The health of Canadian interoperability

The narrative around healthcare technology often focuses on the promising developments of genomics, AI, Blockchain and the Cloud. While these technologies will certainly help transform healthcare, let’s not put the cart before the horse. First, we need to focus our lens on the most pressing technological challenge facing the industry today – one that underpins the whole system – interoperability.

Interoperability is the ability of diverse information systems to exchange data and communicate information, ideally in such a way that the receiving system can use the information meaningfully. Done well, interoperability is fundamental to optimizing the health of both individuals and populations. A lack of interoperability is often cited as the major issue preventing health systems globally from overcoming fragmentation of care delivery, resulting in poor health outcomes.

As patients demand greater access to their entire health record data, the need for healthcare organizations to collaborate and share that information intensifies. Similarly, healthcare professionals require seamless integration of information in order to provide high quality, effective care based on full knowledge of a patient. When the entire care team has access to complete patient information, including an integrated care plan which can be referred to and modified, then we can realize the full potential of a well-coordinated healthcare system.

To get a sense of Canadian healthcare interoperability, Orion Health commissioned an Angus Reid survey earlier this year, taking the collective pulse of 150 digital health professionals from across the country. The report, entitled: The Health of Interoperability in Canada, uncovers a picture of both progress and challenges in achieving an integrated healthcare system, addressing key items such as patient safety, accuracy of medication information, barriers in the system and where government support is needed.

The proven benefits of interoperability

When asked about the biggest benefits organizations have seen from interoperability, six-in-10 respondents said effective care (59%) and half said they have seen improvements to patient safety (52%). Improved accuracy of medication information came in next, followed by cost containment via mechanisms such as reduced duplication of lab tests, radiology tests, prescriptions and unnecessary procedures.

When asked which data types were being exchanged electronically, two thirds of respondents (66%) answered laboratory results, virtually tied with patient demographics (64%). Next were clinical documents (such as referrals, discharges, clinical assessments), radiology reports and medication data including opioids and other controlled medications. Nearly six-in-10 organizations exchange data with a provincial Electronic Health Record.

Barriers to interoperability

Despite the numerous benefits, the report reveals a number of barriers that are still limiting information exchange. These include financial barriers such as the cost of development, appropriate payment models for physicians and an inability to access necessary budgets; technical barriers including poor end user experience, lack of agreement on standards and poor data quality; and trust or legal barriers such as privacy issues and data blocking.

Greater government support for interoperability

Nine-in-10 respondents feel that additional government support would improve interoperability in their jurisdiction. When asked to rank which government initiatives would be most effective, respondents cited legislation as most important (33%), followed closely by mandates for specific standards and architectures (27%), support for population-based funding or
value-based care initiatives (23%) and well-publicized support for a uniform technical approach across Canada (17%).

Healthcare innovation drivers

As healthcare executives turn their attention to meeting the demands and challenges of a new era of healthcare that now includes precision health, patient-centric care and population health, investment in technology solutions is increasingly important.The top drivers for investment in interoperability ranked as follows: care coordination, provincial government mandates, clinician demand, patient benefits, a desire to connect community care with primary and acute care and finally, patient safety.

Open healthcare and APIs

Application programming interfaces (APIs) are often viewed as the ‘Holy Grail’ of healthcare interoperability. As in other sectors of modern society, there is growing support in health care for the use of modern data exchange methods, specifically APIs. To that end, three-in-10 organizations stated that they are already using the best current option of the Fast Healthcare Interoperability Resources (FHIR) as their interoperability approach.

The advances we are seeing from interoperability are encouraging. More efficient care and improved patient safety are strides we want to see in our healthcare system. Interoperability is the key to unlocking the best possible quality of care. What’s more, insight into the barriers and drivers of interoperability directs us on the right path to an integrated, streamlined, coordinated health-care system.

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