Improving Value

Interoperability

Improving Interoperability Across Medical, Behavioral and Dental Systems

Data integration at the patient level has long been a challenge for healthcare providers. Too often, lack of interoperability between electronic health record (EHR) systems prevents clinicians from accessing data collected by other providers in order to view patients' complete and accurate medical histories. Additionally, EHRs do not typically contain information collected by behavioral health, oral health and social support providers, despite its relevance to patients' health and well-being. 

There are numerous challenges associated with achieving interoperability, in both the public and private sectors. In the public sector, laws designed to protect patient information — HIPPA and 42 CFR Part 2 — can prevent the flow of information between medical and behavioral health providers. In the private sector, vendors may have little incentive to make EHR systems interoperable if they fear losing market share as a result of making their products compatible with those of their competitors. 

The U.S. Office of the National Coordinator for Health Information Technology has documented 32 "policy levers" that states can use to promote health IT and advance interoperability.¹ These include, but are not limited to, accountable care arrangements, all-payer claims databases, health information exchange (HIE) connection or interoperability mandates and HIE advisory councils/oversight boards. A detailed map shows which policy levers are being used (in various combinations) in the majority of states. 

Tracking Patients Across Health and Social Systems

Clinical data platforms increasingly help clinicians make referrals to social service providers once patient needs have been identified, but few systems follow patients beyond the traditional healthcare setting to (1) monitor whether the recommended services are received and (2) measure improvement. The Patient Care Intervention Center's Unified Care Continuum Platform² is an exemplar for how medical and social data can be integrated to provide a big picture view of consumers' interactions with health and social systems. The platform links data from "disparate medical and social service provider systems to create a comprehensive record" for each person, allowing healthcare and social service providers to track individuals along the care continuum and collaborate to effectively address related health and social needs.

Notes

1. The Office of the National Coordinate for Health Information Technology, "State Health IT Policy Levers Compendium." 

2. Patient Care Intervention Center, "Unified Care Continuum Platform."