Interoperability

Interoperability can be an intangible concept in healthcare. But now we can clarify its exact meaning.

The HIMSS Integration and Interoperability Steering Committee (I&I) defines it this way:

"Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities."

That high-level definition is further quantified by I&I through six components:

• 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.
• Uniform presentation of data, enabling disparate stakeholders to use different underlying systems to have consistent presentation of data when doing so is clinically or operationally important.
• Uniform user controls, to the extent that a stakeholder is accessing a variety of underlying systems, making sure that contextual information and navigational controls are presented consistently and provide for consistent actions in all relevant systems.
• Uniform safeguarding of data security and integrity as data moves from system to system such that only authorized people and programs may view, manipulate, create, or alter the data.
• Uniform protection of patient confidentiality even as stakeholders in different organizations access data that has been exchanged across systems, particularly in order to prevent unauthorized access to sensitive information by people who should not, or do not, need to know.
• Uniform assurance of a common degree of system service quality (e.g., reliability, performance, dependability, etc.), so that stakeholders who rely on a set of interoperable systems can count on the availability and responsiveness of the overall system as they perform their jobs.

CITL Definition

To further clarify the current transitional environment to healthcare interoperability, the Center for Information Technology Leadership defines 4 levels of Health Information Exchange and Interoperability (HIEI) that can pinpoint where a healthcare organization currently sits in terms of their use of technology, and how they currently exchange patient information. These levels are:

Level 1 Non-electronic data—Transfer of information that is written down or shared verbally. Relies heavily on human facilitation to rapidly review large volumes of data on paper and manually convert and extract content.

Level 2 Machine-transportable data—Transfer of information via basic IT, such as fax and email. Still requires significant human involvement.

Level 3 Machine-organizable data—IT largely replaces human involvement in data exchange, but uniform standards are not used. Requires multiple, customized interfaces to exchange data between systems. Human involvement needed to translate incoming data from the sending organization’s vocabulary to the receiving organization’s vocabulary. Usually results in imperfect translations due to incompatible vocabularies.

Level 4 Machine-interpretable data—Idealized state of full computer-to-computer standardized data exchange without human involvement. All systems exchange data using the same messaging, format and content standards, removing the need for multiple, customized interfaces.

• To understand the value that interoperability delivers in real, tangible terms, look at these example of cost savings across the different levels of HIEI: financial returns.
• To learn more about interoperability, review this backgrounder prepared by HIMSS.
• Discover how the Misys Connectivity Adapter for HIS Systems is a catalyst for interoperability and an enabler for the Connected Healthcare Community.
• Learn the current IHE standards and how they can impact your organization.
• Contact a Misys representative to build your own interoperability strategies for your organization.