Challenges and Risks with Data Interoperability in Healthcare

Healthcare interoperability – the ability of different information systems, devices, and applications to access, exchange, and cooperatively use data in a coordinated manner – is essential for overcoming fragmented care. 

However, the challenges of data interoperability in healthcare include technical barriers, financial constraints, privacy concerns, and cultural resistance that can impede on clinical teams’ ability to achieve true interoperable success. 

In this article, we’ll discuss the key challenges of healthcare interoperability and how organizations can successfully navigate this complex landscape.

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Why Data Interoperability in Healthcare Matters

Interoperability plays a pivotal role in patient safety, operational efficiency, and regulatory compliance. When healthcare systems communicate seamlessly, the benefits extend across the entire care ecosystem – from improved patient care outcomes to increased organization-wide performance metrics. 

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Improved care coordination

Seamless data exchange enables true continuity of care across departments, specialties, and organizations. When a patient's primary care physician, specialists, pharmacists, and emergency providers all have access to a unified, up-to-date health record, care decisions become more informed and collaborative. 

Patient handoffs – a historically vulnerable point in the patient journey – become smoother when receiving providers have immediate access to relevant clinical context, treatment plans, and medication histories.

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Increased operational efficiency

When providers have the right information at the right time, embedded directly within their clinical workflows, efficiency improves throughout the organization. Clinicians spend less time searching for information, making phone calls to track down results, or waiting for faxed documents. 

Additionally, administrative staff reduce time spent on manual data entry and reconciliation. Time savings from real-time communication can translate directly into increased patient throughput, reduced operational costs, and less clinician burnout.

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Reduced medical errors

A well-functioning interoperable system serves as a safety net against common sources of preventable harm and medical errors. Examples include: 

• Duplicate testing: This can be prevented when providers can see recent results from other facilities. 
• Drug interactions and allergies: With an interoperable system, these become visible at the point of prescribing, regardless of where previous medications were ordered. 
• Critical notifications: Updates such as abnormal lab values, radiology findings requiring follow-up, or changes in patient status can reach the right clinicians reliably.
• Miscommunication: Communication during handoffs becomes more accurate and complete when structured data supplements verbal reports.

These benefits represent fundamental transformations in how healthcare is delivered and emphasize the importance of investing in interoperability. 

However, it’s important to also understand healthcare data interoperability challenges you may run into along the way. The path to true interoperability is marked with technical, organizational, financial, and cultural barriers that must be addressed for success. 

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Key Challenges of Interoperability in Healthcare

While many healthcare providers understand the importance of interoperability and the need to achieve every level, there are significant barriers that can potentially hinder decision-making around setting up an interoperable system. 

The major challenges of achieving interoperability in healthcare include:

1. Technical Barriers and System Fragmentation
2. Data Quality and Semantic Gaps 
3. Privacy, Security, and Compliance Risks
4. Governance and Policy Barriers 
5. Financial and Resource Constraints 
6. Cultural and Adoption Challenges 

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1. Technical barriers and system fragmentation

The biggest challenge of establishing seamless interoperability is connecting fragmented systems, especially when legacy tools often present a barrier. For example, EHR systems built on outdated architectures often lack the APIs and standardized protocols necessary for seamless data exchange. Additionally, many healthcare organizations operate multiple systems and devices simultaneously – separate platforms for lab results, radiology images, and clinical documentation – each speaking its own digital language.

Even when organizations adopt modern systems, they often choose different vendors with proprietary data formats and interfaces. This can create additional barriers where data becomes trapped in siloed systems. While there are interoperability standards such as HL7 FHIR (Fast Healthcare Interoperability Resources), organizations rely on other organizations to implement these standards consistently, otherwise, the variations undermine true interoperability. 

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2. Data quality and semantic gaps

Semantic interoperability, one of the four levels of interoperability, relies on data quality and standardization in order for the data to be accurate, complete, and interpretable. However, data quality issues are pervasive. Duplicate patient records, inconsistent formatting, missing units of measurement, and data entry errors all compromise the reliability of shared information. When data moves between systems, these quality problems multiply and can lead to dangerous clinical miscommunication.

