Interoperability for Mental Health EHRs: Promoting Quality of Care During the Pandemic

Sharing information is essential to providing quality care, particularly during a pandemic when staff are working remotely. The soundest clinical decisions are those based on complete and accurate data shared amongst all involved in a case.

EHR systems and health data exchange solutions offer providers a pathway toward efficient collaboration around their cases. However, even after many years of EHR implementations, providers are only beginning to think through how those systems can improve the delivery of care.

For the interchange of clinic information to work well, agencies need protocols that allow everyone to communicate easily, regardless of how that information was stored initially. You can’t have one agency unable to send records to another just because each uses a different EHR system. That’s where interoperability comes into play.

The Healthcare Information and Management Systems Society (HIMSS) defines interoperability as “the ability of different information systems, devices, and applications (‘systems’) to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally. Health data exchange architectures, application and standards enable data to be accessed and shared appropriately and securely across the complete spectrum of care, within all applicable settings and with relevant stakeholders, including by the individual.”

Sending patient data securely between providers can be challenging without interoperable systems. Imagine if iPhone users could only call other iPhone users, or if you could only open a PDF document if you owned a Windows computer.

Unfortunately, while there are national protocols for some aspects of information interchange (like direct messaging of medical information), large swaths of the data landscape have not enjoyed country-wide standardization. Protocols can differ by region and, in the case of billing, individual clearing houses. The problem is most acute when it comes to health information exchanges (HIEs), because local areas can each have their own regulations. While federal initiatives aimed at providing more affordable and efficient healthcare information exchanges are in the works, they are a long way from widespread implementation.

Here’s why interoperability is so critical to quality healthcare:

Improved Care Coordination and Patient Access

Improving care coordination is the primary purpose of interoperability. It instills good collaboration and ensures medical professionals have all the information they need in a timely manner to arrive at informed decisions. Using an EHR with state-of-the-art interoperability makes that information interchange easier.

Convenient access to health records allows patients to be more involved in their own care. By all accounts, the more a patient takes ownership in treatment, the more likely a positive outcome will follow.

On March 9th, 2020, the Health and Human Services (HHS) finalized historic rules that provide patients greater control of their health data in the name of interoperability. The agency that promulgated those rules, the Office of the National Coordinator for Health IT (ONC), set guidelines for developing smartphone-type applications that make it easy for patients to access their electronic health information from their provider’s medical records system.

Clinical Decision Support

Interoperability can improve the quality of care because of its electronic clinical decision support (CDS) capabilities. What that means is that EHR systems can alert providers to critical concerns (like potential adverse drug reactions), and also make sure they have easy access to not just patient information, but also other evidence-based resources. Armed with an EHR that has competent interoperability, a provider can have an ally that helps check all the boxes along a workflow.

Enhanced Patient Safety

A major reason the ONC promotes interoperability is because it can lead to improvements in patient safety. One obvious advantage of digital records over paper ones is legibility. Patients are safer when no one has to deal with a clinician’s illegible handwriting. Safety is also enhanced with an EHR that has a full array of checks and alerts, such as around adverse drug interactions, etc.

According to the ONC: “Growing evidence shows that interoperable health information exchange (HIE) has value to stakeholders and can improve care quality, efficiency, and safety by improving the timeliness and completeness of important patient health information such as medical test results, medications, diagnoses, preventive care measures, and allergies. Improving interoperability has been identified as one of the top health IT safety priorities.”

Saves Time and Money

Interoperability saves time for everyone in the circle of care by getting the right data to the patient, the provider, and affiliate at the right time, every time. It also provides more time to focus on improved patient health outcomes.

According to recent testimony before U.S. Congress by West Health Institute, system interoperability could save the U.S. healthcare system more than $30 billion a year.

Public Health Data Accuracy

The pinnacle of interoperability is when the collection and interpretation of public health data is 100% accurate, even though the patient data is shared across multiple software platforms. The higher the accuracy of information in the databases, the easier it is for health organizations and individual providers to answer pressing questions about individual patients, or the medical system considered more broadly.

The COVID-19 pandemic is a prime example of why more robust public health data is needed to understand the scope of the crisis. By facilitating the sharing and interpretation of such data, interoperability allows healthcare organizations to collectively educate one another on predicting and preventing outbreaks.

Conclusion

Interoperability is essential, especially during a pandemic since many symptoms can be similar to other illnesses. When providers can get an HD view of the patient’s situation and medical history the better the care that will be accessible to the patient. We’ve made some good progress so far with interoperability, but providers, government health officials, and law makers must continue to work in tandem to continue raising the bar for increased interoperability standards across all medical specialties.