The widespread adoption of electronic health records (EHRs) over paper documents has made health data exchange more accessible and convenient in recent years. Overall, this has been fantastic for patients, providers and everyone who plays a role in medical record management. But EHRs can have trouble communicating with one another, which can create barriers to accessing information. This is where interoperability comes into play.
Interoperability is used in a variety of different contexts. So if you come across articles or other content about interoperability and you’re confused, you’re not alone! In this blog post, we’ll break down the basics of interoperability, including key terms, examples and what you need to know as your organization considers various interoperability paths.
What is Interoperability?
In healthcare, interoperability is the ability of different information systems, devices and applications (note: EHRs) to access, aggregate and share data. The goal is simple: to create a seamless, interconnected network where health data is exchanged effortlessly, making sure the right information is available when and where it’s needed.
As more organizations adopt new processes and technologies to achieve interoperability, you may be left wondering what these advancements could mean for your workflows, data privacy and release of information as a whole.
Interoperability Terms to Know: Decoding the Alphabet Soup
Before we dive into the ins and outs of healthcare interoperability, let’s first start by decoding some common acronyms.
- HL7: Health Level Seven, or HL7, sets international standards and provides guidelines for the transmission of healthcare information between different systems. It was developed by the non-profit organization Health Level Seven International.
- FHIR: Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) may be the most widely used interoperability term. Developed by HL7, FHIR provides a standardized framework for exchanging healthcare information electronically, making it easier for EHRs to communicate and share data. FHIR works by defining a set of standard resources contained in an EHR and specifying how these resources can be used.
- API: Application Programming Interfaces (APIs) facilitate the exchange of healthcare data. Think of APIs as bridges that connect islands of information; the API is the set of rules and protocols that allow different software to communicate. APIs are often used in EHR systems to share patient data across different platforms.
- G10: G10 typically refers to the “G10 Certified API,” which is an API designed for patient and population services in healthcare. It is an interoperability requirement imposed by the Assistant Secretary for Technology Policy (formerly known as ONC) on all certified EHR vendors to support querying and access to patient data.
- HIE: Health Information Exchanges (HIEs) are organizations or network systems that connect disparate data sources more easily to share clinical data. There are various types of HIEs, including regional, community, statewide, government-run and non-profit.
- QHIN: A Qualified Health Information Network (QHIN) is a component of TEFCA (another acronym!) This is the Trusted Exchange Framework and Common Agreement, which aims to enhance health information exchange nationwide. QHINs enable health data exchange across different health information networks, ensuring that data can flow seamlessly and securely across the entire healthcare ecosystem.
- C-CDA: Consolidated Clinical Document Architecture or C-CDA defines the structure and semantics of clinical documents (like discharge summaries and progress notes) to ensure the information is standardized and can be accurately interpreted across different systems and platforms.
Breaking Down the Four Levels of Interoperability
Interoperability is a journey, not a destination. This means that implementing interoperability initiatives can look very different from organization to organization. Think of interoperability like a ladder – you can’t just jump to the top step; you have to climb your way up.
To help with some common language around interoperability progress, The Healthcare Information and Management Systems Society (HIMSS) identified the four levels of interoperability and what it looks like at different stages of adoption.
| Foundational interoperability is the basic ability of one system to send data to another. This is the first level of interoperability. Example: A lab system sends test results to a hospital system. The hospital receives the data, but without proper interpretation protocols, it may not fully understand or utilize the information. | Structural interoperability is a uniform format of data exchange that is consistent and can be interpreted accurately by all systems involved. This is the second level of interoperability. Example: Using HL7 message formats to share patient information ensures that all systems read and interpret the data correctly. |
| Semantic interoperability is characterized by different systems exchanging and interpreting data in the same way. This is the third level. Example: An EHR uses standardized codes for diagnoses, ensuring that all systems interpret and use the data accurately, regardless of the source. | Organizational interoperability is the alignment of policies, procedures and governance to facilitate secure and efficient data sharing between organizations. This is the fourth and final level of interoperability. Example: Hospitals and clinics agree on data-sharing protocols, allowing them to securely exchange patient information without violating privacy laws or compromising data. |
What Does the Future Look Like?
As interoperability and the standards that govern it evolve, healthcare is moving toward a future where health data flows seamlessly. However, achieving this vision requires ongoing effort, innovation and commitment.
Interoperability is not a one-size-fits-all, and it’s not just the latest healthcare buzzword; it is actively shifting how healthcare operates and the ways data is shared. Ultimately, it’s up to you to decide how to implement the power of interoperability for your specific organization, team and processes. But no matter which way you look at it, interoperability is here to stay—and embracing it now is groundbreaking for medical record accessibility. As leaders in HIM, what more could we ask for?
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