk as providers are aware of how the patient responds to particular ingredients or treatments. For example, if a care provider has access to a patient's CoC, they can see what treatments the patient has tried in the past and skip any that were ineffective.

Efficient treatment

When health care providers have access to critical information from other organisations, it can speed up treatment, as they already know a patient's background and preferences. It can also make it simpler to get lab results, diagnose conditions and share these findings with patients. When patients can access their own health care information using patient portals and mobile apps, they may find relief sooner. Plus, the ability to send prescriptions to pharmacies digitally can save patients time.

Greater accuracy

It helps prevent errors and inconsistencies between HIT systems. This is because it encourages medical facilities to abide by standards, and documents and messages exchanged between organisations are often unmodifiable. Regulated data exchanges might minimise the risk of errors like:

  • misinterpreted patient care data

  • incorrect coding

  • outdated patient care data

  • missing information

Having more accurate documentation can also help improve the quality of care patients receive. With complete, correct records, health care professionals can make precise, data-backed recommendations and decisions. Plus, standardisation makes it easier for doctors to find the information they're looking for in a patient's records, as documents look the same and follow the same structure. That means providers may be less likely to miss or misinterpret critical information.

Patient involvement

Patients having access to their health information allows them to be more engaged with their health. When providers can message patients and provide them with updates, it can lead to a stronger patient-provider relationship. For example, if a GP recommends a patient implement a diet change to reduce inflammation, they could send a message in the patient portal asking how it's going.

Strengthened security

When providers exchange encrypted data with one another, it helps them protect patient information. Plus, when facilities can download documents containing confidential information instead of manually inputting it into their own system, it reduces the number of people who handle the confidential data. This could reduce the risk of privacy breaches.

Interoperability standards

Standards are important, as they set the perimeters for safe data exchange and define expectations for data transfers. There are various standards development organisations (SDOs) that create and share standards to help align providers locally and globally. Health Level Seven International publishes the Health Level Seven (HL7) standards, a widely accepted set of guidelines for the exchange of electronic health care data between systems.

Here are some categories of standards that providers may refer to when exchanging data:

Vocabulary standards

It's beneficial for health care providers to use consistent language so their systems can interpret one another's documents. Vocabulary standards prompt providers to classify conditions according to the World Health Organisation's (WHO) International Statistical Classification of Diseases and Related Health Problems (ICD). These standards may also extend to medical coding to ensure similar services receive the same medical codes across different facilities.

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Content standards

Content standards dictate the structure and organisation of messages and information exchanged between systems to ensure both parties can access and understand the data. These guidelines help providers create clear communication. HL7 assigns specific criteria to clinical documents to ensure they have a consistent structure. For example, to qualify as a clinical document according to the HL7, a file must be authorisable, complete and readable. These standards might dictate how providers write documents like discharge summaries and family history reports.

Security standards

Providers abide by legal guidelines regarding patient privacy, but they also typically implement measures to keep transfers secure. This involves blocking intrusions from untrusted parties and encrypting data to minimise cybersecurity threats. As of September 2022, the Ministry of Health (MOH) is monitoring the prominence of such threats and may issue national standards in the future.

Transport standards

Transport standards define expectations for data formatting and architecture. These guidelines ensure data is compatible with different software programs and systems. HL7 offers the Fast Healthcare Interoperability Resource (FHIR), a guide that enables health care providers to create mobile apps and patient portals that are consistent with international standards.

Please note that none of the companies, institutions or organisations mentioned in this article are affiliated with Indeed.

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