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When a patient arrives at a health care organization, they are greeted by a nurse who asks a series of questions and collects a number of documents as part of the admission process. While providing this information is crucial for receiving quality care, chances are the patient has been through this process already at least once during a previous care encounter.
This is just one example of where interoperability, the capacity of different information systems, devices or applications to access and exchange data within and across organizational boundaries, could play a role in eliminating the redundant, time-consuming and potentially life-threatening aspects of health care.
In this Q&A, Becky Fox, chief nursing informatics officer at Atrium Health, discusses why interoperability is key to decreasing documentation burden, clinician and provider burnout, and improving the overall health care experience.
The importance of interoperability for nurses and patients
Why is interoperability important to nursing staff, and how does it impact their day-to-day work?
Fox: We want to leverage all the data we have about patients to drive the best treatment and outcomes possible. Through mining the data with analytics, we can make the data more meaningful to clinicians, so they can focus on patient care rather than having to pull information together. In the health care industry, we are at a great place right now, where we can gather information from multiple sources, quickly synthesize to get to understanding and make data actionable.
Let me share an example. When a patient comes into a health care organization or an ambulatory setting, the nurse goes through a series of questions during the visit or admission process to gather information about the patient. Wouldn’t it be great if the nurse already had detailed information from all the patient’s previous health experiences and didn’t have to go through the exercise of asking a lot of repetitive questions? Not only data from prior visits or encounters, but also information about the patient themselves and their own health management—from wearables, to health apps, and of course, demographic and social information. It would be great if all of that information could be taken in, digested, and presented to help the clinicians focus their questions and assessments. The end result would be quicker and better care.
That is what interoperability is all about: bringing multiple sources of information together and using health care technology, innovations and analytics to apply it more meaningfully to the care we provide to patients. It’s also about being able to use the data to engage patients and consumers in changing behaviors in a positive way along their health care journey. Interoperability, coupled with usability, can help remove noise and mundane tasks from the workflow. It’s an opportunity to collectively leverage information that has already been collected and contribute to the bigger picture of decreasing the burden of documentation, clinician burnout and improving the patient/consumer experience.
How does interoperability impact patient care?
There are still gaps that happen in health care. For example, when a patient goes into a care setting and fills out a series of questions, screening tools and has discussions with care providers, and then they go to a different health care setting, and they have to do it all again. Anytime you are repeating processes, things can be overlooked, missed or not understood. It’s also annoying to the patient! They can end up with redundant testing, procedures and assessments, and all these examples have a financial cost to the patient, the institution and payors. There is also the cost of time and potential delay in care and decision-making when, for instance, a lab test has to be repeated.
We, as health care leaders, all collectively must address this by working to improve interoperability, the usability of data and how to better share all data across all systems in meaningful ways.
Overcoming roadblocks to health care interoperability
What are the biggest challenges that nurses face with regards to data access and exchange across systems?
While health care systems collect and document similar information about patients, it is not standardized. If all health care systems, regardless of their EHR vendor, collected and documented the same data, sharing information across hospitals and health systems would be significantly easier. There are some industry leaders working together to establish standards of such, and I think in the near future, you are going to see movement in this direction.
We are also at a place in the health IT journey in which technology and analytics are really making great strides, with even bigger strides to come. We realize we must collect data from multiple places, but we need data normalization to occur in the process, so that we are all speaking a common language. The implementation of standards that we can all agree upon is also extremely important.
The other thing that is shifting is our mindset in how we view and share our data.As we move in the direction of managing the health of large populations and look at data from more outside entities, we will need to be more accepting of data which may have errors in it.We can’t be purists. We must look at data in terms of themes, directions and aggregation. We know there are going to be lessons learned. And, we can’t let perfect get in the way of progress. We have to participate in this transformation and not be afraid of moving forward. As an industry we all need to work together to make sure we are sharing, streamlining and consolidating data. That is what will contribute to changing health care in the U.S. and around the world.
What are your recommendations to other health care systems on how to support their nurses through advancing interoperability?
At Atrium Health, we have a significant focus on our population health strategy. Looking at sources of data across different systems is another step in the journey of pulling information together and providing the best health care for our patients. If a health care system isn’t yet on a population health journey and isn’t sharing information with other health systems, then this would be a good place to start. We’re all in this together, and our patients are going to expect that their health information is being shared, reviewed, analyzed and leveraged to give them the best care possible.
Health systems need to make sure they are participating in all avenues of interoperability and implementing standard tools, work and documentation. Nursing leaders must participate in the conversations of how-to bring interoperability to the beside and to ambulatory clinicians, so they can be their best for their patients.
Interoperability is not just for physicians, it’s for all clinicians, and nursing needs to be at the table to make sure that all of the right data sources are being brought to the forefront in meaningful ways.
At Cerner, we’re doing our part to innovate and transform health information technology for nurses. Learn more here.