By April Miller, Senior Writer, ReHack.com
LinkedIn: April Miller
X: @rehackmagazine
Now that regulators have caught up with the digitalization age, they’ve prioritized regulating data collection, processing, storage and exchanges. However, several downsides to their intervention exist. Do changing interoperability requirements adversely affect information technology (IT) system development? If they do, are there any solutions?
The Issue With Health Care Interoperability Requirements
Many health care facilities have embraced digitalization. Over 60% of hospitals utilized electronic health record (EHR) systems to send, receive, query or summarize patient details in 2021 — a 51% increase from 2017, according to the Office of the National Coordinator for Health Information Technology.
In today’s digital age, it wouldn’t be irrational to assume technological advancements have made most clinical data digitized, shareable and accessible. However, system incompatibilities, setting misconfigurations and ever-changing rules have made interoperability difficult to achieve for many health care providers.
In reality, EHR systems often contribute to poorer patient outcomes. They account for 61.3% of diagnostic mistakes, whether due to technical or user error. While the root of this issue is likely many-sided, its core component lies with changing regulations. Constantly updated interoperability requirements complicate development, leaving professionals struggling to adapt.
How Interoperability Requirements Impact Development
In some cases, the steady stream of changes regarding interoperability has benefited business-to-business (B2B) companies and medical providers. However, for the most part, it has made developing and updating health care IT systems challenging.
1. Accelerated Research and Development
You’ve probably noticed the number of standardized, de-identified data sets using similar formatting and a common vocabulary has risen drastically since interoperability regulations first appeared. Using these continually updated sources as a decentralized resource can accelerate your research and development phase.
Think of how all medical devices approved by the Food and Drug Administration are subject to the Medical Device Reporting regulation. You could use publicly available, real-world malfunction details from clinical trials nationwide to identify potential compatibility or configuration issues more quickly. This way, you can catch problems with your IT systems early on.
2. Increased Number of Data Silos
Despite the regulatory push for interoperability, data silos still exist. Many clinicians view sharing patient records as a competitive disadvantage or simply don’t use EHR systems. Some actively engage in information blocking to limit the exchange of electronic health information — except when they’re required by law to do the opposite.
The rising number of silos is a direct response to the increased transformation and reporting requirements that interoperability rules require of health care facilities. Unfortunately, providers and B2B brands actively seeking workarounds to ease their administrative burden only complicate IT system development and lengthen the time to completion.
3. Delayed Implementation and Advancement
Interoperability requirements act as building blocks, growing more complex with each new release. For example, the Interoperability and Prior Authorization Final Rule now requires you to develop application programming interfaces (APIs) for provider access, prior authorization and payer-to-payer data exchanges.
You can’t overstate the technical complexity of developing new platforms, APIs, dashboards and databases. How are you supposed to oversee your ever-increasing tech stack while managing your growing collection of patient records? As your workload increases and your systems become more convoluted, incompatibilities, data loss and duplication become more likely.
4. Multiplied Cybersecurity Risks
According to one estimate, the health care sector’s breaches compromised 90.49% of patient records from 2015 to 2020, affecting hundreds of millions of individuals. In other words, cybersecurity must be a priority when developing IT systems to prioritize information exchanges and system compatibility.
Securing shareable databases and bulk data export technology against these significant threats slows system development and maintenance. Rural and smaller hospitals — those who have fewer funds and resources — have a higher chance of experiencing these hardships and often lag in innovation even further.
Interoperability Best Practices for Providers to Consider
Since the Centers for Medicare and Medicaid Services published the Interoperability and Patient Access final rule in 2020, regulatory bodies have released new updates and policies every year. The Interoperability and Prior Authorization Final Rule — released in January 2024 — is set to take effect in 2027 at the latest.
Prioritizing proactivity may help you anticipate regulatory changes like these, minimizing the work you need to do to maintain compliance whenever rules are released or updated. If you consistently go above and beyond the bare minimum when developing a comprehensive system, you won’t have to continue playing catch-up.
When creating these health care IT systems for interoperability, you must prioritize standardized interfaces. Designing them for seamless exchanges with databases and data-sharing tools — even ones you don’t currently use — streamlines future development, lessening your administrative burden and workload.
Considering how much attention patient portals and APIs have gotten recently, prioritizing patient data accessibility will likely get you far. While focusing on developing B2B tools and exchanging information with other in-network providers takes precedence, regulatory agencies may soon turn their attention toward generating value for patients.
The Results of Following Interoperability Best Practices
Staying on top of regulatory changes can shorten your IT system development timeline and streamline data sharing, improving coordination. Minor benefits like reduced record duplication, fewer formatting errors, increased transparency and optimized decision-making ultimately culminate in better patient outcomes.