Cerner says the evolution of technology has helped it maintain and facilitate interoperability and patient data sharing over the last 40 years.
From the early-eighties to now, interoperability, its definitions, and the scope of it has evolved tremendously. Whether it’s data integration or data interfacing, interoperability is all about data sharing.
Not only is interoperability the exchange of patient data, but at Cerner, it’s the process of making patient data accessible for health systems and ensuring the data is always relevant to patient care.
However, while Cerner consistently looks forward and adapts to various evolutions in technology, EHR vendors, throughout history, have faced several interoperability challenges.
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“Getting to a common understanding of the data that needs to be exchanged and the increase in the number of stakeholders that we are able to connect to is a challenge,” Hans Buitendijk, director of interoperability strategy at Cerner, said in an interview with EHRIntelligence.
“The variety of provider perspectives and EHR perspectives on the data, how it’s expressed the level of standardization of the data, how you express conditions, diagnoses, procedures, and tests.”
Buitendijk said interoperability has seen quite an expansion over the past 40 years.
“If you look at our mission and history, we have done it from the get-go as the need for exchange at a wider scale arose,” he explained. “From an overall perspective, when you look at it, you can go back to many years ago with the founder of Cerner, Neal Patterson.”
Patient data began to move between hospitals in the eighties, if not before that, Buitendijk explained.
Hospitals began to communicate with one another to exchange patient information. Then by the mid-eighties, hospitals wanted to exchange information with independent organizations, such as reference labs or clinics.
Fast forward to the early nineties, when regional health information exchanges began to pop up. HIEs allowed hospitals to connect and share patient data with health organizations in their respective regions.
Cerner knew the next challenge would be to expand beyond regional to nationwide interoperability.
“When the HITECH Act started to pick up in the late-2000s and nationwide information networks started to come up, that’s the next level,” said Buitendijk.
The vendor took what it was doing from a local interoperability standpoint and then scaled it nationally.
“It has been an ever-expanding area and Cerner has been part of that from the get-go,” continued Buitendijk. “Being able to provide connections to other parties and working with those parties to find ways to make it more consistent. Therefore, joining and partaking into a variety of initiatives to get standards in place, get networks in place.”
From working with Carequality and eHealth Exchange, to establishing a nationwide network such as CommonWell, or utilizing HL7 to define standards, it’s all been on the vendor’s path to improve connections and capabilities across various stakeholders.
Cerner had to focus on pulling together its regional capabilities to do it on a national level. The vendor wanted to follow the patient wherever she goes and ensure the data is available.
“How can we include and incorporate in there a record locator at a national level to enable that? So that a patient who might be in the Philadelphia area can go on a business trip to Kansas City, and something happens there, the patient has an opportunity to access his data,” explained Buitendijk.
“At that point in time, we are connecting with it and through it with CommonWell, which provides the platform, but we’re working through that with them.”
Cerner’s current goal is helping health organizations exchange patient data across the country.
“Then these days it’s also about using modern web-based technologies, being able to integrate into web-based apps, enabling consumers to connect using a web-based API and getting outreach to consumers,” explained Buitendijk.
“The landscape for interoperability has grown over time as people are interested in it, need it, and the technology enables it.”
Not only is interoperability the exchange of patient data, but Cerner calls it a swirl of data that is being shared back and forth between a number of providers.
“At the core of it, it’s all about how we can make sure that the data that is relevant to a patient’s care, Buitendijk echoed.
But when there are so many users on the EHR — and not every user works with the same EHR vendor — how can the health IT industry make sure data can follow the patient wherever she goes?
“It used to be, and still means you exchange data from one party to the next, from one provider to the next provider in some way,” he said. “There are different techniques and methods for that or you can remotely access it and still get that full picture.”
The advance of technology has enabled Buitendijk and his team to do things they couldn’t have done before, or at least it would’ve been really hard. But now technology allows interoperability to become more available.
“With those technologies, we can do more interoperability to link systems together,” explained Buitendijk. “A core part of the mission, a core part of our history and moving forward, it’s a core part of expanding it and then improving upon it. So, it’s certainly in our DNA.”
With all of Cerner’s initiatives, from public health to regulatory initiatives, the vendor’s goal is to share all relevant patient data that needs to be shared.
“We can improve and enhance on it, but it is absolutely critical from our perspective there’s an open, transparent fluid set of pipelines so that there is no blockage, no interruptions,” concluded Buitendijk.
“We have the ability to get a patient’s full relevant dataset in front of the decision-maker. That’s what it’s about.”
Source: EHR Intelligence