What does interoperability really mean?

The word interoperability is used a lot. While there are several different types, generally speaking, everyone has an idea of what the term means. In the broadest sense of the word, interoperability simply refers to computer systems exchanging information and making use of that information.

When it comes to long-term post-acute care (LTPAC), users likely rely on some type of software for managing prospective residents, resident care, or resident billing and financials. In this field, interoperability can often be thought of in three categories: connections between external products, connections between internal products, or connections to third-party exchanges.

Understanding these categories, described in more detail below, helps us understand why interoperability is important in the LTPAC industry and why the more interoperable systems are, the easier it is to get work done.

The important thing to keep in mind is that what people think of as the most common example of interoperability—integrating into networks for referral sources—is not the only type that brings value. Yes, it certainly makes intake of new residents more efficient. But another category of interoperability, connections to third-party exchanges, has a great deal of potential for our industry and it shouldn’t be overlooked.

In a perfect world, every piece of software would talk easily, and with perfect quality, to every other product without any delay or extra cost. We all know it doesn’t quite work that way. But, as the LTPAC software industry continues to evolve, improvements in interoperability have decreased connection times, lowered costs, and increased the quality of data exchange.

Understanding interoperability can help users and companies make more informed decisions when choosing an electronic health record (EHR) provider and accompanying software. To give you the necessary context for what this means for the LTPAC industry, let’s take a closer look at three categories of interoperability.

Connections between external products

EHRs connecting with third parties is the most recognizable category of interoperability. EHR systems have many functions, from gathering vital signs to documenting medications and tracking family contact information.

There are endless possibilities to the data that can be tracked in these systems, but every EHR vendor must decide what functionality they want to build into their system and what they want to leave for third parties to focus on. It is simply not possible to build every possible function, especially when there are systems geared specifically to those functions.

For example, take pharmacy software. Most pharmacies use one of a few pharmacy software products as part of the ePrescribing process within their skilled nursing facilities. It would make little sense for EHR vendors to try and build new pharmacy software since pharmacies have already invested in their preferred product. It would be too expensive to build this software directly into an EHR.

Additionally, since a pharmacy works with many different providers, it wants to have a single software product to track all medications for its customers. The EHR and the pharmacy must use interoperability tools, often known as APIs or application program interfaces, to connect those software products and exchange resident prescription information. This makes for a smoother experience for those working with the pharmacy and the EHR.  The better those interfaces are, the better the experience is for the end user.

Connections between internal products  

The next category of interoperability, a vendor’s interoperability within its own products, is often overlooked by users. When a vendor connects its own products, it relies on interoperability for those products to talk to each other. Often, an EHR company will acquire another company and they will quickly want their products to work together. While that may sound like a simple task, the two products can be built on very different technologies; using interfaces allows the products to talk to each other far quicker than integrating the two products directly into one another.

Another common reason for a company to use interoperability within its own products is when two distinct software systems that previously did not have a common purpose suddenly find one. The assisted living industry is a good example—over time, it takes on more functionality, such as point of care documentation, than historically has been used in the skilled nursing industry.

Connections to third-party exchanges

The third category that is associated with interoperability is connecting to third-party exchanges such as a state Health Information Exchange or Carequality. The idea behind these exchanges is to allow distinct providers to share resident data. When a resident requires a visit to another care provider, such as a hospital or doctor, these exchanges allow the resident’s medical data to be easily pulled.

As these exchanges mature and more providers connect with them, the continuity and speed of care will continue to improve. Imagine a day when a change in medication, regardless of where the update took place, is accessible in real-time by the resident and all stakeholders in his or her care.

Final points to consider

These three categories of interoperability allow LTPAC providers to interchange data easier. However, there are many challenges that accompany this flow of data that need to be considered. The first challenge is that although interoperability standards exist, there are still many areas left open to interpretation.

For end-users, this means it can take a long time for two companies to initially connect. Often, when there is only a small amount of data to be exchanged, it may be difficult to create a business case for making a connection. For example, if a party makes a request for only a first and last name to be exchanged on an infrequent basis, the expense that would be incurred directly or indirectly by providers would likely not be palatable. This also increases the potential points of failure and requires the provider to work with two vendors to achieve resolution.

For a minimal amount of data and/or an infrequent rate of transmission, this might not create valuable time savings. Good software integrators will focus on creating strong partnerships with both providers and other vendors, minimizing problems, aiding in troubleshooting, and communicating honestly about what types of connections will provide value. Some vendors may choose to have fewer, more strategic integrations to deliver a higher quality experience.

When end-users determine the level of interoperability they would like, it’s critical to think about what data they want to exchange, the frequency of that exchange, and which primary integrators they would like to work together. Reach out to your EHR provider and ask about connections they have made already; chances are good that the vendors they are working with are trusted partners whose relationships with your EHR vendor will enhance your experience. It may provide the perfect opportunity to look at another vendor for that ancillary service you may need.

Above all else, remember that the greater the interoperability, the easier it is to work.