Improving Healthcare

New Year, Same Challenge: Navigating Healthcare Interoperability in 2024

New Year, Same Challenge: Navigating Healthcare Interoperability

Posted by Anthony Gomes on January 04, 2024

It’s the time of year when a lot of us make resolutions. Maybe you want to lose weight, read more, or travel to new places. For us, the new year is a great time to double down on our commitment to improving healthcare by implementing interoperability.

Interoperability is the ability of different information technology systems and software applications to communicate, exchange, and interpret data seamlessly. Despite the widespread adoption of electronic health records (EHRs) and tireless efforts to standardize data exchange, interoperability is still limited across the healthcare ecosystem. But it’s a fight worth fighting. In fact, there’s real overlap between interoperability and the most popular resolutions many Americans make.

Lose weight

If you’re looking to shed a few pounds, you’re looking to trim some fat and run a little leaner. Honestly, it’s a good metaphor for health systems across the country where economic headwinds are forcing leaders to find new ways to drive results with less. Interoperability can help your organization run leaner! CMS is mandating Prior Authorization Burden Reduction by 2026, but implementing this year could save your organization millions of dollars. In fact, we’ve talked to organizations who estimate that 30% of their call volume is related to prior authorization. Reducing (or maybe eliminating?!) that number is a huge opportunity for those trying to run lean.

Learn a language

To most people, learning a new language involves Spanish or maybe French. To us, it’s about FHIR, USCDI and other standards—more importantly, it’s about how we use them to transfer EHR and healthcare data between stakeholders. Learning any language requires a set of common vocabulary and standards that all users learn and use to communicate. That’s where interoperability comes in.

While the Fast Healthcare Interoperability Resources (FHIR) standard has emerged as a beacon of hope, the challenge lies in its widespread implementation and acceptance. Industry stakeholders must collaborate to ensure a consistent and widespread adoption of FHIR to create a unified language for health data exchange. Opala is committed to these data standards and offers an accelerated path for health plans and providers to adopt these ways of communicating with each other.

Improve grades and study habits

There are more than a few students out there pledging to double down on their schoolwork to improve their grades. In healthcare, it’s less about our marks in math, science, and reading, and it’s more about our HEDIS scores and MA star ratings. These scores promote accountability, transparency, and ongoing improvement in healthcare services, and drive reimbursement for many lines of business.

Interoperability plays a pivotal role in improving HEDIS scores and MA Star ratings by facilitating seamless information exchange between health plans and providers. Improved interoperability ensures that relevant patient data, such as preventive care and chronic disease management, is accurately and efficiently shared among different providers and health plans. This enables a more comprehensive assessment of care quality, positively impacting HEDIS scores.

Additionally, enhanced interoperability contributes to care coordination and timely access to patient information, key factors considered in MA Star ratings. When healthcare entities can effectively communicate and share data, it results in a more connected and integrated healthcare ecosystem, ultimately positively influencing both HEDIS scores and MA Star ratings.

As we face the familiar challenge of interoperability in the healthcare industry in 2024, let us embrace the new year with a collective resolve to overcome these obstacles. By fostering collaboration, advocating for standardized practices, and embracing technologies that promote seamless data exchange, we can pave the way for a future where interoperability is not just a goal but a reality that transforms patient care and healthcare outcomes.






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