UPMC executives share insights on interoperability in health care

Survey highlights challenges for health systems and opportunities to improve data sharing

Interoperability is moving up the priority list as health care executives realize the importance of sharing medical data to gain operational efficiencies, enable new models of care, and improve population health. Many though are still working through how best to achieve interoperability inside their organizations and with outside stakeholders.

New survey results from HIMSS Media and the Center for Connected Medicine (CCM) highlight the challenges that many health systems are facing when it comes to sharing data with other health systems, tapping into unstructured data, and using data to reduce the cost of care. The CCM, jointly operated by GE Healthcare, Nokia, and UPMC, connects and inspires leaders and innovators through research, analysis, and events.

UPMC, an integrated health care provider and payer, has been working to overcome interoperability challenges from its multiple electronic health record (EHR) installations, which cover different patient populations and clinical care operations. Without a unified view of all patient data, health systems can find it difficult to optimize operational efficiencies critical to value-based care.

Advancing interoperability is a key strategic priority for UPMC, which has 40 hospitals and more than 3.5 million insurance members. IT leaders across UPMC are working to improve the health system’s ability to share data. The work involves creating a suite of cloud-based components that store, manage, and process health care data, and relies on HL7 FHIR (Fast Healthcare Interoperability Resources) standards and open application programming interfaces (APIs).

“We are working to improve interoperability by using standards like FHIR, which helps our health plan to programmatically access clinical data for our members. With clinical information, UPMC Health Plan is in a better position to direct care to members who most need it,” says Adam Berger, Chief Technology Officer for UPMC Enterprises, the innovation and commercialization division of UPMC. Berger is one of several senior executives at UPMC working to improve interoperability.

Standardizing data is key to improving care

Finding the right solution — whether an API-driven, automated interface, or a combination of existing and emerging technologies — is a challenge for many health systems. Organizations everywhere are searching for ways to standardize and govern disparate data sets, which are increasingly important to the overall health of an organization, not just the patients they serve.

The survey shows where hospitals are making advances and facing challenges. Based on a survey of 100 U.S. health care IT stakeholders, the research found:

Almost all respondents are taking necessary strategic steps and aligning their technology roadmaps with interoperability initiatives. That includes keeping current on interoperability-related regulations and putting the right people, policies, and procedures in place.
Beyond those basic functions, however, interoperability remains a challenge, particularly in deploying the right technical solutions for their environments. Less than four in 10 report success in sharing data with other health systems.
Switching to a single, integrated EHR is the most popular solution to address interoperability. Some 57% of respondents are pursuing that option, followed by hiring new talent, partnering with technology vendors, and upskilling existing staff.
Executives were more likely to be optimistic about their interoperability advances than middle managers and staff. They do all agree that their organizations are better at sharing data internally than with outside payers, patients, pharmacies, and other health systems or partners.

Move to a single, integrated EHR?

The challenge of interoperability for large health systems, many of which have expanded by affiliations with various other hospitals, can be especially difficult due to different EHR systems not only across facilities, but even for inpatient, outpatient, and specialty service lines within facilities.

Migrating to a single-EHR platform would come at great cost for large health systems. UPMC leaders agree it would be a huge financial hurdle to move to a single EHR system. Instead, UPMC is finding innovative ways to work within a multi-EHR system.

But while UPMC Enterprises is helping to build solutions utilizing FHIR standards and APIs that allow disparate software systems to more easily exchange data, only 37% of survey respondents said they were eyeing standards like FHIR to advance interoperability. That’s no surprise to UPMC IT leaders.

Health care needs better solutions than what currently exists to unify all health system data and make it easily shared and analyzed. Similarly, the survey found that access to better technology solutions was one of the three key needs for addressing interoperability. The other two were a commitment from senior leadership to make solving interoperability challenges a strategic priority and financial incentives or penalties.

These findings fit with UPMC’s work to advance interoperability. The health system has a commitment from leadership and is building technology solutions to improve data sharing in health care.

“Solving these challenges is a strategic priority for UPMC,” said Tal Heppenstall, Executive Vice President and Treasurer of UPMC and President of UPMC Enterprises. “Our goal is to create some of the tools that will help us and others overcome the interoperability hurdles and securely surface the right data for the right purpose at the right time, every time.”