Government, organizations working on interoperability

Interoperability was a big topic at the recent Health Care Innovation Day, an event jointly hosted by the Office of the National Coordinator for Health IT and West Health Institute.

During one session, Neil Chawla, associate CMIO of Inova Health System in Falls Church, Va., said that pregnant patients often are referred to the hospital by private physicians not employed by the health system. These referring physicians use different EMRs that are unconnected to its system, and obtaining lab work is particularly challenging. As these physicians often contract lab work to third parties, Chawla said he is working to have these labs send data to the system directly.  

Benjamin Scot Miller, the father of an infant who spent time in the intensive care unit, said the lack of a centralized system meant that nurses often spent time on charts and handling devices as opposed to direct care. “Anything that can be done to make the nurses’ lives easier so they can spend time with your child will make you feel much better.”

Sarah McGregor, RN, a neonatal nurse at Nationwide Children Hospital in Columbus, Ohio, who worked with the Miller family, said direct care suffers because nurses are overwhelmed trying to complete their admission charts and pull data from the devices.

From the nurses’ perspective, the ability to connect machines would be ideal. “There are still lots of devices that are disconnected and it does delay treatment for fragile babies,” she said.

Interoperability continues to be a main topic at the monthly Health IT Policy Committee meetings. Last week, Doug Fridsma, MD, PhD, chief science officer for the Office of the National Coordinator for Health IT (ONC), said that for interoperability standards to be successful, “we have to build incrementally. The systems we install today are the legacy systems of tomorrow. We need resilient ways to make sure standards support what we have now and in the future.”

Fridsma discussed five elements ONC is trying to standardize: meaning, structure, transport, security and services.

"We have to tie to the levers we have and make sure we continue to refine testing tools," he said. “Some we got right and some we didn’t. We’re working to see how we can provide extra testing, demonstration … to get to interoperability and test for interoperability, not just conformance to the standards.”

Numerous fronts are addressing interoperability and, clearly, that's what it will take to make progress.

Beth Walsh

Clinical Innovation + Technology editor