Interoperability is a term that is appearing more and more within the healthcare industry. According to the Healthcare Information and Management Systems Society (HIMSS),
In short, interoperability means systems can work with each other. It’s a popular buzzword these days due to the many advances in the technology that support it.
However, while some organizations already have interoperability systems for exchanging data, many others are left waiting on the sidelines. If healthcare sectors are looking to leverage interoperability, it starts with making the technology more available.
Interoperability in Healthcare
You might wonder if something so technical is relevant to you and your practice. The answer is yes. Interoperability continues to grow in importance each year. The Centers for Medicare and Medicaid Services (CMS) have updated their EHR Incentive Programs to focus on promoting interoperability.
Most EHR (Electronic Health Records) vendors base their systems on interoperability and they’re developing more uses for them all the time.
But what does this mean for independent pediatric practices? Whether you know it or not, you're already enjoying the benefits of interoperability in healthcare. So how does it improve your workflow?
The Benefits of Interoperability
Interoperability provides more efficient access to data—you save time and resources when information is readily available. And it leads to safer transitions of care—medical records can travel with a patient when they move.
Interoperability also produces better patient outcomes—if you receive data quickly and efficiently, you have more lead time to prepare for the appointment and offer better treatment.
How are EHR Vendors Interoperable Today?
When looking for an EHR vendor, it's important to make sure you get the features you need. With a vendor like PCC, there are four key clinical areas where interoperability shows up:
- Direct Secure Messaging
The first benefit here is that pediatricians can see immunization forecasting results and warn providers in the EHR.
Why does this matter to pediatricians? It helps keep patients on the recommended schedule with vaccines, and prevents over-immunizing or administering vaccines prior to minimum intervals.
Here's a snapshot of what the interoperability process looks like to make that happen:
For results to appear for the provider, the EHR has to send immunization history data to STC, who then sends forecast data and warnings back to PCC EHR. This two-way data exchange happens in a Simple Object Access Protocol (SOAP) message, the standard for exchanging information online.
Healthcare sectors use interoperability to share immunization information with state immunization registries, and PCC has connections with 30+ registries across the country. PCC EHR and the state registry share information such as VFC, dose, lot, and administration route.
Why does this matter to pediatricians? It’s a great time-saver! PCC EHR can receive and display acknowledgement messages to the user. That way, they can proactively check on the status of immunization data and halt any errors in their tracks.
Pediatricians used to log into the immunization registry portal and check for errors there, or just wait for the registry to let them know. This is where the benefits of interoperability in healthcare shine.
Direct Secure Messaging
Direct Secure Messaging (DSM) is a process that lets you communicate with a third party. This communication will often include a document known as a Continuity of Care Document (CCD). And it’s written according to the Consolidated Clinical Document Architecture (C-CDA) standard.
Why does this matter to pediatricians? DSM is a form of interoperability letting healthcare providers securely and efficiently share clinical records. It saves time and resources that would otherwise be spent mailing, faxing or scanning documents.
More importantly, it increases the amount of information available to pediatricians. Providers can manage documents from other providers and place the data into their charts. Additionally, if a provider sends more than 100 referrals, at least 10 percent of them need to be electronic referrals, which makes DSM a simple solution.
A truly interoperable EHR can receive eLab results with the touch of a button. With PCC EHR interoperability, lab results pass through a secure 'Clinical Hub' to process results and send them to the EHR. Once it goes through, the EHR will automatically enter the lab results into the patient chart for ease of access. Here's what the process looks like:
Why is this important to pediatricians? Having connections to a lab saves loads of practice resources. When you use the system to its full potential, results are directly imported into the EHR. And, this workflow reduces the transcription errors that can pop up when providers enter vital data directly from a fax.
ePrescribing (eRx) is another function that benefits from interoperability software. For example, some of the interoperability processes involved in creating a prescription include:
- sending formulary information and medication history
- identity verification for EPCS
- requesting and receiving medication history from pharmacies and payers
- prescription validation
- prescription delivery confirmation
- renewal requests
Many of these processes require interfaces with third-party software, and behind-the-scenes interoperability is what makes this possible.
Why is this important for pediatricians? ePrescribing saves on paper prescription pads and it increases patient safety by helping to prevent drug abuse and prescribing errors. It's also quick and easy, so it saves time for all involved.
Interoperability Best Practices
To hear some tips and tricks for best practices, we sat down with Jennifer Marsala, one of PCC's Business Analysts. She works on a team focused on bringing interoperability into the PCC EHR. Here's her advice for making interoperability work for you:
1) Make sure your data is clean
On this point, Jennifer says, "Assume anything you enter in the EHR is going to be shared—if not today, then in the future. With interoperability being the way things are going, you've got to have clean data so that it can be used by whoever receives it."
Why does this matter to pediatricians? Jennifer gives an example related to immunizations:
"Sometimes even with all the interconnectedness, you still don't realize that not putting data in one place can lead to something negative happening somewhere else."
Here's a frequent scenario: a new patient comes in and their name and date of birth get put into the EHR. However, there’s no account for them in the system, so the providers can’t enter an address or custodial information. The patient then proceeds to the visit and gets immunizations while they're there.
The EHR sends the immunizations data to the registry, but since no one was able to assign them an account, the registry receives the partial patient information and rejects their data.
Not all registries will allow you to resubmit the information—sometimes you have to go through a whole new submission. If the data was 'clean' and complete from the get-go, the providers would have saved time and effort. One thing affects another when it comes to interoperability."
2) Check for typos
Make sure you check everything you enter into the EHR for spelling errors. Something as simple as a typo or a misentered lot number can cause a rejection.
Look for missing information
When information is missing, it can cause errors when two interoperable systems are trying to 'talk.’ Jennifer uses the following example:
"If you are missing up-to-date demographic information and you use a program like Notify for appointment reminders, the reminders might not go out because of the missing information. In that way, you lose your effectiveness.
"It's the same for eligibility. If you reach out to payers with the wrong policy information or address, that's going to delay getting the right information back."
3) Eliminate transcription errors
On this point, Jennifer shares, "If you don't have a connection with your local lab and you're getting eLab results by fax and have to manually enter them into the EHR, there's a good chance for transcription errors. So that's a good reason to establish a connection with your local lab. Having an electronic connection saves time and reduces errors.
4) Avoid discrete data fields creatively
Some practices have their internal uses for discrete data fields and everyone in the practice knows what it means. Jennifer says, "What works for your practice might be confusing and create problems for a third party looking at that data."
5) Enter complete and accurate immunizations data
When it comes to entering immunizations data, Jennifer says it's crucial to be thorough. "Make sure you enter the manufacturer, the lot numbers, etc. If you do VFC and there are errors in your immunizations data, the immunizations registry could withhold a shipment.
Usually, practices won't even be aware of errors, so it's a surprise when suddenly an expected shipment doesn't show up. Then they have to take the time to call and correct the issue, inventory gets behind, and time is wasted."
Interoperability is the Future of Healthcare
"Interoperability is the way of the future. Going forward, there's only going to be more and more data shared with different entities. It's not limited to one particular area—it's all kinds of things including immunizations registries, HIEs, eLabs—everyone wants and needs data, so it needs to flow out and be received back. There's a strong trend toward more and more interoperability. It's the way things are going to be done."
She stresses the importance of understanding interoperability in healthcare and knowing the best practices for a smooth workflow. If you use interoperability to its fullest, you can save time and make your pediatric practice’s vital information easier to access.