HomeLong Term CareAchieving the Ideal State for Interoperability in Canada

Achieving the Ideal State for Interoperability in Canada

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by Michael Green

 Canadian digital health leaders are joining clinicians and patients who say it’s vitally important to improve health system interoperability — the ability of health data to flow seamlessly across the care continuum and across different IT systems with different infrastructures. This will result in greater efficiencies for the system and for clinicians, and most importantly, better health care and better outcomes for patients.

In a recent article, I wrote about a new Canada Health Infoway (Infoway) survey of more than 800 Canadian clinicians that found they are overwhelmingly in favour of greater interoperability: 92 per cent said having more complete, timely and accurate information at their disposal would enable safer patient care; 88 per cent said it would improve their ability to collaborate and coordinate care with providers outside their practice; and 85 per cent said it would increase their productivity.

Patients might not be familiar with the term “interoperability” but they understand the benefits of being able to access their personal health information (PHI) online in a timely manner and being able to share it with their circle of care. Our survey of Canadians found that, of those who are able to access their PHI online: 88 per cent said they are more informed about their health; and 82 per cent said they are better able to manage their health.

We wanted to see if digital health leaders shared the sentiments of clinicians and patients, so we recently conducted in-depth interviews with 77 key digital health leaders from across the country. This group included clinicians who have been leading the way in the use of technology, primarily electronic medical records (EMRs), and connecting with systems outside their practices. It also included non-clinicians who are: CEOs of Health, Chief Information Officers, Directors of Information Management and Digital Health Standards, program and regional managers, solution architects and digital health advisors. These leaders were in the public sector (governments, health organizations) and private sector (vendors).

They overwhelmingly told us interoperability is a high priority. They shared clinicians’ and patients’ understanding of interoperability and the many benefits that can result — more efficient and effective care, enhanced access to care, and greater collaboration among health care professionals. And they agreed that the current state of interoperability is far from ideal.

The clinicians we talked to had three main issues: incompatibility of their practice system with external systems; technical issues and malfunctions; and inability to connect seamlessly from their EMR to specialists and hospitals.

Administrators shared the clinicians’ views about lack of compatibility between systems, especially between hospitals, private practices and pharmacies whose systems don’t speak the same language. They also expressed frustration with lack of consistency across regions, provinces and organizations, and they said this lack of standardization makes any rollout of systems difficult.

Government representatives were similarly frustrated by this lack of standardization. While they expressed a desire for greater interoperability, they said they have to balance these larger system changes with more immediate priorities, such as the COVID-19 pandemic and emergency room capacity.

Vendor representatives said a disjointed health system makes it more difficult for them to deliver systems, and that we need a “whole-system” approach to truly experience the positive impact of technology.

All of these digital health leaders were confident that we will be able to advance interoperability by working together, but they said it will take time and funding because the challenges are significant and complex.

They agreed that implementing standards-based solutions that allow systems across clinical settings to communicate is a central challenge. They also identified challenges with data privacy, funding and differing strategies among the provinces and territories. And they said it’s essential to focus on workflows and intuitive design, and to provide change management support and incentives for clinicians.

Most agreed that it is up to governments — federal and provincial/territorial — to provide the leadership to overcome these challenges and drive interoperability forward. They said governments have the ability to set policy and make investments, two key drivers that are beyond the capabilities of other stakeholders. They also said Infoway is a trusted partner and thought leader who can play a key role.

While many of the digital health leaders said the ideal state for interoperability could be achieved within five years, nearly all agreed that it will take up to 10 years.

These valuable insights from Canada’s digital health leaders reinforce what we have heard from clinicians and patients, clearly showing that we are all on the same page about the benefits of interoperability and the challenges in achieving its ideal state. Now we need to move forward together to overcome these challenges so patients, clinicians and our health system can realize the benefits.

 Michael Green is President and CEO, Canada Health Infoway


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