Addressing Interoperability Challenges in Healthcare

Addressing Interoperability Challenges in Healthcare

Healthcare interoperability implies well-established coordination between the information systems both within and across the organization to enhance effective healthcare delivery in the community. It contributes to the bigger healthcare picture while helping patients and provides an adequate database to aid innovations and studies. Healthcare interoperability can be achieved through uniformity in state privacy laws, augmented patient matching capabilities, and adopting the right health information technologies (Braunstein,2018). However, there are several challenges associated with the lack of interoperability in healthcare, with the major one being the care coordination gaps. The problem requires the integration of health information technology to develop digital care coordination by improving legibility, allowing asynchronous communication, and providing remote access to information.

Care coordination gap arises when health care providers fail to share crucial health information or fail to rightfully organize care, thus leading to problems including missing lab reports or unnecessary test administration(Doty, 2017).It is merely a divergence between recommended best practices and provided care.  Among the various challenges states face in healthcare are heavy clinical workloads, fragmentation of care among several providers, and shortage of primary care providers.Poor primary care coordination records 5.2 percent in high-income countries with the young and those with chronic illness recording high poor care coordination(Doty, 2017).Care coordination is a systematic issue since it is independent of characteristics, including household income, gender, health, and insurance status. The most affected are the individuals missing age-based screening, those not adding a medication to meet evidence-based guidelines, individuals failing to consult with doctors concerning a prescribed medication, and factors including vaccines and annual screening. The essential part of closing the gaps in identifying the gaps.

Care coordination gaps occur in several forms. First is the missing link to the community resources, which include programs and services outside the healthcare system aimed at improving patient wellness. These include social services, Medicaid, educational resources, meals, and support groups. Secondly, the healthcare system faces the misalignment in resources between population needs and the patients. From the patient/family perspective, patients and their families experience failure in coordination, particularly in transition points (Braunstein,2018).These transitions could be between overtime and healthcare entities characterized in the information flow and shifts in responsibility.  Elsewhere, the coordination gaps occur in systems when they deliberately fail to integrate information, resources, and personnel required to undertake patient care activities between informal caregivers and patients. Coordination failures affecting financial performances on the system would motivate corrective interventions(Doty, 2017).Moreover, coordination failure could occur when a patient is involved in clinically substantial misfortune resultant of care fragmentation. Furthermore, there exist gaps in meeting the patient’s social, educational, developmental, financial, and interrelated medical needs to achieve wellness, optimal health, and end-of-life outcomes basing on patient preferences. The analysis of the workflow is crucial in determining the quality of the healthcare practice and increase profitability. A workflow built on proven procedures and processes can swiftly improve the effectiveness and proficiency of the practice. In this case, the workflow involves the subtasks, including nurses assessing and recording the patients’ vital signs, and CCs contacting patients directly through emails and phone calls, and physicians taking notes in the HER systems. Concerning CCs making calls directly, the subtasks include obtaining contact information, identifying patients who need direct contact, contacting the patient, discussing crucial information, and documenting the discussion outcomes..

The appropriate solution for care coordination gaps is the development of digital care coordination. The technology addresses the care coordination challenges all at once rather than one by one (Kressel, 2019). Apart from the necessary scheduling of appointments, it handles member referral coordination and self-scheduling alongside robust analytics aimed at enhancing system operations. It further enhances automated outreach and appointment booking without necessarily calling the providers. The digital network connection ensures streamlining activities across the healthcare facility; thus, the right provider matches to meet the patient’s needs and improve patient flow visibility within the network (Kressel, 2019). There are several ways in which the digital care coordination system helps fill in the gaps in healthcare. First, it improves the call center efficiency through mitigation of the need for the dreaded three-way call between the provider, health plan, and the patient. Healthcare centers operate efficiently with the elimination of three-way calls and use of guided search. The call centers can direct patients to best appointments compared to the previous manual shifting of patients’ concerns and conversation scheduling with providers. Secondly, digital care coordination enhances automated outreach and self-scheduling. The outreach could be on the form of text messages, and interactive voice response phone calls, thus enabling appointment scheduling through option selection (Kressel, 2019). Thirdly, the technology significantly increases the retention over time and patient attendance. Its customized, automated, and optimized booking forms make the process easy and reduces no-show appointments. Finally, digital care coordination reduces patient wait time. Less miscommunication and real-time scheduling certainly connect providers and specialists to patients within a shorter time frame (Kressel, 2019). With the little wait for an appointment, the patient is likely to return for the services and follow-up care from the facility. Shorter wait times implies more time for addressing other care needs.

Interoperability is crucial in ensuring that doctors and healthcare providers provide sufficient information needed to provide competent care to patients. Lack of interoperability, many healthcare systems require manual input, analysis, and reporting of data, a slow process that is also susceptible to errors. The major problem with the lack of interoperability is care coordination gaps, and this could be countered through the adoption of digital care coordination. Its technologically innovative approach makes it a powerful facilitator of health providers and plans towards achieving healthcare goals.

References

Doty, M. M. (2017, March 30). Minding the Gap: Factors Associated with Primary Care Coordination of Adults in 11 Countries. The Commonwealth Fund: https://www.commonwealthfund.org/publications/journal-article/2017/mar/minding-gap-factors-associated-primary-care-coordination

Braunstein, M. L. (2018). Health care in the age of interoperability: the potential and challenges. IEEE Pulse, 9(5), 34-36.https://pulse.embs.org/september-2018/health-care-in-the-age-of-interoperability/

Kressel, J. (2019, January 4). Closing Gaps In Care With Digital Care Coordination.  Health IT: https://www.healthitoutcomes.com/doc/closing-gaps-in-care-with-digital-care-coordination-0001