Beyond data quality, there’s also the challenge of semantics – ensuring that data has the same meaning across different contexts or systems. Medication names, dosages, and administration routes may be recorded using different terminologies or coding systems (ICD-10, SNOMED CT, LOINC, RxNorm). For example, one system may use “BP” while another says “blood pressure.” In another instance, “penicillin allergy” may not be recognized across systems, which can lead to patient safety risk.

Additionally, the context surrounding clinical data – why a test was ordered, what the patient's symptoms were, what the clinician was thinking – is often stripped away during data exchange, leaving receiving providers with decontextualized facts that may be difficult to interpret appropriately.

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3. Privacy, security, and compliance risks

Patient information is the most sensitive data healthcare organizations manage, and keeping that data secure and private is a key challenge organizations face when thinking about interoperability. 

Each connection point between systems represents a potential vulnerability for data breaches or unauthorized access. As data moves across organizational boundaries, maintaining proper access controls, encryption, and audit trails becomes exponentially more complex and critical. Data breaches, for instance, pose legal, reputational, and financial risks. A report from IBM found that the average cost of a healthcare data breach is $7.42 million, the costliest of all industries analyzed. 

Healthcare privacy regulation compliance adds another layer of complexity. HIPAA requirements in the US, PHIPA in Canada, GDPR in Europe – along with various other regional regulations – impose strict rules about how patient data can be shared, stored, and accessed. 

Organizations must ensure that every system connection maintains compliance by obtaining proper patient consent, implementing business associate agreements, and maintaining detailed documentation and access control. The fear of compliance violations and the potentially costly financial penalties and reputational damage they bring can make many organizations extremely cautious about sharing data, which ultimately becomes an obstacle for improving interoperability. 

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4. Governance and policy barriers

Studies have found that one of the biggest challenges to achieving organizational interoperability is the absence of clear governance structures within health information exchange (HIE) networks. 

Without a strong framework to follow, there’s ambiguity about who is responsible for what in interoperability initiatives. Questions about data ownership, liability for data quality issues, responsibility for maintaining infrastructure, and authority to make decisions about standards and protocols remain unclear. When multiple organizations participate in data sharing, establishing governance becomes a negotiation of competing interests and organizational cultures.

Policy barriers can also impede progress. Despite federal initiatives like the 21st Century Cures Act, which establishes information blocking provisions, many regulations inadvertently hinder data sharing. State laws vary significantly in their approaches to HIE, creating a complex patchwork that is especially challenging for organizations operating across state lines. Antitrust concerns can make competing healthcare organizations hesitant to collaborate on interoperability initiatives, even when it would benefit clinical teams and patients alike. 

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5. Financial and resource constraints

Achieving interoperability requires substantial financial investment that many healthcare organizations, particularly smaller facilities, simply can’t afford. In addition to the cost of purchasing interoperable systems, additional expenses include implementation, customization, staff training, ongoing maintenance, and continuous upgrades as standards evolve. Integration projects often exceed initial budget estimates as technical challenges emerge.

Resource constraints extend beyond finances. Healthcare IT departments are frequently understaffed and overwhelmed with competing priorities. A 2023 report from Extreme Networks and HIMSS found that 47% of healthcare organizations ranked IT staffing shortages in their top three challenges. 

Interoperability projects require specialized expertise in integration engines, data standards, and healthcare workflows – skills that are in short supply. Clinical staff must also invest time in learning new systems and workflows, taking them away from patient care during already demanding workdays.

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6. Cultural and adoption challenges

Clinician resistance to new technologies and workflows is an underestimated yet significant challenge to achieving interoperability. Many physicians and nurses may be skeptical of interoperability initiatives, viewing them as administrative burdens that generate communication fatigue, require additional documentation, and take time away from patients without providing clear clinical value. 

