Interoperability & Health Information Exchange

Lecture 10Friday, February 8, 2013

Victoria Aceti

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Agenda

• Interoperability • Health information exchange• Comparison of interoperability and

health information exchange• Requirements for HIE– Benefits & Challenges

• Final Thoughts• Case Study

Interoperability & H

ealth Information Exchange

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Interoperability

• Improve the continuity of care• Ensure that all healthcare providers are “in the know”

with regards to a patient’s condition• Ability to look at information without having to TRACK the

information down

“The ability to transfer and use information in a uniform and efficient manner across multiple organizations and

information technology systems” (Hovenga, 2010, p.135)

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Types of Interoperability Interoperability &

Health Inform

ation Exchange

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Levels of Interoperability

Interoperability & H

ealth Information Exchange

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Health Information ExchangeInteroperability &

Health Inform

ation Exchange

Health Information

Family Physician Cardiologist Pharmacist Physiotherapist

Patient Access?

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Interoperability VS Health Information Exchange

Interoperability

• Systems “speaking” to each other.

• Information is still kept locally – ie. Multiple records/per

person• Usually only a pull of

information, not a push of information

• Example: ePrescribing

Health Info Exchange

• Clinicians have access to information and ability to add to that information

• Information doesn’t HAVE to be kept locally– ie. one record/per person

• A push AND pull of information.

• ie. NEON

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Requirements for HIE

1. Interoperable aspects (semantic & clinical)2. Collaboration and coordination between

organizations3. Move beyond old healthcare services

architecture 4. Data sharing agreements – potentially

through external organization5. Revised security policies and procedures

Interoperability & H

ealth Information Exchange

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Benefits of HIE

• More scalable• Easier to change systems• Resources can focus on security issues• Improves communication and

coordination between regional health care organizations

• Easier access for patients to their health data

Interoperability & H

ealth Information Exchange

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Challenges of HIE

• Technical migration is a huge process that takes time

• Communication and coordination is sometimes tricky or highly political

• Requires a major shift in security policies and procedures which could take years in legislation

• Clinicians have a huge push back for patient access to their own data

Interoperability & H

ealth Information Exchange

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• Originated at Toronto Sick Kids in late 2000• Covers 98% of pediatric patients in Ontario• Just under 2.6 million records• Wants to deepen the type of information gathered in eCHN

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“The ConnectingGTA project will allow electronic patient health information to be seamlessly and securely shared to deliver better, timelier and more coordinated care in the Greater Toronto Area (GTA). ConnectingGTA will deliver robust, scalable and re-usable building blocks to exchange clinical data across the GTA and accelerate the delivery of electronic health records”. (C-LHIN, 2011)

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Final Thoughts

1. Interoperability has 3 main aspects: technical, semantic & clinical.

2. Interoperability is a sufficient but not necessary condition for HIE success.

3. HIE requires the coordination and collaboration of all participating organizations for success.