Interoperability

The national rollout from The Strategic Health Information Exchange Collaborative enables hospitals and patients to more easily share health data.

VA Secretary Shulkin said that a recent meeting between the VA and Cerner was far from good, but the VA’s team is consulting with other IT leaders to ensure the best outcome for veterans.

Several years ago, leaders at a large healthcare system put together a strategic plan that included among its goals to make clinical workflows more mobile and create “smarter” rooms using wireless medical devices. New technologies were purchased based on feedback from stakeholders, and everyone was properly trained on the new tools. Then it was time to go live in three hospitals. “The ultimate hiccup was with reliability of the wireless network,” recalled Kelly Aldrich, who had a key role in that major rollout and is now the chief clinical transformation officer for the non-profit Center for Medical Interoperability. “You can make multi-million-dollar investments, but if you don’t have the reliability of your infrastructure, you’re going to have very frustrated clinicians who do not adopt the technology and will not advance how it could actually work for them.” Healthcare organizations in recent years have been caught off guard by a mushrooming number of mobile devices that continually outpace existing networks’ capacities. Some groups have modernized their wireless infrastructure to securely accommodate the swell of mobile usage. Others haven’t kept pace or aren’t sure where to start. One thing all organizations do know: Failure to build and maintain a secure, reliable and scalable wireless infrastructure threatens to put their clinicians at a disadvantage, and could even compromise patient care if today’s mobile clinical communications tools can’t work as intended because of technical and telephony issues beyond users’ control. “The innovations in technology that are enabling greater use of portable devices, and the clinical communications apps on them, means you must have the infrastructure in place, and often it isn’t there yet,” said Joyce Sensmeier, RN, vice president of informatics for HIMSS. “It has to be a really secure, medical-grade wireless to support this level of access to the information.” A matter of trust Aldrich believes that wireless networks deserve the same attention as other ubiquitous utilities, such as those providing power, climate control and traditional telephony throughout a facility. After all, physicians and nurses shouldn’t miss critical alerts or alarms sent to their mobile phone because they are in a wireless “dead zone.” It’s one reason many doctors still rely on pagers that work regardless of their location. “This is a huge problem around people adopting future wireless technologies,” Aldrich said. Adding more access points is only a temporary fix but may also cause other unintended consequences. Instead, Aldrich advocates that healthcare organizations consider developing a future-ready Trusted Wireless Health plan for both wired and wireless systems that leads to reliable, secure wireless service from any location within a medical facility. Under such a plan, devices are selected based on select data, power and roaming criteria, and they operate within a virtual local area network for greater privacy and security protections. Buildings are architected to place more access points where wireless traffic is denser, while leaving no space uncovered. Patient and guest Wi-Fi-enabled portable devices automatically are routed to another access area to provide network teams greater mobile device management, particularly to prevent BYOD bandwidth and security issues. Interoperability important Alongside a proliferation of Wi-Fi-enabled medical devices and smartphones have come a growing constellation of mobile communications applications. Inconsistent access and voice quality due to unreliable wireless networks frustrate clinicians and fragment their workflows. This is exacerbated when they must use multiple form factors to access a multitude of mobile apps or can’t talk because of poor voice quality. The situation is causing more organizations to consider consolidating devices and apps into a unified solution that integrates more functionality, like telemetry and electronic medical records access. “You need interoperability among these systems for better decision support all along the path of caregiving – from gathering a patient’s history and then moving into medication documentation to the next day’s discharge planning,” Sensmeier said. “That needs to be all cohesively connected so you have all the information you need at your fingertips.” Sensmeier recommends all healthcare organizations, regardless of the maturity of their mobile strategy, to assess what is actually happening within their facilities based on network trends and feedback from those in the field. This is an interdepartmental issue, so it’s important to partner tightly with networking, telephone, clinical informatics and any other stakeholders to avoid any degradations in service. Working together these teams can build a future-proof, trusted wireless infrastructure to keep mobile clinical communications devices – and the users behind them -- working as intended. “This not only makes you more successful in your implementation and adoption and utilization rates,” Aldrich said, “it also makes the products you invest in become useful, instead of useless, tools.”

Akiri is developing a networking platform it says will help healthcare organizations more easily share data using blockchain.

In preparation for the new year and HIMSS18, we're hosting the #EmpowerHIT Twitter Chat to take a closer look at interoperability and identify priority areas and strategies to move forward.

During the past year, private sector innovations, rather than government policy, dominated the interoperability discussion.

As the VA embarks on its EHR replacement, IHS puts out a request for information as it explores updating its RPMS system.

We look back at 2017 and the stories that struck a chord with readers – the new tech, policy changes and the sagas. Take a moment to reflect on a busy year. 

The biggest electronic health record company made plenty of big news this past year, beginning with the scoop that it would develop new technology aimed at smaller hospitals.

DeSalvo, who also served as Assistant Secretary for Health at HHS, will be a professor in Dell Med's Department of Internal Medicine, with a secondary appointment in the Department of Population Health.