The challenge: How do we get to full interoperability?

The COVID-19 pandemic has been a proverbial ‘double-edged sword’ for global health systems. 

The scale of the pandemic and the rate of infection caught many providers by surprise as they quickly realised their systems and level of resource were not equipped to cope with the influx of patients requiring treatment. However, the flip side is that this unexpected demand has forced health systems and providers to adopt new technology and ways of working – often at pace and with relatively few roadblocks. So, how can we make the most of this ‘silver lining’ when it comes to interoperability?

Think little fireworks, not ‘big bang’

The first step is for healthcare providers to think of their path to advanced population health as a journey, not a destination. The work ahead of them should be characterised as little ‘fireworks’ of development, rather than a ‘big bang’ of change. Incremental steps toward interoperability, not a drastic reboot of entire information technology systems.

Follow the Plan-Do-Study-Act model

The Institute of Healthcare Improvement (IHI) promotes the Plan-Do-Study-Act (PDSA) model of improvement, which is a scientific method for implementing changes to existing systems.
How do you make incremental improvements or changes to your existing technology systems? The PDSA model, or cycle, is a recommended method for testing a change as a way for busy clinicians to improve the way their clinic or facility functions: plan it, try it out, observe the results and then act on the outcomes by applying what you have learned.

Select a small-scale problem to solve

Healthcare providers should choose something that is a priority for them, take the PDSA approach to the change, make it work, and then move onto the next priority.

For example, US providers could join an Health Information Exchange (HIE) (in the UK, an Integrated Digital Care Record (IDCR), or Electronic Health Record (EHR) in Canada, New Zealand or Australia) to instantly be able to view a lot of relevant data with minimal change required. Some healthcare organisations might choose to set up a new workflow where a clinic nurse reviews the HIE before the physician sees the patient and highlights any new information from outside the practice organisation. As a result, when the physician sees the patient, they are immediately aware of the patient’s complete picture.

Another organisation might make the decision to adopt a FHIR API that allows patients to access their own laboratory results. This change immediately reduces the need for a phone call from a nurse to the patient to tell them their results. To make the change even more manageable and effective, organisations could select a small cohort of patients to trial the change, such as all those with diabetes.

The next step is to study the intervention. Did the small change make a difference to the overall efficiency of the provider’s operations? Are patients happier with the service? Did it help to provide the right care, to the right patient, at the right time and in the right place? If it fulfils these criteria, then you have made a positive and incremental step towards advanced population health and you can act on it.

Work with what you have and scale it up

With health systems already overwhelmed, the goal is to minimise the stress involved and maximise the benefits. The priority use-case organisations choose to begin with should be simple, such as establishing a view-only connection to a local HIE, or implement a patient-access API for diabetics or some other priority cohort (for example, patients who have been tested for COVID-19). Don’t try to do everything at once: work with the technology you have and try incremental improvements to make it work better, and then move on to the next.

This is how we start out on the path to advanced population health.

Interested in learning more about how Orion Health can help you start your journey to interoperability?