Workflow integration failures can exacerbate this issue. Data might flow seamlessly between systems, but if clinicians don't know the information is available, can't easily find it within their workflow, or don't trust its accuracy, it won't be used. Staff may even bypass new tools with manual – potentially non-compliant – workarounds to get the information they need. 

Effective interoperability requires not just technical integration but careful redesign of clinical workflows and extensive change management to help staff understand the value and adopt the platform along with new practices. 

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Real-World Risks of Poor Interoperability

The impact of poor interoperability goes far beyond technical issues. When not implemented or used properly, interoperable systems pose risks to patient care, operational efficiency, and compliance. 

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Patient safety risks 

When information exchange, access, or interpretation breaks down between systems, the risk of miscommunication and information gaps rises dramatically. This can put patient safety at risk by increasing the chance of medical errors. 

Delayed or limited access to the right information can have critical outcomes on patient care and safety. This is emphasized by the fact that poor communication is a contributing factor in over 60% of all hospital adverse events.  

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Workflow inefficiencies 

Poor interoperability can have a trickle-down effect throughout healthcare organizations. When data isn’t seamlessly exchanged, clinicians lose critical time manually hunting for information. This can involve toggling between fragmented platforms, playing phone tag with other departments to locate results, or duplicating data entry. These actions can add up and have a direct impact on workflow efficiency. Research shows that poor interoperability was reported to necessitate repeat diagnostics, lengthen hospital stays, and prolong clinic consultations. 

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Compliance risks 

Poor interoperability creates significant compliance risk exposure. The 21st Century Cures Act and ONC's interoperability regulations explicitly require healthcare organizations to implement systems capable of seamless data exchange while prohibiting information blocking. Organizations running fragmented, non-interoperable systems risk substantial penalties and legal liability for non-compliance.

Demonstrating healthcare compliance is also impacted by interoperability failures. When data is poorly tracked, stored, or shared, maintaining proper audit trails and meeting documentation requirements becomes increasingly difficult. While using a fully compliant platform can help address this, it remains critical for organizations to understand compliance regulations and requirements to ensure they aren’t at risk for breaches or penalties. 

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How to Improve Interoperability in Healthcare

Achieving true interoperability is an ongoing process that involves multiple technologies, frameworks, and policies. The best way to improve interoperability in healthcare is by following these steps: 

1. Adopt interoperability standards: Aligning with interoperability frameworks like HL7 and FHIR (Fast Healthcare Interoperability Resources) ensure your clinical systems can all seamlessly exchange information using standardized formats. 
2. Use a clinical communications platform: Unified clinical communication platforms streamline multiple communication channels into one place so clinicians can access the right information at the right time – which is critical for decision-making and care coordination. 
3. Consider vendors’ open API framework: Vendors that use open APIs can more easily integrate within your organization’s clinical workflows. 
4. Establish interoperability policies: Organizations must create governance around data ownership, access controls, and quality standards to ensure successful interoperability. 
5. Invest in training: Change management is a critical component of implementing an interoperable system and new policies. Open the lines of communication, provide ongoing training, and refine processes as workflows evolve. 
6. Improve with analytics: Using a platform with built-in analytics can help organizations  identify bottlenecks and understand the effectiveness of interoperability efforts.
   
   

Key Takeaways and Next Steps

The major challenges that healthcare organizations face on the path to interoperability are around technical barriers – such as legacy technologies and data quality – policies, and organizational frameworks. 

While these barriers may feel daunting, understanding what’s at risk if your systems aren’t interoperable is critical. Patient safety is a top priority for clinical teams, and interoperable systems help ensure clinical teams can deliver the best care. Interoperability can also help organizations remain compliant and avoid costly penalties or security risks. 

It’s critical to assess your current interoperability gaps to understand how your systems may need to improve or how a unified clinical communication platform can help address those concerns. To explore Hypercare’s interoperable communication solutions, book a demo below.