Why Interoperability is Crucial in Healthcare Systems: Part 1 Blog Feature
Matt Thomas

By: Matt Thomas on May 12th, 2017

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Why Interoperability is Crucial in Healthcare Systems: Part 1

Provider Credentialing

Interoperability1.jpgHealthcare records have come a long way since the first casebooks and paper charts, and it is now unthinkable that modern healthcare organizations operate without at least some form of digital record. Many organizations maintain these records with health IT systems that have become critical to healthcare management.

These IT systems often lack the ability to operate together as an ecosystem, and instead act as independent silos of information. This has become an issue of broader concern, affecting the hospital, managed care sectors, and the public. 

Interoperability, or the idea that disparate healthcare IT systems should work together, is emerging as the key to efficient data management.

In fact, according to the Center for Medical Interoperability, the lack of interoperability in today’s healthcare environments can compromise patient safety, impact care quality and outcomes, and waste billions of dollars each year.

The concept of health information technology

To better grasp the concept of interoperability, it helps to understand the various components of health IT infrastructure. Health IT refers to a vast array of solutions designed to store, analyze and retrieve healthcare data. These tools include:

Electronic Health Records (EHR) 
EHRs are the key component of health IT infrastructure. These real-time digital records include a variety of data relevant to a person’s health (previous treatments, tests, medication history, allergies and caveats). They can be accessed and shared between authorized users, including providers, insurance companies and state agencies.

Claims Systems 
Claims systems are used by managed care organizations to ensure that healthcare providers are compensated for the care they provide. Interoperability solutions that work with claims systems help ensure that that compensation is timely and correct, allowing practitioners to provide healthcare instead of acting as accountants.

Quality and Risk Management Systems
These systems record and track quality metrics around healthcare provider performance, facility safety, procedures performed and diagnosis made. Not only do these systems help ensure that organizations are delivering the best healthcare possible, they assist in an organization’s compliance with state, federal and accreditation requirements.

Health Information Exchange (HIE) 
HIE facilitate the publication, standardization, validation, retrieval and distribution of data between different health IT systems. It can be securely accessed by healthcare organizations, doctors, pharmacists, state agencies, health researchers and patients within a community, region or healthcare delivery systems.

Provider Data Management
Considered the source of truth for healthcare provider data, these systems store and track everything from demographic data to privileging, credentials and verifications, scheduling, directory, managed care contracts and continuing medical education data centric to practitioners.

So, what exactly does interoperability mean to a healthcare organization?

Healthcare organizations across the U.S. use different vendors for their IT systems, such as EHRs. Interoperability allows these systems to communicate, exchange information and present it in a comprehensible way. This involves the transfer of data between providers, claims systems, online directories, and provider data management system within and across organizations and vendors.

On a federal level, the Office of the National Coordinator for Health IT (ONC) is leading the efforts to implement advanced IT solutions and set unified standards that ensure seamless interaction between heterogeneous healthcare IT systems.

The major benefits of interoperability

The idea of interoperability is to minimize dysfunction in data exchange, enhance patient care, eliminate silos of information, reduce costs, and allow real-time interaction between systems. The implementation of advanced IT integrated solutions forms the basis for high-quality healthcare and improved patient outcomes.

You can improve the quality of care your organization delivers to patients when your team works in an interoperable environment. Application program interfaces (APIs) contribute to better interoperability by providing flexibility for easy integration with other systems and services.

Ready to learn more? Stay tuned for part 2 of our Why Interoperability is Crucial in Healthcare Systems series.

The Cactus API can provide flexibility for easy integration with Cactus provider management applications and platforms you are already using. With Cactus APIs and provider management tools, you can achieve a 360-degree view of your provider network.  


symplr’s Provider Management solution enables gathering and storing provider data to perform primary source verifications, maintaining years’ worth of records, and distributing information across your organization. Learn more about our advanced medical credentialing software at www.symplr.com/products/provider-credentialing or schedule a demo at sales@symplr.com.




About Matt Thomas

Matt Thomas is a Product Manager at symplr in Overland Park, Kansas. Matt has been part of the symplr/Cactus team for over 10 years in roles ranging from training, implementation and technical consulting to business analysis and Cactus product management. Matt works with both clients and symplr development and operations departments to ensure the vision of the Cactus interface applications, web applications, peer review, quality, and event reporting products meets our clients’ needs.