A Collective Approach to Interoperability
By moving to value-based care, healthcare payers and providers can collaborate more effectively to reduce provider abrasion and improve satisfaction, which in turn drives better member outcomes and lower care costs. However, these benefits aren’t achievable without a truly interoperable system that allows healthcare data to be seamlessly and securely exchanged, integrated, and applied across all care settings and between all relevant stakeholders. It's no secret that the shift to value-based care has taken longer than anticipated. According to the Healthcare Payment Learning and Action Network (HCPLAN) 2023 APM Measurement report, 40.6% of healthcare payments still come through fee-for-service models with no link to quality or value. A key reason for this failure to achieve widespread adoption of value-based care is because the healthcare industry has not yet reached the level of interoperability needed to fully support it. Healthcare leaders have (understandably) made interoperability investments based on satisfying regulatory mandates and fulfilling their own internal use cases, rather than on the needs and processes of their external partners and other organizations. But when every healthcare organization only invests in interoperability to achieve compliance and improve internal information exchange, the result isn’t a single interoperable system but a series of interoperable systems. Data moving seamlessly within siloed systems is great for the organizations controlling those systems. Unfortunately, it doesn’t bring us closer to what the Healthcare Information and Management Systems Society (HIMSS) calls organizational interoperability. HIMSS defines organizational interoperability as “includ[ing] governance, policy, social, legal, and organizational considerations to facilitate the secure, seamless, and timely communication and use of data both within and between organizations, entities, and individuals.” In other words, there has to be connective tissue between organizations that enables them to exchange data with any stakeholder across the entire healthcare ecosystem. That’s where Fast Healthcare Interoperability Resources (FHIR®) comes in.What Is FHIR?
Healthcare organizations use a variety of data formats, designed and governed by more than 40 different standards development organizations (SDOs). Some formats are more common than others, but every organization uses its own unique software systems, processes, and data formats, and getting everyone to agree on a single standard for each would be nearly impossible. With FHIR, they don’t have to. Designed with collaboration and extensibility in mind, FHIR enables the ingestion of data in any format and converts it to a standard that can be shared with any organization, regardless of the formats, systems, or processes in use by the recipient. FHIR's inherent flexibility makes it a powerful tool that can help support organizational interoperability. But to achieve strategic interoperability, healthcare leaders will need to choose their FHIR investments wisely.FHIR’s Role in Strategic Interoperability
In our experience, interoperability is about enabling information exchange and multi-party workflows within and across organizations, regardless of standard or protocol. If you’re trying to achieve strategic interoperability, each investment should aim to maximize the number of value-added, non-compliance use cases for your organization. FHIR’s versatility makes it an ideal standard not only to promote organizational interoperability, but to enable organizations to maximize the utility of their existing EDI investments as well. Forward-thinking healthcare leaders are taking a “FHIR-first” approach, making it a priority to ensure their data is in FHIR format. To achieve strategic interoperability and maximize ROI, however, healthcare leaders need to take advantage of everything else FHIR can support, including:- More efficient workflows – Spending less time on data retrieval reduces administrative workloads while supporting automation of manual processes
- Ease of implementation – FHIR’s use of open standards and APIs makes it easier to implement in any system
- Better scalability – FHIR is designed to be extensible and scalable, enabling organizations to adapt more easily to evolving business priorities
- Earlier intervention – FHIR simplifies the process of data sharing for public-health purposes, enabling organizations to intervene earlier when their patient populations’ needs change
- Clinical decision support – Structured and organized patient data is easier to exchange between EHRs and allows providers to more quickly access and utilize patient data.
