Interoperability in Healthcare

Interoperability is the ability of health information systems to work together within and across different organisations to advance the effective delivery of healthcare for individuals and communities. 

Interoperability in healthcare is basically about getting healthcare systems to talk to one another:

• Disparate software exchanging data between a range of sources including hospitals, GP’s, pharmacies, laboratories and clinics.
• Health data exchange architectures, application interfaces and standards enabling data to be accessed and shared appropriately and securely across the complete spectrum of care.

There are many health and social care systems used across healthcare settings today. Bi-directional connectivity between systems in real-time, is essential to support health and care professionals in the delivery of safer, improved patient care.

Why is interoperability in healthcare important?

Health data has always been challenging to share because it’s sensitive and requires a high level of privacy and security, and the inability to access it can cause significant harm. But a lack of interoperability can result in an incomplete understanding of an individual’s or population’s health needs, which can lead to poorer outcomes and higher costs.

Interoperability is increasingly critical:

• Populations around the world are ageing and people are living longer
• The use of electronic health records (EHRs) has increased significantly

With better interoperability we can transform healthcare:

• Clinicians achieve a more complete view of patients to drive better care models, better patient safety and better experiences
• NHS and Government develops a better understanding of data, including trends, utilisation, demand
• Life science organisations can drive faster, more informed research

Why Interface?

The main reason why any organisation should consider interfacing is to improve patient outcomes and quality of care. 

Interoperability gives clinicians a complete and consistent view of patient information and enables them to make better-informed decisions, faster. Patient experience also improves with this as they no longer have to repeat the same information to different healthcare professionals involved in their care.

Ultimately, interfacing enables access to information that informs an individual’s full, longitudinal health story, enabling; clinicians to deliver better care; patients to become active participants in their care plans; and health IT developers to leverage evidence to create systems that improve care delivery.

It is also important to note that Point 17 in the NHS England Service Standard requires a digital health service to be interoperable.

Opportunities to interface

With these benefits in mind, taking a use-case driven approach can frame how information sharing may inform care or business practices and can help frame the potential benefits and drive interoperability forward. The following examples provide a snapshot at how interoperable exchange may occur:

• Care delivery data
• Consent management
• Lab results
• Patient intake
• Provider alerts
• Query services
• Record locator services/master patient indexes
• Referrals
• Secure messaging
• Transitions of care

What routes can I take to interface?

Direct vendor integration

• Full access to APIs and functionality with reduced throttling
• No third parties dependencies in architecture
• Direct support from the vendor
• Integrations are usually pay to play and can be expensive

NHS Digital API Platform integration

• APIs are mostly free to use
• API functionality and access is accelerating, with a strong roadmap of upcoming features
• Support from NHS Digital. NHSD API management mission is to “make integration easier”, NHSE’s policies are aligned, see Open API policy
• There are limitations with some APIs

Integration via a third party proxy

• Off the shelf product which can be implemented quickly
• A fully managed service which includes implementation, support and maintenance
• Third parties are pay to play and can be expensive
• No ownership of the technology, reliance on a third party

Useful Interoperability resources

• Healthcare Information and Management Systems Society (HIMSS)
• The Global Consortium for eHealth Interoperability
• Health Level Seven HL7, HL7 FHIR, HL7 UK
• Systematized Nomenclature of Medicine (SNOMED) International
• Clinical Data Interchange Standards Consortium (CDISC), SNOMED CT (on NHS Digital website)
• NHS England Open API Policy
• NHS Digital guidance to building healthcare software
• NHS Digital API Platform, NHS Digital API catalogue, NHS Digital API Management Product Backlog